Hartley Locums

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. People and relatives told us if they provided feedback on areas of learning about their care, staff listened to them and changed how they cared for them. This included in relation to people’s safety needs and care preferences. Staff knew the importance of escalating any safety incidents and gave examples showing how learning from incidents was promptly communicated across the whole team.

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 gave us examples showing how staff identified if they needed support from other health and social care professionals. One person told us because of the care provided by staff, they were able to return home from hospital as soon as possible, as support was promptly put in place by Hartley House. Relatives told us staff extended their care calls when their family member’s wanted access to emergency care. Staff understood which key information needed to be communicated to other health professionals so people would be able to safely access care from other services. For example, details of the medicines people had been administered. A health and social care professional told us the service supported people safely when they moved between services. The health professional said staff consistently checked if people’s care needs had changed when they returned to their own homes, so they could be sure people’s needs continued to be met.

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 relatives were positive about the arrangements in place to promote people’s safety. Staff knew how to identify potential safeguarding concerns and understood the importance of escalating these, so people would remain safe. Staff were confident senior staff would support people, should they experience any abuse. Staff also understood which other external organisations had responsibilities for promoting people’s safety, should this be required. Senior staff gave us examples showing how they had investigated and escalated concerns about people’s safety appropriately.

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 said staff worked with them at the pace they wished, so their risks would be managed. Relatives described working in partnership with staff so their family member’s risks would be reduced. Staff had a good understanding of the risks people experienced, and explained how they tailored the support they offered, to reduce risks whilst promoting people’s independence. This included risks in relation to people experiencing poor skin health, dehydration and falls. A staff member told us, “I definitely feel the combination of training and the care plan instructions gives me enough information to safely move people.” People’s care plans and risk assessments reflected their individual risks. For example, if one or two staff members were required to safely support people.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Relatives told us staff identified if their family members required additional equipment and gave examples showing how staff worked with other health and social care professionals, to ensure their family members had access to the equipment they needed. Staff told us they were not allowed to provide care to people until senior staff had undertaken an environmental risk assessment. This considered the safety needs of people and staff. The provider’s environmental risk assessments considered a broad and appropriate range of risks and detailed how these risks could be controlled.

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. Relatives were complimentary about the knowledge and skills of the staff providing care. A relative explained new staff had opportunities to work alongside more experienced colleagues before they cared for people on their own. Another relative told us, “Staff are friendly and know what they are doing. You don’t need to explain, they come in and get stuck in, the new ones pick it up well.” Most people and relatives told us they could rely on staff providing care at the times, and for the duration, planned. One relative said, “You don’t have to worry about them. When they leave you know they have done the jobs.” Another relative said, “In the 3 years [staff] have cared for [person’s name] they have only been late once, and rang up and let [person’s name] know they were running late.” A further relative told us, “I am not sure how [registered manager’s name] selects staff but the staff they have coming in are up to scratch.” However, whilst most feedback showed staff stayed the length of time agreed, some feedback indicated staff did not always do this. There was no indication of harm to people, but this may be a missed opportunity to maximise the positive social impact of people’s care calls. Some people required support from 2 staff members to provide their care. People, relatives and staff told us 2 staff always attended the calls, as planned. The registered manager told us there had been recent changes in the staff team and told us they were recruiting new staff. Systems were in place to check the suitability of staff before they commenced employment. Staff were supported through an induction process and on-going supervisions, training and competency checks.

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 said staff followed good infection control practice when providing care and kept people’s homes clean. One relative told us staff were always careful to dispose of any soiled items promptly and safely. Another relative said, “[Staff] always use PPE, [personal protective equipment], and sanitiser.” Staff confirmed they had access to PPE and cleaning products, which helped to promote good infection control. Senior staff checked staff practice to assure themselves staff followed good infection control practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Some people managed their own medicines, or with support from their family members. Other people received support from staff to ensure they had their medicines they needed to remain well, and told us they could rely on staff to assist them. One relative told us, “I still fill the dosette box, [staff] give them. Medication is never left lying around.” The relative also said they could rely on staff applying medicinal creams and told us because of this, “[Person’s name] skin in very good.” Staff said people’s care plans provided them with the guidance they needed to administer people’s medicines safely. Staff gave examples showing how they checked if people who were not able to tell them if they wanted “as and when required” medicines, required these. Staff gave us examples showing how they worked with people, relatives and other health and social care professionals so people would be able to continue to receive their medicines as independently and safely as possible. Staff were not allowed to administer people’s medicines until they had been trained to do this, and their competency had been checked.