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 – 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 remained 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.

We identified a breach of the regulation for safe care and treatment. This was because the provider had not ensured risks to people were assessed and managed safely and that medicines were also managed safely. We also identified a breach of regulation relating to staffing, because the provider had not always ensured staff completed mandatory and refresher training in a timely manner to ensure they could care for people safely.

We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.
 

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were systems to record and learn when things went wrong, although these were not always followed. The provider showed us their incident and accident log, lessons learned reports, and action plans. However, we found 1 incident on the lessons learned report was not recorded in the incident and accident log.

Lessons learnt reports included recommended actions to prevent re-occurrence to keep people safe. However, we noted that some actions and lessons highlighted in the lessons learnt reports were not applied in practice. For example, staff had not received additional training on risk escalation and tube blockage prevention following two safety events. The registered Manager explained that additional training would be provided to all staff on risk escalation and the prevention of tube blockages, to address identified shortfalls, reduce risks, and ensure the safety of people using the service.

Staff told us that learning from incidents and accidents were discussed with them to help prevent re-occurrence. We saw that safety events and actions taken were discussed at the monthly staff meeting to aid learning.
 

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There were procedures designed to protect people from abuse. People told us they felt safe with staff. The provider had worked closely with the safeguarding authority to investigate potential abuse and to help put protection plans in place to prevent abuse in the future.

Staff told us they knew how to raise concerns and had completed safeguarding training. One staff member stated, “I would report to my manager, and I am aware of the whistleblowing policy.” A whistleblowing policy encourages staff to report wrongdoing in an organisation without fear of punishment. It keeps reports confidential and ensures fair action is taken.

Risks were not always safely managed. This was because assessments did not always consider risks related to individuals' health, mobility, or medicines. Where risk management plans were in place, these were not detailed enough to ensure staff had all the necessary information to deliver safe care and treatment to people. For example, the provider had not completed appropriate risk assessments where people were at risk of falls, or required essential equipment such as wheelchairs, hoists, and slings.

Additionally, moving and handling assessment forms were only partially completed. This resulted in insufficient guidance being available for staff to minimise risks and ensure safe moving and handling practices, to help maintain the safety of people being supported, as well as the care workers.

Where people using the service required staff support to move due to the risk of falls, we found the provider had not carried out risk assessments on fall prevention and care plans did not contain appropriate information on how to move people safely. This meant that staff were not fully informed to understand and mitigate the risks relating to the people they supported.

One person using the service required support to manage their PEG feeding. PEG feeding is a method of providing nutrition through a tube inserted directly into the stomach, used for individuals who cannot eat or swallow safely. The person’s care plan and risk assessment lacked guidance on how to perform this task safely. This meant the person was not adequately protected from the risks associated with having a PEG, such as infections and tube blockages.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff were not always provided with the training they needed to deliver safe and good quality care. Some people were at risk of falls, some were living with dementia, some were diabetic and one person required assistance with PEG feeding. However, we identified that some staff were supporting people without prior training in these areas. We also found that some staff were not always completing the training they needed on safeguarding, fire safety, basic first aid, health and safety, moving and handling and nutrition and hydration. This meant that staff may have been lacking the necessary skills and knowledge required to perform their roles effectively and ensure the safety of those in their care. At the time of our assessment, the registered manager explained they were currently reviewing staff training and working towards improving staff’s compliance in this area.

Staff recruitment files included an application form, proof of identification, references and evidence of Disclosure and Barring Service (DBS) checks. A Disclosure and Barring Service check is a record of a person’s criminal convictions and cautions held on the Police National Computer. The check helps employers make safer recruitment decisions.

Staff felt supported in their roles. They told us they had completed an induction programme when they started working for the company. They were also provided with training opportunities, monthly supervisions, annual appraisals and spot checks to assess their knowledge and skills. A staff member told us, "Supervisions and appraisals allow my manager and me to identify both challenges and achievements over the months, helping me stay motivated and productive."

Staff told us they were given enough time for each visit to complete the tasks identified in people’s care plans. A relative confirmed, ‘’Staff visit 4 times a week in the morning, and we are very happy with what they do and how it works. They are very punctual, and they stay between 1-2 hours. “

There were enough suitable staff employed to meet people’s needs. A relative told us, ‘’One of the things we really like is that [Loved one] has regular carers. One [staff] does Monday to Friday and then [Loved one] has another [staff] at the weekend.’’
 

There were no systems in place to help prevent and control infections. Staff had not undertaken training on Infection Prevention and Control (IPC). However, staff had told us they understood the principles of IPC and wore personal protective equipment (PPE) to help prevent and control the spread of infection to people. People confirmed that staff wore gloves and aprons during visits.

People’s medicines were not managed safely. Some people’s prescribed medicines and creams were not always recorded on the medicines administration records (MAR).

Another person had been prescribed 2 different 'when required' (PRN) medicines. However, only one of these medicines was recorded on their MAR chart. We noted that staff did not administer the second medicine and had recorded it as ‘not needed’. Additionally, we found the provider did not have a PRN protocol in place to guide staff on when to administer these medicines and how to properly record their administration.

At the time of our assessment, we observed that 3 people did not have a list of their prescribed medicines in their care plan. The provider explained that their medicines were administered by family members. However, we found records indicating that staff had prompted these individuals to take their medicines. It is important that care staff know what medicines people are taking, in order to be aware of any contraindications and help them recognise when people may be experiencing any harmful side effects from their medicines.