Catto Homecare

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 changed to 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.

The service was in breach of legal regulation in relation to staff recruitment and training.

This service scored 62 (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. However, a review of the provider’s systems and processes highlighted the need for further improvements in the oversight and auditing of care call monitoring, incident reporting, safeguarding, and complaints handling. The management team acknowledged these areas for development and acted promptly to implement changes. While the new and improved practices were introduced swiftly, time was needed for them to fully embed and demonstrate sustained impact.
People confirmed they knew how to raise any issues or concerns and felt confident the management team would be responsive. Where issues had been identified, the management team implemented actions aimed at addressing the concerns and reducing the likelihood of recurrence.

Staff were able to explain how they would report accidents or incidents. They confirmed there was a procedure in place and outcomes of investigations were shared. Another staff member explained their role was to ensure relevant agencies had been informed of any accidents or incidents when reviewing the audits.

The provider had worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

They ensured people received continuity of care by providing regular care staff. Staff knew people well and people felt staff knew the care required during each visit. One person told us, “The staff are kind and caring and are looking at what needs to be done. They know at each visit what activities need to be carried out and I never need to tell them.”

The provider carried out a face-to-face assessment as part of their pre-assessment process. The management team told us they only accepted new care packages if they had capacity to do so and they felt they were able to meet the needs of the person. The registered manager assessed all new people who were to receive care and developed their care plans in partnership with them and family members or professionals as required.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff focused 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.

Staff we spoke with confirmed they had received safeguarding training and were able to state what action they would take in response to witnessing abuse, including contacting the local authority’s safeguarding team. When safeguarding concerns were raised, the registered manager dealt with these appropriately and recorded all actions taken. Staff knew how to recognise abuse and protect people from the risk of harm. People told us they felt safe with care staff who were kind, caring and good at their jobs.

The provider worked with people to understand and manage risks by considering their overall needs and circumstances. 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 consistent and clear and the guidance that staff should take to mitigate risks was accurately recorded. There were specific, in date, risk assessments in people’s care plans, such as risk assessments for moving and handling and medicines, which staff could readily access. The service had a business contingency plan in place to meet the support needs of people in case of an emergency.

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

Staff knew how to undertake safety checks in people’s homes such as smoke detectors and care alarms and how to report concerns. Specific risk assessments in relation to environmental concerns were in place to ensure staff were aware of actions to take. There was a lone working policy for staff and equipment was provided to aid their personal safety.

The provider did not always make sure there were enough qualified, skilled and experiencedstaff. They did not always make sure staff received effective and required training, supervision and development.

We reviewed staff records to check whether all necessary checks required were completed prior to staff employment. We found information to explain gaps in employment had not been requested. Also, where staff had previously worked within health and social care, evidence of conduct and verification of reason for leaving their previous roles had not always been requested. This was discussed with the registered manager and they stated changes in the provider’s recruitment process and policies were to be undertaken. Following the inspection, the updated application form and recruitment process was submitted to the inspector.

The service provided mandatory training in topics such as fire awareness, manual handling, medicines and food hygiene. However, the service did not provide training to staff in relation to people with a learning disability or autistic people. There was also no evidence of regular moving and handling competency checks. This was discussed with the registered manager who advised this would be reviewed.

There were enough staff employed to meet people’s needs and this was supported by the service’s rotas. Rotas showed that, when possible, people were supported by the same staff enabling continuity of care. This was confirmed by people and relatives. One person told us, “[Staff member] regularly goes to see [person]… [person] has a really good relationship with [staff member].”

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.

We were assured that the provider was using Personal Protective Equipment effectively and safely. People and relatives confirmed this and said staff wore the protective equipment while supporting them. All staff had received infection control training.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

We found no evidence that audits had been completed on medicines administration records [MAR]. Therefore, there was no system in place to monitor the administration of medicines. People’s records did not have contain individual instructions for ‘when required’ (PRN) medicines were prescribed for them. This was not in line with best practise set out in the National Institute for Health and Care Excellence (NICE) guidance for "Managing medicines for adults receiving social care in the community." It was also found that the provider did not have a PRN policy in place. The above meant staff had no instructions on the use and administration of prescribed PRN medicines for individuals, potentially placing people at risk of harm. The MAR sheets did not include clear information when regular medicines were not administered.

Staff administering medicines had completed medicines training and had their competency assessed to do so. Following the inspection, the registered manager advised they would introduce PRN protocols and plans to audit MAR on a regular basis.