Hope Care Agency

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

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 requires improvement. At this assessment the rating has changed to 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had implemented strengthened governance systems including care plan audits, medication audits, infection prevention and control audits, spot checks and welfare monitoring arrangements. These systems enabled risks to be identified, monitored and addressed more effectively than at the previous assessment.

The registered manager told us, “We have looked at improving how we work following the last inspection and we have changed a few of our teams and systems we use. Our quality assurance is now better, and we can audit and see what is happening."

Records showed that concerns identified during the assessment were taken seriously and acted upon promptly. Where inconsistencies were identified within documentation, leaders reviewed records and updated information during the assessment process.

The provider worked with people, relatives and partner agencies to establish and maintain safe systems of care.

People’s care needs assessments were completed before they started using the service. Care plans incorporated information from healthcare professionals, family members and people using the service where appropriate. Records showed people's needs, preferences and support requirements were understood before support arrangements were implemented.

Care plans reflected people's current needs and included information designed to support continuity of care. Documentation addressed communication requirements, medicines support, health conditions, mobility needs and risk management arrangements. This helped ensure staff had access to clear information regarding how people wished to be supported and what risks required monitoring.

Managers described maintaining communication with people, families and healthcare professionals where needs changed. Reviews, welfare monitoring and feedback from staff were used to identify changing risks and determine whether additional support or updated assessments were required. The provider worked with external professionals including General Practitioners (GPs), district nurses, social workers and specialist healthcare services to ensure support remained coordinated and responsive.

People benefitted from support arrangements which reflected effective information sharing and communication between the provider and relevant healthcare partners. The systems in place provided assurance that care remained coordinated and that important information was shared appropriately to support continuity of care.

The provider worked with people to understand what being safe meant to them and acted to protect them from abuse, neglect and avoidable harm.

People told us they felt safe receiving support from the service and relatives consistently reported confidence in the staff and management team. One relative told us, “Definitely safe in their hands.” Another person said, “I feel safe with them because they are around.” This feedback provided assurance that people felt protected from avoidable harm and trusted the staff supporting them

Staff had a good understanding of safeguarding responsibilities and could explain how concerns would be identified, reported and escalated. One member of staff told us, "I write it in the notes and call the office or manager straight away," whilst another explained, "For serious or urgent concerns, I report them straight away.

Safeguarding training formed part of mandatory training requirements and records evidenced staff had completed safeguarding training. Managers monitored training compliance and staff competency through workforce systems.

At the previous assessment, concerns had been identified regarding safeguarding oversight and notification processes. During this assessment, the provider had strengthened arrangements for reporting incidents, safeguarding concerns and notifiable events. Records showed governance systems now provided greater oversight of incidents requiring escalation. Leaders understood their responsibilities and were able to explain reporting processes and arrangements for sharing concerns with relevant agencies.

Policies reviewed during the assessment reflected safeguarding responsibilities, whistleblowing arrangements and reporting processes. Managers used governance systems to monitor safeguarding activity, oversight of incidents and learning from concerns. As a result, people benefitted from a service that had improved its approach to safeguarding and protection from harm.

The provider worked with people to understand and manage risks by taking a person-centred approach.

Risk assessments reflected individual circumstances, preferences and support requirements. Risks associated with falls, medicines, pressure care, mobility, moving and handling, diabetes management, PEG feeding, fire safety and infection prevention and control were assessed and documented.

At the previous assessment, we identified significant concerns regarding risk assessment processes. At that time, risk assessments relating to PEG feeding, diabetes and moving and handling did not provide sufficient guidance to support staff. During this assessment, we found detailed risk assessments and care planning documentation had been developed and reviewed. These provided staff with substantially improved information regarding identified risks and the interventions required to support people safely.

People were involved in discussions regarding their care and support needs. Care plans reviewed reflected people's wishes and preferences and incorporated a strengths-based approach which promoted independence whilst managing identified risks. Records also showed people were involved in decisions regarding their mobility support, medicines management and daily routines where appropriate.

