Dale Care and Support Ltd Also known as Heritage Healthcare-Rochdale

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.We identified concerns around risk management and the auditing of medicines.

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 mostly had a positive culture of safety based on openness and honesty.

The provider had systems and processes for staff, people and their loved ones to report any concerns, incidents, accidents and complaints. However, lessons were not always learnt to continually identify and embed good practice. Whilst the service completed an analysis and had some oversight of incidents, these were not always looked at in depth. Accidents and incidents were not always documented and reviewed for themes, patterns or lessons that could be learned.

There appeared to be an open culture of reporting and staff were knowledgeable on what to do should someone have a fall. Staff told us that they would report issues right away to higher management. Staff understood the importance of reporting safety concerns and told us the deputy manager was always quick to respond and very supportive when dealing with any issues that were raised. People and their relatives knew who they needed to contact if they were unhappy or had any concerns about people’s care. A relative told us,“There is no problem with the safety aspect of my relatives care.”

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.

The provider had a pre-assessment process in place which enabled them to gather relevant information prior to care being provided. The provider worked with other agencies and people and relatives to gather information.

Staff knew people well and demonstrated a good understanding of a person’s needs, working closely with health care professionals such as GPs and district nurses to ensure the person experienced good outcomes.

Feedback from partners was limited, however, we saw there were systems in place for information sharing between services and an exchange of assessment documentation when packages of care and support were being arranged.

The provider understood the importance of protecting people from abuse. However, Improvements were required to safeguarding processes to ensure people's safety was maintained.

The provider had a safeguarding log in place. However, this did not evidence an overview of themes, trends or lessons learned from safeguarding events.

Safeguarding incidents were documented although we were not assured these were always managed effectively. For example, some safeguarding concerns had no confirmation of actions taken including what referrals had been made, if any investigations had been undertaken and if these had been raised with the Care Quality Commission (CQC). The provider’s governance system had not identified this.

Overall, people were protected from the risks of abuse because staff had been trained to safeguard them.Staff confirmed they had received training, and they understood how to raise concerns. Comments included “Safeguarding is a procedure to prevent harm, abuse and neglect.”

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. However, we found some shortfalls in relation to risk management records.

The provider did not always have risk assessments in place that guided staff on how to manage risks.For example, 1 person had a risk assessment in place, documenting the use of a hoist.However, when providing feedback to the service they informed us the individual did not use a hoist and the risk assessment was incorrect. We were provided with assurances that this paperwork had been amended. Another care plan we reviewed identified that a person who used the service could display behaviours of concern, with no risk assessment in place informing staff on how to deal with the behaviours. The provider told us they had rectified these issues when brought to their attention. We found no evidence to suggest people had come to harm because of these concerns. This was because the staff we spoke with knew people well and were aware of people’s individual risks and how these risks should be managed. Some risk assessments and care plans contained more detail than others, including where a person was at risk of choking, an appropriate risk assessment was in place.

The provider generally detected and controlled potential risks in the care environment. Most of the time, they made sure equipment, facilities and technology supported the delivery of safe care. People lived in their own homes, and it was clear people felt safe and had access to support to maintain their personal safety. Appropriate risk assessments of people’s homes had been completed to ensure care could be provided in a safe environment.

People were supported to ensure they lived in an environment that met their needs. However, we found examples of some people not having risk assessments and adequate checks in place for the equipment they were using.

The provider made sure there were enough qualified, skilled and experienced staff who received effective support, supervision and development.

Staff had been recruited safely and in line with the provider’s policy and best practice guidance. Rotas demonstrated staffing levels were maintained and people were being supported by a consistent staff team.

People supported by the service told us they were happy with the support they received from staff and said, “We get a cluster of about five carers and I’m happy with the balance of continuity and familiar faces” and “I think the continuity is fantastic.”

Staff told us they had received an induction which included training appropriate to their role. One staff member told us, “I did my training when I started and received an induction, I worked alongside an experienced member of staff completing shadowing shifts, they also do spot checks to monitor my work.” We saw evidence that competency assessments had taken place.

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 had a care plan and risk assessment advising staff how to reduce the risk of the spread of infections. The provider has policies around infection prevention and control and staff had knowledge of these. Staff told us they had received Infection Prevention and Control training and we saw evidence of this on the training tracker.

Medicine administration records contained key information in line with best practice guidance. Medicines administration was recorded in an electronic record. Staff told us they received training in medicines and people confirmed they had support to take their medicines. However, medicines administration records were not always accurately completed. Staff used an electronic recording system; we found several entries which showed people had not had their medicines recorded as given in the system. There was no evidence of any actions taken to check if people had received their medicines and so we could not be assured people had their medicines as prescribed.

As required (PRN) medicines protocols were in place and generally well detailed. There was evidence of staff’s medicines administration competencies being carried out and spot checks were in place. Consent to medicines administration was also in place.