Archived: Passion Tree Care Service 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 72 (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 had processes in place to capture information from safeguards, accidents, incidents and complaints. Appropriate investigations had taken place when a concern was raised. However, the provider told us they were introducing a more robust system to pull all the information together. Staff were able to tell us the action they needed to take following an accident or incident.

Staff told us information was shared in staff meetings to promote learning. A staff member told us, “They share examples of accidents, bruising, pressure sores, they give us examples so we can talk about it.”

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.

The service worked closely with other agencies particularly in relation to their reablement service. Regular meetings were held with therapy teams to discuss people’s care and support.

Risks to people’s care were assessed during initial assessments and used to develop care plans. Staff told us information was available to view on an electronic system prior to them visiting people.

The provider had systems and processes in place to protect people from abuse, neglect, harassment and breaches of their dignity.

The provider had oversight of safeguarding concerns and investigated any concerns raised. More work was needed to ensure all accidents and incidents which could meet the threshold for a safeguarding alert have been considered. Whilst we saw appropriate action was taken following any accidents or incidents it was not always clear about why the incident was not referred. However, we did note most accidents and incidents were reported appropriately. The registered manager told us they had sought additional support from an external auditor to further strengthen their safeguarding processes and demonstrated a new online system they were trialling which tracked all actions taken.

People told us they felt safe with the staff supporting them. Comments included, “I am very happy with the care I get; I get a regular carer. I feel very safe”,” I feel very safe with the carers”, “I get them four times a day to help me with personal care” and “I like the carers and feel safe with the duties they do for me. I generally get one carer with occasional another to cover for holidays.”

Relatives also were positive about the safety of their family members. A relative told us, “We have no issues on the safety aspect of my relative’s care. The carers are very helpful and really support [person’s] personal needs. The carers that they get are quite consistent and the continuity works well for their needs. We can usually rely on them turning up on time and the odd time they don’t they will always let us know.”

Staff had received safeguarding training and had a good awareness of reporting processes. A staff member told us, “If I suspect a service user is being abused or is at risk of harm, I report it immediately to the office and the safeguarding lead and I document the concern appropriately. I am encouraged and supported to speak up about poor care.”

The provider had systems in place to identify and monitor risks to people’s care and support.

Care plans contained guidance for staff to follow to mitigate risks to people. Whilst we identified some minor issues these were addressed at the time of the inspection.

People and relatives told us they were involved and discussed risks to their care and support. A person told us, “They always want to walk behind when I'm walking.” A relative said, “Yes, definitely. [Family member] had a hip replacement and they helped them to mobilise with a walker.”

Staff told us they had access to all the information they needed about risks to people. A staff member told us, “They brief us about clients, when they assign people to us, we go to the App and it has all the details about the client. I do think the information is enough and it enables me to provide care. All the medical histories are there.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Care was provided in people’s own homes. Environmental risk assessments were completed to ensure staff member’s working environment was free from hazards. Staff promptly referred to other professionals if they identified any concerns with equipment within people’s homes.

The provider had effective oversight of call monitoring as they employed a specific team to view their electronic monitoring system in live time. However, we did identify some concerns related to their electronic system and the information provided to us to analyse this data. We fed this back to the registered manager who contacted their call monitoring provider. We were also able to see the provider was taking appropriate action when staff failed to sign in and out appropriately which meant the data captured was inaccurate. This did not impact on the care provided as overall people were happy with how their visits were planned and carried out.

People and their relatives told us staff turned up when expected and stayed for the required time. A person told us, “Their punctuality is very good and 99% on time”. I’ve not had problems; the agency has been very good to me. I’ve been quite impressed with the level of care so far.” A relative said, “I feel the carers are very reliable. “My relative has never reported a problem with the carers not being there on time.”

Staff told us they were not aware of any missed visits and overall felt there were enough staff and they were encouraged to stay the right amount of time supporting people. A staff member told us, “I think we have an adequate number of staff, with no missed visits experienced as the carers are supervised and followed up by the access monitoring team. On morning calls, I have at most 6 to 7 and I do have adequate time to support each person in the proper way they like to be supported.” Another staff member said, “Absolutely [enough staff], there are no issues with staffing levels, people get the support they need.”

Staff were also positive about the training and support they received. A staff member told us, “Yes, my training is up to date. The training is good quality.” Another staff member said, “When I started work at Passion Tree Care Services, I shadowed my supervisors and they put me through. In addition, I have had refresher courses and updated training.” The service had several senior staff trained to deliver practical training to staff.

Competency assessments were in place for medicines and spot checks were carried out. We discussed with the registered manager how other tasks such as catheter and stoma care could benefit from specific competency assessments. This was immediately actioned and the registered manager sent us examples of these checks.

Systems were in place to ensure staff had been through a safe recruitment. However, some minor improvements were needed to ensure systems were robust. For example, some references were received after start date without explanation and reasons were not always given when a previous employer reference had not been obtained.

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 were positive about staff using personal protective equipment (PPE) in their homes. A relative told us, “I think the carers have a good standard of hygiene, both personal and domestic. The carers wear the PPE protection.”

Staff had undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. A staff member told us, “There is sufficient PPE always readily available.”

Medicine processes were in place and staff were trained in the administration of medicines.

The service employed a senior staff member to oversee the medicine processes. They told us, “I educate the carers on medication administration and enrol them in refresher training. I check the medicine administration records (MAR) charts to ensure there are no missed doses. Any incidents, I investigate and liaise with GP’s and the pharmacy.”

Medicine audits were in place which identified and followed up any concerns. There were gaps in MAR records due to the electronic system which meant staff were recording the administration within their notes. This was followed up by senior staff who were monitoring the live system who would contact staff to ensure they had administered medicines.

We noted during our visit that staff were recording application of prescribed creams within their notes and a MAR was not always used. We discussed this with the registered manager who told us they would ensure MARs would be put in place. Evidence of this was sent to us following the assessment.

People and relatives were happy with the way their medicines were being administered. A person told us, “They give me my medication. I'm happy how it all goes.” A relative said, “Recently somebody came in from the office to review all her medications and check that none were out of date.”