While a small number of documentation inconsistencies remained, there was no evidence these issues had adversely affected people receiving care. The provider demonstrated a willingness to review and update records when concerns were identified and acted promptly during the assessment process.

The provider considered environmental risks and maintained systems to ensure people's home environments supported safe care delivery. Environmental assessments, fire safety arrangements and emergency planning information were available where required and reflected people's individual circumstances.

Care records contained guidance regarding mobility equipment, falls prevention, moving and handling equipment and emergency arrangements. Staff had access to information necessary to support people safely within their own homes.

The provider had developed fire risk assessments, Personal Emergency Evacuation Plans

(PEEPs) and emergency planning arrangements where required. Records also addressed risks associated with paraffin-based emollients and included appropriate fire safety guidance.

Managers monitored environmental risks through reviews, updates to care records and communication with people and their families. This helped ensure support arrangements remained appropriate when circumstances changed.

The provider made sure there were enough suitably skilled and experienced staff to meet people's needs.

People and relatives consistently described positive experiences regarding staffing continuity and reliability. Many people received support from regular carers who knew their preferences, routines and support needs well.

At the last assessment, significant concerns had been identified regarding specialist training and competency oversight. Staff supporting people with diabetes and PEG feeding needs had not always received appropriate specialist training. At this assessment, we found considerable improvement. Training records evidenced completion of mandatory training and specialist courses including PEG feeding, diabetes, dementia, autism and mental health awareness.

We reviewed a sample of staff files and found the provider had recruitment processes in place to help ensure suitable staff were employed. Records reviewed included evidence of employment checks, references, Disclosure and Barring Service (DBS) checks, proof of identity, right to work documentation, interview records and induction documentation. Staff files also contained records of training, supervision, competency assessments and appraisal arrangements. These records provided assurance that staff were appropriately recruited, trained and supported in their roles.

The registered manager explained, “We go through everything. Induction for 3 days and if needed another 3 days and shadow for 2 days. We then sign them off as competent." They also stated, “We cover shifts to enable staff to undertake training." Supervision, competency assessments and appraisals supported ongoing staff development and oversight.

People and relatives consistently described reliable staffing arrangements and told us staff understood their needs and preferences. The provider had systems in place to support continuity and safe deployment of staff.

People and relatives spoke positively about staffing consistency. One relative told us, “[Person] has 24-hour care. With complex needs so continuity of staff is essential. Some have been coming for years.”

The provider had systems in place to assess and manage infection prevention and control risks.

Staff received Infection Prevention and Control (IPC) training and managers carried out IPC audits and spot checks to monitor practice.

The service-maintained arrangements for providing Personal Protective Equipment (PPE) and supporting staff to follow infection prevention procedures.

The registered manager told us, “We do spot checks and we look out for cleanliness and if care workers are following IPC policies. We have gloves in the office, and the care coordinator will supply PPE." This demonstrated ongoing management oversight of infection prevention arrangements.

Care records addressed infection risks where relevant and provided guidance regarding personal care, continence support, blood borne viruses and use of PPE. Infection prevention and control audits reviewed demonstrated a structured approach to monitoring standards.

This provided assurance of ongoing management oversight of infection prevention arrangements.

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.

The provider had made significant improvements to medicines management since the previous assessment. During this assessment, we found medicines management systems had improved considerably.

Monthly medicines audits including PRN medicines and medicines risk assessments were now in place. Records demonstrated the provider monitored medicines arrangements more effectively and had implemented guidance to support safe medicines management. The provider reported there had been no medicines related errors for the past 12 months.

Care plans reviewed included information regarding medicines support needs, medication self-management arrangements and associated risks. PRN protocols were available and records reflected significantly improved medicines oversight compared to the previous assessment.

The registered manager explained, “We audit the Medication Administration Record (MAR) charts and offer training. We complete audits monthly." Governance records reviewed supported this statement and demonstrated ongoing monitoring of medicines systems.

People who managed their own medicines were supported through risk assessments and care plans which reflected their capacity, independence and preferences. The provider had taken significant steps to strengthen medicines governance and ensure support arrangements met people's needs safely.