ICare (GB) Limited - Runcorn

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 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.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. For example, medicines audits had not been analysed to identify themes and lessons learnt to improve safety and continually identify and embed good practices. However, recently the provider had taken steps to embed new ways of working to making the audits effective. The provider was aware of their regulatory responsibilities to notify the CQC and submission of statutory notifications of any significant events at the service. We spoke with the management offering support and told us they would ensure CQC and relevant healthcare professionals were notified of any incidents when they occurred. Records showed notifications had now been submitted to CQC as required.

The provider did not always work well with people to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services. There had been shortfalls in the provider’s assessment processes and how they ensured continuity and safety for new care packages. We found updates and relevant information was not being acted upon quickly and some staff told us they did not feel confident the information in care plans was up to date. The provider was aware of these issues and had implemented an action plan to make the required improvements and this needed further time to become embedded, so they were effective.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 manager demonstrated a clear understanding of their responsibilities in safeguarding people from harm and abuse. Procedures were in place to identify and address safeguarding issues, enabling timely action. Staff confirmed they had received safeguarding training and knew what action to take in the event of suspected abuse. They demonstrated a strong understanding about risk management and risk escalation processes.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People’s care plans and risk assessments contained out of date information with reviews not being complete within a reasonable time frame. One staff member told us, “Sometimes the office listens and have a lot on but I don’t expect things to happen quickly. Maybe 6 weeks for risk assessment or care plans to be updated.” People and their loved ones were not confident staff had the right information to care for them. One person loved one told us, “I do not feel confident with them at all.” We saw the provider was aware of this issue and had implemented a series of improvement plans to update records.

The provider detected and controlled potential risks in the care environment. Staff and leaders escalated any risks identified then adapted their support to keep people safe. People told us staff maintained their home environment to a high standard when this was part of the agreed package of care. Risk assessments were undertaken on people’s living environments and this ensured potential environmental risks to both people and visiting care staff were identified and measures were implemented to mitigate any identified risks. 

The provider did not always make sure staffing deployment was effective and proportionate. We saw issues with two to one care and the number of different staff completing calls in one month. This is unlikely to be a good experience of care for some people which some people and their loved ones confirmed when we spoke to them. The manager told us they were aware of these issues highlighted and we found meaningful evidence they were addressing these concerns. We saw the service was being coordinated around people who used the service. The provider made sure there was qualified, skilled and experienced staff, who received effective support, supervision and development.

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 indicated they had received training focused on infection prevention and control, including refresher training, and confirmed they had sufficient access to personal protective equipment (PPE). People and their loved ones confirmed all staff wore appropriate PPE and followed good practices to minimise the risk of relatives and friends, professionals and others visiting from spreading infection.

The provider did not always make sure medicines and treatments were safe and met people’s needs, capacities and preferences. We saw up until recently medicine audits were not effective and did not highlight issues or pick up any themes. However, the provider had recognised this issue prior to this assessment and had begun to use a new audit system which would offer robust oversight to identify issues, but to be effective this required further time to be embedded.