iCare Solutions Manchester 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 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The management team had systems in place to record and monitor accidents and incidents. Staff managed accidents and incidents safely; first aid support was provided where needed, medical support and advice was sought, and management were kept updated. Events were logged electronically by the manager and analysed regularly to support lessons learnt.

Staff reported an open culture where they were encouraged to report all concerns. One staff member told us,“I report to [manger]. They are amazing, one of the best managers I have ever had. If I went to [manager] with concerns, they talk me through things and they would a 100% act upon the concerns immediately.”

People were encouraged to raise concerns with staff and were supported to do this in a variety of ways.

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’s needs were assessed prior to them receiving a service. Information of care needs assessed by the local authority prior to people joining the service was used to inform people’s care plans and risk assessments. Care plans also informed staff of external support input from health professionals such as district nurses or the speech and language therapy team (SALT).

Processes were in place to ensure people received continuity of care, for example, when being transferred to hospital, their care slots remained available for a period of time to allow them to return back to the same care provider.

Staff were positive about the communication within the service and reported good relationships with local health and social care professionals. One staff member told us, “We are in constant contact with other professionals [involved in people’s care] including, moving and handling team, physiotherapists and nurses.”

The service was working within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Information about people’s cognition were recorded in their care plans. Concerns about people’s metal capacity were escalated to the local authority and health care professionals.

Staff received training in the MCA. Staff understood consent, the principles of decision-making, mental capacity and deprivation of people's liberty. One staff member told us, “MCA is about whether a client has the ability to make their own decisions.”

People were protected from the risks of abuse and staff were trusted to keep them safe. People and relatives told us they felt safe with the staff and the care provided. Comments included, “I have always felt safe [with the staff]”, “I do feel safe with them because they [staff] know me and they know what to do” and “[Relative] is safe with the carers.”

Staff had received training in how to safeguard people. Staff we spoke with were confident to report concerns and satisfied that action would be taken to investigate them. Staff told us, “I would inform the office [of any concerns] and let them know what happened. I can also speak to CQC and the local authority” and “The care co-ordinators are always available and I report any concerns to them.”

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’s needs were assessed prior to them receiving a service. Care plans provided guidance for staff to ensure people received safe and responsive care and support. Risks were assessed and mitigated to keep people safe. Risk assessments were person centred and regularly reviewed. A staff member told us, “I write the care plans and do the reviews. We share the information with the carers via the [electronic] app. The app is quite good, it always asks if the care plan has been read and flags up when changes are made [during people’s care visits].”

People and relatives were involved in care planning. This was reviewed regularly or when people’s needs changed. People told us, “I do have a care plan and they [staff] came about 8 weeks ago to review it. There were a couple of little things that were changed and they [staff] have given me a copy of the new care plan” and “I do have a care plan and I had a review last week as my needs have become greater.”

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's care plans contained information which evidenced that the safety of people’s home environment had been considered. Environmental risk assessments were in place to ensure staff were safe whilst supporting people. Where people required the use of aids for safe moving and handling, risk assessments were in place to support staff to be able to use this equipment safely.

The provider’s office environment was well maintained for staff to access.

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.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults. Staff had the necessary safety checks in place before starting work and completed a full induction. A staff member commented, “I had an induction when I first started, which covered all training, such as first aid, catheter care, safeguarding, etc. I also did some shadowing [observing experienced members of staff]. It was a good induction process and it was enough for me.”

Staff had regular training and opportunities for supervision [one to one support sessions with their line manager]. Staff told us, “I get supervisions and spot checks” and “[Manager] does my supervisor, I get them regularly and can request one [outside the supervision schedule] when I feel like I need to speak to [manager].”

The provider had systems in place to monitor staffing levels and ensure people received their visits. Earlier this year we received concerns around the provider’s rota systems. During this assessment we found the provider had worked closely with the local authority and issues with the rotas had been vastly resolved and further work was underwayto review the quality of rotas and drive service improvements. An electronic system was used to determine staffing levels, issue staff rotas and deploy staff to people’s care visits. Staff told us, “My rota is manageable, there are no issues”, “I have regular clients on my rota and enough travel time” and “When staff call in sick, we check on the system what visits need cover and get staff on overtime shifts [to ensure people receive their visits]."

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.

Staff received training in infection prevention and control and told us personal protective equipment (PPE) was readily available to them. Staff told us, “PPE is stocked in the office and the carers collect PPE and when they need it” and “I have enough PPE.”

People and relatives told us staff members wore PPE during when providing support and care. Comments included, “They [staff] have plenty of gloves and they use them” and “They [staff] are always in uniform and have gloves that they wear when they are washing me and applying my creams.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People received their medicines as prescribed and electronic medication administration records [MARs] were completed daily. People told us, “They [staff] do give me my medication and that's always been excellent from what I can remember” and “They [staff] put cream on my legs as I need this doing 3 times a day.”

The provider had systems in place to minimise the risk of non-administration of people’s medicines. Staff used an electronic devise to log in and out of peoples’ properties and completed electronic MARs as part of people’s care visits. If staff forgot to complete the electronic MAR, they were unable to log out of peoples’ properties, which acted as a failsafe, ensuring staff had administered peoples’ medicines and recorded it on the system prior to leaving.

Audit processes were in place for medicine records. Staff audited MARs on a monthly basis and took follow up action with the staff involved where required.