Astoria Homecare Ltd

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 changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to risk and medicines management. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

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 a process for staff to inform senior staff and complete incident records when an issue occurred. Information relating to incidents was recorded on a spreadsheet which included details of the concern, who was involved and the actions taken. The registered manager confirmed that issues were directly discussed with staff who supported the person to identify how to reduce possible risks. The registered manager explained that these discussions were not recorded, and they stated they would review the process so there were records of the discussions and actions taken.

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.

The registered manager reviewed information they had about the person, from either the local authority referral or from discussion with the person. They met the person and any family/representatives involved in supporting the person to discuss their support needs and any wishes they had about their care. From the assessment, the senior staff ensured the service could meet the support needs and the wishes of the person. People’s care plans identified their GP and any other health and social care professionals involved in their support to ensure continuity.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff 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 relatives confirmed staff provided safe care with comments including, “It’s good care, no concerns and they do the care they need to. Safety is good”, and “I feel safe with my carers, they listen to me.” The registered manager confirmed there was a safeguarding policy. They complied with the local authority procedures for reporting safeguarding concerns. We reviewed the records of a safeguarding concern which included records of investigation statements from staff and any actions taken. Staff confirmed they completed training on safeguarding adults, and they demonstrated their understanding of safeguarding. Social care representatives told us they felt the provider had a clear understanding of their safeguarding responsibilities and took prompt actions when concerns occurred.

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.

At the last assessment we found that the provider had not always developed risk management plans to provide staff with guidance on how to manage risks. At this assessment, we found that improvements had been made. Risk assessments were completed with risk management plans which included guidance for staff on how to provide appropriate support for each person. The registered manager explained they discussed possible risks with the person as “They are experts in their own risk.” They identified an outcome which met the person’s wishes and limited the risks while enabling the person to maintain their independence. The registered manager said, “If you don’t support a person to take responsible risks, you are restricting the person. They should be able to take reasonable risk to maintain their autonomy.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider carried out risk assessments in relation to people’s home environment. Personal emergency evacuation plans (PEEPs) had been developed for people who were living with mobility needs as they faced increased possible risks if an emergency happened. The registered manager told us the home environment was also reviewed during the quality assurance checks.

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 usually the same staff members provided care which promoted consistency. Their comments included, “We have 1 main carer and that is what makes all the difference” and “We have a group of the same carers, maybe about 6 so [family member] knows them all.”

The provider had a process for the recruitment of staff with the appropriate skills and knowledge. A range of checks were completed including obtaining references, criminal records reviews and proof of the right to work in the United Kingdom. New staff completed a range of training including the care certificate, an induction and shadowing an experienced staff member. There were team meetings, supervisions and competency assessments. Staff confirmed they felt supported, had completed training and had regular discussions with the senior staff.

The provider assessed and managed the risk of infection but staff competency and understanding of infection control process were not always assessed. The registered manager confirmed they had previously completed competency assessments in relation to staff understanding of infection control. These had not been undertaken since the previous year which meant staff members understanding of infection control had not been reviewed, but they were reviewing how these could be reintroduced. People and relatives confirmed staff had access to personal protective equipment (PPE) and wore gloves when providing care. Staff told us they had completed infection prevention and control training and were provided with enough PPE. Checks on the usage of PPE by staff were carried out as part of the spot checks completed as part of the quality assurance process.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences however staff competency in medicines administration was not always assessed. Staff involved people in planning, including when changes happened.

At the last assessment we found that the provider had not always managed the administration of prescribed medicines in line with best practice. At this assessment, we found that some improvements had been made but further improvements were required. The registered manager told us that staff did not administer medicines until they had completed their face-to-face training, but they did not currently undertake competency assessments which they were planning on reintroducing. Staff confirmed they had completed training on the administration of medicines and felt confident when providing this aspect of support for people.

Relatives confirmed staff supported their family member with their medicines with comments including, “The carers do the medication, and they are good”, and “The carers do remind medications, it’s all in blister packs.” A medicines care plan had been completed for each person they supported with their prescribed medicines. This care plan included a list of the medicines, dosages, possible side effects and where to apply any creams.