Zara Healthcare

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 was our first assessment of Zara Healthcare Ltd, and we rated this key question good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (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. The registered manager listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The service had a proactive safety culture and reflected on their practices, learning from mistakes and responding appropriately to incidents. All staff we spoke with knew what actions they would take in an emergency or if there was a noted change in a person’s needs. Daily safety huddles helped ensure effective communication across the service.

The manager had support from a quality advisor who sampled audits on safety already carriedout to help ensure consistency and identify good practice or practices that needed improving.

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.

People using the service received holistic care following a detailed assessment of their needs. Staff identified changes in their needs and took the necessary action to address this including updating care plans and ensuring they received the support they required. For example, a staff member told us, “If I felt that a person was not receiving enough support to meet their needs, I would raise my concerns with management, document them carefully, and follow safeguarding procedures. This ensures the person’s safety, dignity, and wellbeing are prioritised while respecting their rights.”

We found care plans informative giving very detailed instruction about what support the person needed from staff and any risks or equipment necessary. We asked health care professionals about joint working. One health care professional told us,” This was one of few care teams who were always happy to take on the most complex of patients on discharge. They appear to have gone above and beyond with obtaining additional training to manage a wide variety of needs.” They went on to say on discharge the agency ensured they attended any discharge meetings and were involved in planning the person’s care. The professional told us the agency, ‘went above and beyond.’

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. The provider had a clear safeguarding policy and staff received regular updates to ensure they understood their responsibilities to safeguard people in their care and were familiar with whistle blowing policies. A staff member told us, “Yes, as a carer, keeping vulnerable people safe is always my top priority. I would feel confident raising a concern if I noticed any form of abuse, because safeguarding is everyone’s responsibility.”

We asked people if they felt safe whilst receiving a service from Zara Healthcare Ltd. One person said, “I feel safe with all of them: they’re cheerful and willing. I’d know how to get in touch with the manager, but I’m happy.” Two people had experienced minor concerns which staff had reported, and both said the matter had been dealt with to their satisfaction. We reviewed a safeguarding incident which had been raised about an alleged theft. The service worked in cooperation with the local authority who requested the agency carry out a full investigation which they did, and appropriate actions were taken and records were made. This demonstrated that the service dealt with concerns in an open, transparent way so they could be appropriately addressed.

The provider worked with people to understand and manage risks by thinking holistically.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were completed and reviewed and formed an integral part of people’s care. Risks were identified as part of the person’s ongoing assessment and there was clear guidance for any equipment used. Staff had guidance around the use of emollient creams, and how to safely administer medicines. Staff told us there was an effective on call system which was always answered and staff felt supported. We asked care staff about managing risks. One staff member told us, “We check our clients skin integrity every day, taking note of any changes, redness and swelling. I keep encouraging people to drink more fluids to stay hydrated. I make sure people are drinking much on each call and leave a drink before leaving. I contact the GP the moment I notice any swelling or redness around the skin and any signs of dehydration.” We asked people and relatives about safety and any identified risks. One relative told us,” They [staff] were very helpful and knowledgeable about what equipment would help. They told me and when the occupational therapist came, they suggested the There's also pressure relieving equipment, a cushion and mattress. [person] has no sores, as they take good care of them and do their skin care very well. They apply cream and will tell me if anything changes, straightaway.

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

Daily notes and care plans illustrated that staff helped people to access the services they needed and ensured any equipment was in good working order. One family member raised a concern around manual handling. The manager immediately addressed these concerns, providing retraining for staff and ensuring the occupational therapist was involved to address any unmet needs. Staff gave us a very good overview of their training including manual handling which was very detailed and a staff member was being trained so they could deliver training in house. People told us staff respected their homes, left things clean and tidy, correctly disposed of any rubbish and left them safe. One person said, “They do leave things safe from any hazards.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The registered manager told us staff recruitment had an impact on the business in terms of growth affected by restrictions from the home office which they had appealed against. This was frustrating as Zara Healthcare Ltd was providing a well-planned, well managed service which was highly regarded by staff, professionals and people using the service.

Staffing numbers did have an impact on the business in terms of the manager and other management staff covering care calls and staff picking up extra hours within the conditions of their sponsorship. However, it was not impacting on the support people received which was both reliable and consistent. Calls were monitored to ensure they were effectively delivered and staff feedback about how long calls were taking in line with people’s needs were listened too and responded to. Should a person need’s change or there was an emergency staff would stay with the person until they could safely hand over the care to a paramedic or family member.

There were robust recruitment processes in place and staff were well supported. Necessary employment checks were carried out before a staff member commenced employment and staff were supported with induction and training.

There was a business continuity plan, and people’s needs were risk assessed to help with continuity planning and understand where care was absolutely essential.Should the service experience high levels of staff absence arrangements could be made to cover essential calls whilst other calls may be able to be covered by a family member or not be essential. The service only had one missed call, and this was due to a misunderstanding, (staff error) with no impact to the individual. The service took lessons from this to strengthen their processes. People were happy with the care provided. One person told us “I have visits three times a day, which suits me. They’re more or less on time and will let me know if they’re held up by traffic. They all seem to know what they’re doing, they’re confident and capable.”

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.

Staff received training to understand the risks of cross infection and the importance of hand washing and using personal protective equipment which the team leader said was delivered to staff. There were clear infection control procedures.People told us staff adhered to good infection control procedures. One told us: “They wear gloves and aprons, and they do wash their hands – oh yes, definitely!” A staff member told us,” I follow strict infection control procedures, including effective hand hygiene, correct use of PPE, and safe disposal of waste. Clinical waste is disposed of in accordance with current guidance and household waste is managed appropriately to minimise the risk of cross-contamination.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Most people spoken with did not need support with medicines, but we saw that there were clear procedures to support, train, and assess staff to feel competent when giving medicines. People’s medicines and support needed was clearly documented and reviewed to ensure medicine records were up to date and in stock. Medication audits were viewed and showed no errors. An example was provided when medicine stocks had run low and staff were reminded to ensure medicines were available. One person said “My medicines are in compartments, and the carers make sure that I have them. I can do them myself. They just supervise me and give me a drink. There haven’t been any problems. I have creams applied, which they always do carefully and gently.”

A staff member told us, “I do not administer medication now, but I supervise the service user’s care while they take their medication. I ensure that it’s the right person, right medication, right time, right dose and right way of administration. I have completed medication administration training, but I understand my limits as the service user is independent and has a right to refuse. If they refuse to take medication, I would document and report the refusal accordingly.”