Share the Care Limited Office

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

At our last inspection we found there were not systems in place to ensure that lessons were learnt. At this inspection we found these systems were now in place. The provider demonstrated a willingness to learn and improve. Staff described regular training and meetings where issues were discussed. Staff we spoke with knew how to report incidents, and could tell us where learning had been applied to mitigate risks to people.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety.

At our last inspection we found there were not systems in place to manage or monitor people’s safety. At this inspection we found these were in place, however, on one occasion a package of care was re-started prior to a re-assessment of needs being carried out. All other packages of care had been re-assessed since our last inspection, and there were now processes in place to ensure that referrals were made in a timely way.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

At our last inspection we found that’s systems to protect people from the risk of abuse were not always in place or effective. At this inspection we found there was now a system for documenting safeguarding concerns, which was being used by staff. Staff had all received training on safeguarding since our last inspection. Staff told us, “The safeguarding training was good, things change constantly so it’s good to have the reminder of what to look out for.” Staff understood safeguarding and how to report concerns. One staff member said, “If I saw an incident, I would go via my line manager… If I do not get a response, I can go above them and report to the council or CQC.”

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

At our last inspection we found that risks to people had not been assessed or mitigated. At this inspection we found that although new care plans were in place, and some guidance was in place to inform staff how to support people safely, this was not consistent. For example, choking and diabetes risk assessments did not include clear guidance for staff about who to share concerns with. Guidance for all aspects of people’s health and wellbeing were not in place to inform staff how to support people safely or in line with their wishes, for example for people living with MS. Multiple sclerosis (MS) is a condition that affects the brain and spinal cord. This placed people at risk of not receiving care and support safely. Staff we spoke with understood risks to people, including their health and care needs however there was a risk without robust guidance new staff would not be able to meet people’s needs safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

At our last inspection we found that risks to the environment were not detected. At this inspection we found improvements had been made. There were risk assessments in place to assess risks to staff and people within their homes. Relatives told us staff were alert to risks to the environment. A relative told us, “They make sure there are no trip hazards… they check for the walker and slippers.” Staff told us how they identified a risk with a chair within a person’s home, and reported it to the office who were able to support the person to order a new chair.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

At our last inspection we had concerns around staff not having travel time between care calls, and some staff leaving care calls 25 minutes early with some care calls being 5 or 6 minutes long. At this inspection we found this had improved. Travel time was now factored in, which staff told us was a big improvement, and staff did not leave care calls early.

Staff training and support had improved since our last inspection, with staff telling us that training was much improved. Specific training for health needs had been completed, for example stoma and diabetes care. People and their relatives told us they felt safe with staff supporting them. A relative said, “Yes, definitely, they’re confident, I’m never worried.”

At our last inspection, we identified that not all gaps in work history had been explored when new staff were recruited. At this inspection, we found the same concern, however, when we shared this with the provider, action was taken to review all staff files to ensure that every staff members work history had been reviewed.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

At our last inspection we found that the risk of infection was not well managed. At this inspection one relative told us that staff did not always wear PPE (personal protective equipment) when supporting their loved one, which was concerning due to the risk of infection. We raised this with the provider who told us they would discuss this with staff. However, staff we spoke with told us they wore PPE, and daily notes referenced staff donning their PPE.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

At our last inspection, we found there was a lack of management and oversight of medication. At this inspection, we found that staff had received training in medicines administration, however some areas of medicines management was still not safe. For example, there were no medicines administration records (MAR) or body maps in place for medicated creams. This placed people at risk of not having their medicine applied in line with the prescription. When we highlighted this to the provider, a MAR was put in place, and information shared with staff. However, medicines audits had not identified this shortfall.