Delta Care Ltd

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 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 provider treated people’s safety as a priority and risks to people were not overlooked or ignored. Incidents and accidents which had occurred at the service were analysed. Incidents were shared and discussed with staff and used as an opportunity to learn from, and to help support improvement in practice.

Policies were in place to help ensure people’s safety, such as a whistle-blowing and safeguarding policy. Staff had completed training in topics of health and safety.

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.

Staff understood their responsibilities for ensuring safe systems of care including working with other professionals and services, to help ensure people received continuity of care.

Staff told us they felt confident in recognising and responding to any changes in people’s needs, for example, following people’s discharges from hospital.

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.

Staff understood what safeguarding meant and how to take appropriate action. Staff had completed safeguarding training. A safeguarding policy was in place to provide staff with the most up to date guidance. One member of staff told us, “I would report any concerns if needed yes - and I know I can approach external agencies if needed.”

People told us they felt safe when receiving care and support from staff. One person told us, “Staff make me feel safe - I would recommend them."

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Although we were assured staff were familiar with risks to people and what action they needed to take to mitigate those risks, people’s care records didn’t always best evidence this. This included risks which had been categorised as high and severe.

For example, for 1 person who was at risk of weight loss, there wasn’t sufficient information or guidance in the care plan to direct staff on how best to support the person. For another person who had been identified at risk of falls, the falls risk assessment was incomplete. For another person who was at risk and had a history of UTI (Urinary tract infections), there was no guidance for staff on how to best manage this. We spoke to the registered manager who confirmed they would review people’s records during our assessment.

Staff worked with people to manage risk where possible. One member of staff explained, “If a person had a congested room and we identify hazards and risk, we report this and work with the client, to perhaps move things around.”

Staff told us they knew people well. One member of staff commented, “Most of the time I go to same people, I get to know people and get to know their needs, preferences and routines."

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Although environmental risk assessments were carried out in people’s homes, we were not fully assured all potential risks in the environment had been assessed. For example, an incomplete risk assessment for 1 person at risk of falls, didn’t provide us with assurance that any potential risks to the environment had been identified.

However, we were assured that for people who required the use of any equipment, such mobility aid equipment, staff were competent to use this appropriately.

Although the provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We were not always assured they worked together well to provide safe care that met people’s individual needs.

People told us staff were kind and treated them well, but they didn’t always feel staff stayed for the duration of their care call, comments included, “I get half an hour call, but they don't stay for that long,” “Staff do cut the call time, but that is the nature of the industry” and “I do feel staff are rushed.”

Feedback was mixed about having the same staff. Comments from people included, “Staff are well trained and have experience, but I would like more consistency in my staff team” and “Yes I have the same staff, I’m happy with that”. A relative was keen to tell us, “[Name] has the same care staff team which is fantastic. I am very impressed with this, and [Name] has a good relationship with the staff, and they know him well.”

Some people also fed back that start times for calls could be sporadic. Comments included, “The times that they [staff] arrive can vary,” and “Times are not consistent - they are all over the place.” Whilst others felt staff were ‘largely on time.’

Processes were in place to help ensure staff were recruited safely. For overseas staff, required right to work documentation was in place. Staff underwent an induction process which included ‘shadow shifts’ where other more experienced staff were followed to help ensure good practices.

Staff received training and underwent competency and spot checks to help test and develop their knowledge and skills. More specialist training was also offered to help better meet people’s more specific needs. One member of staff confirmed, “I’ve had dementia training, and this has helped me in how I deal with them [people living with dementia].”

Another member of staff told us, “We have an annual appraisal and supervisions every 3 months, I am involved and can say what I feel. We can ask for extra training if needed, for example, I asked for extra training and for a new client who needed their blood pressure checking and I got it.”

The registered manager explained how additional workshops were put on for staff to help them respond more effectively to people living with dementia, they told us, “We’ve introduced workshops and dementia training in response to people’s refusal of personal care.” The registered manager explained how the training had helped staff in their approach and led to a reduction of refusals of personal care for people living with dementia.

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 were trained in safe infection control practices and had access to supplies of PPE. One member of staff told us, “I always use PPE and masks for certain clients if they have a virus or Covid, if I suspect someone has a virus I report it to the office."

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

One senior member of staff told us how some issues with people’s medicines had been caused by the pharmacy and how they had to safeguard the situation, “Sometimes we have to get an emergency prescription, so people don’t miss their doses.”

In some cases, people hadn’t received their medicines as prescribed, however, the provider acted appropriately by identifying the issue quickly and implementing remedial action.

We also saw instances where audits had highlighted where staff had not recorded the administering of people’s medicines correctly or forgot to sign that they had been given, meaning that people’s medicines records were not always reliable. Where any medicines errors had occurred, the registered manager took appropriate action, for example, by consulting with the person’s GP to ensure any risks to people were minimised.

Although people’s allergies to any medicines were documented in their care plans, they were not highlighted, (for example by using red ink) meaning there was a chance they could be overlooked by staff. We discussed this with the registered manager who confirmed they would change this moving forward.

Staff who administered medicines to people had received appropriate training. Staff competency and spot checks were carried out to help ensure medicines were given to people safely and effectively. One member of staff confirmed, “I give out medicines, I have spot checks, most people have blister packs, so I check the medicines off against the list."