Amplelime Healthcare Limited

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 remained 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 recruitment of staff.

This service scored 50 (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 have a system in place to review incidents and learn lessons to continually identify and embed good practice. The registered manager told us when incidents occurred staff completed an online form which were then used to create an alert for the registered manager. The registered manager took any immediate actions to keep the person safe. However, there was no system in place to review these incidents to learn lessons and enable prevention of similar incidents from occurring again in the future. People told us when accidents occurred staff supported them to access medical assistance if needed. Staff understood the actions to take if people experienced an accident or incident and described how they would document the incident and seek support for the person’s immediate needs.

The provider did not always maintain safe systems of care. They did not always manage or monitor people’s safety. There were care plans in place to support safe delivery of care, however, the provider did not always ensure people received care and support at the right time in line with their assessed needs and planned care. People told us staff did not always arrive for their care calls at the time they needed support, and not all staff understood how people’s needs needed to be met. A relative told us, “Some staff understand [person’s name] needs. Not all the staff look at the care plan.”

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. People and their relatives told us the staff helped them to feel safe and they understood who to speak with if they had any concerns about safety. The provider had a system in place to share any concerns about people with the appropriate body. Staff had received training in recognising abuse and could tell us how they would report any concerns.

The provider did not always manage risks to people’s safety. Staff did not always provide the care at the right time to meet people’s needs. People and their relatives told us they sometimes did not get their needs met at the time they needed. A relative told us the late calls meant their relative did not have enough time between calls, so they often were not eating lunch as they were not hungry when the morning call had been late. This meant the person was at risk of not having their nutritional needs met. However, staff did understand risks to people’s safety and there were risk assessments in place for example, for moving and handling, nutrition and hydration and skin integrity with plans for staff to follow to keep people safe. Risk assessments were reviewed on a regular basis and when things changed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People told us the staff supported them to maintain a safe environment and used equipment safely. A person told us, “The staff are well trained to use the hoist. 2 carers always do this with me.” The provider told us an environmental risk assessment was carried out and shared with staff. Staff told us the risk assessments gave them the information they needed to keep people and themselves safe in the property. Risk assessments and plans were included in care plans which outlined the support people needed to maintain a safe environment.

The provider did not always make sure safe recruitment practice was followed, however there were enough qualified, skilled and experienced staff to support people. Staff recruitment practice did not always ensure staff full work history, reasons for leaving employment and complete recruitment records were in place. The provider did have a policy in place for safe recruitment however this had not been consistently followed this meant we could not be assured staff were recruited safely. People and their relatives shared mixed views about staffing levels. Some felt the staff came on time and had no concerns. A relative told us, “The staff come at the right time and sometimes they stay longer if needed.” Whilst others had experienced late calls on several occasions. A person said, “We have an issue in the mornings, they come 1 hour to 1 hour 30 minutes late. If I need to go somewhere I could not rely on them.” Staff told us sometimes one call would run over making them late for the next call. The registered manager told us they had a system to alert them if staff were running late and would call to let people know. We saw the system showed alerts which showed people had received their calls much later than planned. However, staff received an induction into their role, had regular updates to their training and received supervision.

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 their relatives told us staff used protective equipment when supporting them. A person told us, “Aprons, gloves and masks are worn by staff when they visit.” The registered manager told us they had a policy in place and gave staff training in safe practices for infection prevention control. Staff confirmed they understood how to protect people from the risk of cross infection. We saw spot checks included checking with staff if they were using protective equipment safely and everyone had received training in line with the policy.

The provider did not always ensure medicines and treatments were safe and met people’s needs, capacities and preferences. 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 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. The registered manager told us when medicines alerts came in, they should be recorded as resolved and the action taken should also be included, however had not consistently been done. Despite this people and their relatives were happy with the support they received with medicines. A relative told us, “The staff support [person’s name] with medication. Let me know when things are running low.”