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 health care, 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 manager listened to concerns about safety and investigated and reported safety events.

Lessons were learnt to continually identify and embed good practice. Staff told us how they were supported to develop their professional practice through mandatory training and advanced study. Policies were accessible and linked to regulation and good practice. These were regularly updated. Staff were aware of the role of CQC and other statutory agencies. 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 already carried out 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. 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 well-being 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 reviewed a safeguarding alert which had been raised about an alleged theft. The service had contacted the local authority and had fully investigated the concerns at the local authority’s request. They had taken appropriate actions to share the outcome with appropriate agencies.

We asked people if they felt safe whilst receiving a service from Zara health care. 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 issues which they’d reported, and both said the matter had been dealt with to their satisfaction.

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, reviewed, and formed an integral part of people’s care. Risks were identified as part of the persons ongoing assessment and there was clear guidance for staff. For example, the person had a behavioural support plan as they could become distressed. Their Positive Behaviour Support (PBS) Plan was clear, well-structured and written in plain English. It described the person’s needs and health conditions in a respectful and positive way, helping the reader understand the individual rather than focusing only on behaviours. This supported dignified care because staff were given a clear picture of the person and how to support them in a respectful and compassionate way. It also incorporated other aspects of care such as clear communication to reduce risks from behaviour occurring for both the person and staff delivering the care.

Staff were well trained and new staff were adequately supported to ensure they felt confident delivering care. Risks associated with the person receiving supported living had been identified as a result of an incident and robust actions had been taken to ensure their ongoing safety. Lessons had been learnt and embedded in the persons care delivery.

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 worked in harmony with them. Staff ensured equipment was in good working order.

Systems and processes were in place to support the person to maintain a safe and pleasant home where risks were identified and managed alongside the persons need.

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 provider/ manager told us staff recruitment had an impact on the business in terms of growth affected by restrictions from the home office. This was frustrating as Zara health care 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 was a business continuity plan, and people’s needs were rag rated. Should the service experience high levels of staff absences, 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) which had no impact to the individual. The service took lessons from this to strengthen their processes. The person receiving 1-1 care had continuity of staffing over a 24-hour period and staff had the necessary skills and training to meet the persons bespoke needs.

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. Feedback from people receiving home care and staff told us staff had a good understanding of infection control and spot checks helped ensure staff were adhering to infection control policies. 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.

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.

A staff member told us, “I do not administer medication at the moment, 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.”