Future Care Enable Ltd

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.

This is the first assessment for this newly registered service.

This key question has been rated 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 safe care and treatment.

This service scored 59 (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 were aware of the importance of listening to concerns about safety and investigating and reporting safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place for recording, analysing and responding to incidents such as safeguarding issues, complaints and accidents. There had been no incidents of concern within the service. Staff and people told us they were confident the provider would respond appropriately to incidents and accidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider gathered information about people before the service started providing personal care to them. This ensured staff could provide the support required. We reviewed pre assessment documentation that had been completed with people before the service began providing their support and saw it contained all necessary information about people’s needs and preferences.

Care and support was planned and organised with people, relatives and relevant healthcare professionals in ways that ensured continuity and managed to keep people safe during their care journey.

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.

There were systems to protect people from the risk of abuse. There were safeguarding and whistleblowing policies in place to report potential abuse. Staff had completed safeguarding training and were aware of the different types of abuse and reporting procedures to follow if they had any concerns.

The provider did not work well with people to understand and manage risks.

Staff did not have clear guidance on how to support people safely. Care plans and risk assessments were inaccurate and inconsistent. Key areas of risk had not been addressed in relation to people’s moving and handling, skin integrity and health conditions.

One person required staff to support them to transfer using a mobile hoist. The manual handling care plan and risk assessment contained incorrect information about the type of hoist in place, it did not describe the specific risks related to supporting the person to move or explain in sufficient detail how staff should support the person safely.

One person required staff to support with the application of prescribed creams to maintain their skin integrity. The person’s skin care risk assessment did not refer to the application of cream and incorrectly stated there were no risks in relation to the person’s skin integrity. A separate skin management risk assessment referred to pictorial documents for leg supports, there was no mention of these in the main care plan and risk assessment.

Another person had previously had a pressure ulcer, their care plans and risk assessments contained inconsistent information regarding the current condition of their skin and whether the pressure ulcer had healed. Pressure relieving equipment was in place to support this person’s skin integrity, this was not mentioned anywhere in the care plans or risk assessments.

One person had an indwelling urinary catheter and required staff to provide support with this. The care plan was inconsistent and, in some areas, stated the person managed their catheter care independently.

Where people used paraffin based creams, risk assessments were not always in place to provide guidance to staff in the mitigation of fire risks.

The failure to assess and support people to manage known risks in their lives placed people at risk of not receiving safe care. People told us they were supported to understand and manage risk by staff who knew them well, but as the information provided to staff was inaccurate and inconsistent we could not be assured of the ongoing safety of the care provided.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Processes were in place to ensure risks within the environment were assessed and monitored.

Assessments of people’s home environment were carried out covering areas such as clutter, home security and fire safety to ensure people were supported in a safe environment. During the inspection we identified one person did not have an environmental risk assessment in place, the provider implemented this immediately.

Staff were not always recruited safely. We reviewed staff recruitment records and found gaps and inconsistencies in information that was required to ensure safe recruitment. For example, files reviewed did not contain required evidence to demonstrate staff were eligible to work in the United Kingdom. Where agency staff were used the provider had not ensured all appropriate checks had been carried out, for example detailed information about Disclosure and Barring Service Checks. (The Disclosure and Barring Service helps employers make safer recruitment decisions by processing criminal record checks and preventing unsuitable people from working with vulnerable people). These concerns were discussed with the provider and appropriate action taken to ensure the appropriate checks and records were in place.

Staff had received all the training required to ensure they were able to effectively meet the needs of the people they supported. For example, training records demonstrated staff had received training in safeguarding, moving and handling and communication. People told us they thought staff were well trained to meet their needs, one person’s relative said, “I think they are trained well, they are good, confident.”

People’s staffing needs were individually assessed and allocated and people received care from consistent staff. People told us there were enough staff to meet people’s needs, staff arrived when expected and stayed for the allocated time. One person said, “They always come around the time we expect them, if they’re running late, they usually let us know.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us staff used appropriate personal protective equipment and supported them in a clean and hygienic way. One person’s relative said, “After providing care, the staff will clean the bathroom and tidy up the room where [family member] is.”

Staff had received infection control training. Monthly infection control audits had been undertaken to ensure safe infection control practices were implemented and staff had access to personal protective equipment [PPE] when needed.

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 the time of the inspection no one in receipt of the regulated activity of personal care received support with oral medicines, however staff did provide support with prescribed topical creams.

People’s care plans and risk assessments contained unclear information about the support people required with medicines. For example, two people’s care plans directed staff to ensure they took their prescribed oral medicines for specific health conditions, the provider confirmed staff did not administer these medicines to people. There was a risk that staff would provide people with unsafe support.

Where staff supported people with the application of topical creams on a when required basis records were inconsistent and incomplete and did not contain the information needed to administer the cream safely. For example, there was no information to guide staff on signs and symptoms that indicated the cream was required. There was a risk staff would not support the person to apply the cream when needed.