Lilyrose Care Group Ltd - Staffordshire

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 Good. At this assessment the rating has remained 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.

People and relatives, we spoke with confirmed they were able to raise concerns with staff, and the provider acted on any concerns to make improvements. One relative said, “My relative had an area of soreness which I raised. The issue was resolved quickly, and it has never happened again.”

Staff stated they were able to approach the management team if they had any concerns or suggested improvements. When issues had been raised these had been dealt with by the registered manager. One staff member said, “I haven’t had many issues with the service since working for them, any issues have always been resolved within a timely manner.”

Records of incidents and accidents were kept by the provider, which contained the circumstances and action taken to mitigate the risk of further occurrences. The provider completed monthly audits where incidents/accidents were analysed to ensure the appropriate action had been taken and any trends could be identified and acted upon.

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 and their relatives told us staff were attentive to changes in health needs. Staff raised concerns with health and social care professionals when needed. A relative told us, “The carers will alert us to any issues they feel need a doctor. They are very good at informing us if they feel my relative’s emotional wellbeing has significantly changed.”

People’s care records contained details of advice received from health and social care professionals, these records were updated to ensure staff had up to date information to follow when providing care. Hospital passports were in place when required to ensure people who had limited communication received consistent support when they moved between different services, such as being admitted into hospital.

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.

People and their relatives told us they felt safe with the staff who provided care. One person said, “I feel safe with my carers.” Another person told us, “I feel safe with staff, there have been no incidents that have affected me.” A relative told us, “Mum is safe with the carers as she has good continuity of staff.”

Staff had a good understanding of their actions and responsibilities to safeguard people from harm. Staff understood how to recognise suspected abuse and the processes in place to report concerns to keep people safe from harm. One staff member said, “I have had safeguarding training, and I know who to report any concerns about the treatment of people to.”

The provider had clear systems and processes in place to ensure people were safeguarded from the risk of harm, which were followed by staff. Referrals had been made to the Safeguarding Authority when required to keep people safe.

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.

People's risks were managed and mitigated to keep them safe. People and relatives told us how staff understood the risks to people’s health and wellbeing. One person told us, “I have mobility issues and have 2 carers at each call… I feel safe with my carers.” Relatives told us they felt staff understood their loved one’s needs and managed behaviour safely. One relative said, “The carers are well trained in dealing with my relative’s condition and interact well with them. They [staff] have a good way of distracting my relative when she becomes a little distressed.”

People’s individual risks and explained how they supported people to remain safe, whilst promoting their independence. One staff member said, “I can access all the information needed to support people on our digital apps or within paper files which are kept at clients’ homes. This helps me to understand their support needs and preferences.”

Risk assessments and care plans were completed with people and their relatives. Staff confirmed the records provided enough information and guidance to follow to support people safely in line with their needs and preferences.

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

People and relatives told us staff used equipment competently and in line with assessed needs. One relative told us, “My relative has 2 carers at each call as she requires a hoist. The carers manage the hoist safely and there have been no incidents.” Access to people’s own homes was managed safely by staff. A person told us, “The carers access my home with a key from the key safe and there have never been any problems”.

Environment risk assessments of people’s homes and equipment had been completed before staff provided support to people. This ensured identified risks associated with the environment and use of equipment were mitigated to maintain people’s safety.

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.

People and relatives told us there were enough staff to provide support at the time they preferred in a calm and unrushed manner. One person said, “They [carers] are on time and stay until all the jobs have been done.” Another person said, “Their [staff] timekeeping is good and if staff are running late, they do call me.” A relative told us, “There have been no missed calls. They [staff] stay for the allocated time.”

People confirmed they had a consistent staff group providing their care which was important to them. One person told us, “There are 4 different carers that call, so it is quite consistent. They know my routine and I get on well with them all.” A relative said, “I would say she has the same group of 4 or 5 carers that provide consistency of care.”

We received inconsistent feedback from staff regarding the staffing levels at the service. One staff member said, “We are highly short staffed.” Another staff member said, “Yes we have enough staff, and we have bank staff who come and assist us sometimes.” However, the feedback received from people and relatives, and the call monitoring information we reviewed suggested there was enough staff available to provide care when people needed it.

Staff had been recruited safely, and the provider had carried out checks to ensure staff were of a suitable character. People and relatives felt staff had the knowledge and skills to support people. One person said, “The carers are well trained, and I highly recommend the company.” Staff told us and the records confirmed they had received an induction before they provided care which was tailored to people’s individual needs and conditions.

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 and relatives told us staff consistently followed Infection Prevention and Control guidance. One relative said, “The carers wear their Personal Protective Equipment (PPE) at all times” and “They adhere to infection control, disposing of incontinence pads in bags and then place them in outdoor bins.” Another relative said, “We have observed carers washing their hands and changing gloves after personal care.”

Staff explained how they followed infection control guidance when they supported people. Staff confirmed there was always enough PPE available for them to use. One staff member said, “We use PPE, and it’s always available to collect from the office, such as gloves, aprons, face masks and shoe cover in wet seasons.” This meant people were protected from the spread of infection.

The provider ensured staff understood how to reduce the risk of cross contamination through training, discussions in team meetings and spot checks.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People were supported with their medicines and creams as prescribed. People and relatives confirmed staff understood how and when they needed their medicines. One person said, “They [staff] hand me my medication to take and watch me take it.” A relative said, “The carers prompt my relative to take her tablets and will hand them to her and watch her take it.”

Staff were trained in the administration of medicines, which was refreshed annually. Competency assessments had been carried out to ensure staff understood the training and were competent to administer medicines safely in practice.

Medicine Administration Records (MARs) were used to record when staff had supported people with their medicines and topical creams. The MARs contained guidance for staff to follow for prescribed medicines.