GoodOaks 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 records.
 

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. Lessons were learnt to continually identify and embed good practice. The registered manager held a thorough oversight of accidents and incidents. We saw examples where measures were put in place following people having persistent falls, this included medicine reviews, sensor equipment being installed and staff encouraging a healthy fluid intake for people. The registered manager told us people’s falls risk assessments were reviewed after each fall and when required referrals to the falls team were made. Staff were kept informed of any lessons learnt through meetings and the service’s communication app. A staff member told us, “Incidents or accidents are recorded promptly and accurately following the organisation’s procedures. This usually involves completing an incident report form in care plan or verbally what happened when and where it occurred, who was involved and any actions taken. If the incident is serious or relates to a safeguarding concern I escalate it immediately to a manager. We also log it in the client’s records to ensure continuity of care and ongoing monitoring.”

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. A person enjoyed going on organised holidays with a group, the registered manager helped the person arrange the holidays and with consent, shared their full care plan with the holiday provider to ensure a continuity of care. Each person had a ‘hospital passport’ which contained important information about them. The hospital passports included people’s wishes, likes, dislikes, medical summaries, GoodOaks Homecare’s and next of kin’s contact details. The hospital passports also included a list of medicines people were prescribed; we identified the medicine list was not always up to date due to changes in some people’s prescriptions. We fed this back to the registered manager who told us they would undertake an immediate review.

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 told us they felt safe and content with staff, comments included, “Yes, very safe. They are always very friendly, confident and helpful.” Staff demonstrated their understanding to report safeguarding concerns and knew how to escalate concerns within the service. A staff member told us, “It’s (safeguarding concerns) reported to CQC, and the company and safeguarding team.” A professional told us of their experience of the service and said, “It is due to the professional approach of the GoodOaks care provider that we were alerted to a safeguarding concern. They followed the professional advice/guidance and responded appropriately in a timely manner. Professionally I have found the provider to be supportive both to their staff and ourselves. When I requested support to attend a joint meeting with the client, the manager was proactive and supportive. I would recommend the GoodOaks agency and the manager, as they are professional and conscientious.” We saw instances where staff had reported concerns to the registered manager, they were appropriately referred to the local authority team and a log of investigations were kept.

The provider mostly 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 were involved in managing any associated risks with their health or equipment they required. Care plans contained enough information for staff to support people who required continence aids, such as, catheters and stomas. However, we identified some areas where full guidance was lacking, for example, how staff would support someone if they were to experience a seizure when eating, and when a person’s needs had changed, there was a delay in updating care records. We fed this back to the registered manager who was in the process of reviewing the care records for these people. People’s moving and positioning care plans and risk assessment were detailed and provided staff with clear guidance on how to support them safely. A healthcare professional told us about their observations of staff and said, “I have never observed unsafe practice, staff follow professionals’ advice with regards to moving and handling. Their training and knowledge appear up to date and they raise concerns appropriately and when required. Whenever I observed staff interacting with the service users and their family they were courteous, caring and professional.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were completed for each person’s home. Their individual circumstances were considered, for example, when pets were at the property or if a person smoked cigarettes. Assessments identified and mitigated potential risks to people and staff, where needed referrals were made based on the findings. For example, the registered manager identified where a person’s safety could be enhanced by a supportive visit from the local fire and rescue service. A staff member told us, “I also encourage the client to be involved in keeping their space safe and support them with tasks they find difficult. If I notice anything that could affect their safety like faulty equipment or blocked fire exits I report it promptly so it can be addressed.”

The provider did not demonstrate they followed safe recruitment processes. Checks were not always completed prior to some staff employment. We identified some staff members did not have references and/or DBS checks in place before supporting people in their own homes, this included where people received live-in care. The provider was aware of these requirements, a member of the management team told us they were migrating paper records to electronic records and the documents had been accidently missed. Without robust checks, people could be at risk of being supported by unsuitable staff. We raised our concerns with the member of the management team who addressed the issues and sent us evidence that checks had subsequently been made or risk assessments were put in place to safeguard people. They further sent us a revised recruitment check list to ensure future recruitment checks would be in place before staff commenced their duties. The check list included for a second review to be conducted by another member in the office team. We discussed our concerns with the registered manager who advised they had not been involved with staff recruitment processes; however, they have taken our feedback seriously and will now have full oversight of staff recruitment. The registered manager provided assurances the concerns would not happen again.

The provider assessed and managed the risk of infection. People and their relatives told us staff kept their homes clean and abided by infection prevention and control procedures. A relative said, “[Staff member] asks [person] what they want and likes. [Staff member] hoovers and the kitchen is immaculate.” People’s wishes were taken into consideration, for example, some had different requirements in respect of personal protective equipment (PPE), care plans captured their preference of what staff were to wear when in their homes. We observed staff visiting the office to collect PPE, staff told us they could do so whenever needed. The registered manager held oversight of any infections people acquired, for example, chest infections or urinary tract infections and made sure temporary care plans were in place to guide staff on additional support to offer.

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. Staff administered medicines to people in line with the prescriber’s instructions and in accordance with their preferred way of taking their medicines. Medicine risk assessments were conducted and where high risk medicines were identified, additional risk assessments were completed, for example, for anti-coagulant (blood thinning) medicines. When people had changes to their medicines, electronic medicine administration records (eMAR) charts were updated, however, changes were not always included on the medicine risk assessment forms and hospital passports. We fed this back to the registered manager who advised they would review this to ensure information was current. A staff member spoke about their training and said, “I administer medication, I received training to administer and also I learnt the first thing is gain consent and making sure they (people) have the right to refuse, the right dose, person, time, documentation and route. The [registered manager] gave me types of medication to give and observed what I was doing before giving consent for me to be able to do that (administer medicines alone).” As a result of a medicine audit, the registered manager implemented daily stock counts of medicines to ensure they were re-ordered in a timely way.