Trinity 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 outstanding. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (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.

Staff raised incidents and concerns through the provider’s digital system. This was reviewed by a team of office staff who would take any immediate actions required. Senior managers were also able to monitor incidents and accidents, and they confirmed certain levels of incidents were actioned by them. The registered manager was responsible for ensuring actions were taken including referrals and any changes to people’s care plans if required. The provider’s quality assurance team reviewed incidents and accidents for any trends and learning across the organisation. There was a positive learning culture that was based on an open and honest approach. Referrals were made to health and social care professionals if required.

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 felt supported by staff with their individual care needs. Care staff confirmed they supported people with any changes to their individual needs. This included raising with the office if the person needed a GP referral or other health and social care professional referral. Information was available within people’s care plans of referrals made including any outcome.

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. Although, we found some improvements were needed to ensure 1 person had best interest decision paperwork to support all aspects of their care and support.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the capacity to do so for themselves. Any decisions made on their behalf must be in their best interests. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. People’s care plans confirmed if the person had capacity. Although improvements were needed to 1 person’s care plan as their care plan confirmed they lacked capacity, but best interest decisions had not been undertaken for all aspects of their care and support. We raised this feedback following our inspection so the provider could review this and take any action needed regarding this.

People were happy with the care and support provided to them. Staff had a good understanding of the different types of abuse, and all felt people got safe care. The provider had a quality assurance system to review safeguarding concerns along with what actions were taken. Concerns were reviewed by office staff or the registered manager and any queries or actions were followed up, including any care plan reviews.

The provider had learning forums that staff and others could attend. These sessions were an opportunity to discuss cases studies and any learning to prevent poor care from occurring.

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. Although, improvements were identified to some people’s care plans and associated guidance and risk assessments for their diabetes care and support.

People were supported by staff who knew them and their individual care and support needs. People were part of their care planning and care plans had information and guidance for staff on how to support them with their individual needs such as their mobility, personal care and any reassurance the person might need from staff. However, we found improvements were needed to ensure guidance and risk assessments were available for all people who had diabetes. The medical condition was confirmed within the person’s care plan, although care plans, we reviewed, had limited information on how the person’s diabetes was being managed, what was normal for their diabetes care and support and what risks this might pose and what staff should do should the person become unwell with their diabetes. We raised this during our inspection so those people’s care plans could be reviewed. Following our inspection improvements were confirmed as being taken to these people's care planning information.

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 had any risks identified and equipment provided so they received safe care. Referrals were made to health and social care professionals and other organisations when any risks were identified or equipment was needed. Office staff liaised with those professionals and were part of reviewing people’s care plans and risk assessments if needed. Care staff had observations undertaken to ensure they had the skills and knowledge in how to use people’s equipment safely.

People’s care plans contained important information such as what equipment the person used and guidance for staff on how to use this. There was also information within people’s care plans on where the person’s utility supply was and any assistive technology they used.

The provider ensured there were enough staff who received effective support, supervision and development. Although, some improvements were needed to ensure staff had completed refresher training.

For example during our inspection we found improvements were needed to ensure staff received refresher training relevant to their role. For example, some staff needed refresher training in safeguarding adults, moving and handling, infection control and first aid.

Staff had received training in how to support people with a learning disability or autism. This training is a requirement for all staff to complete, including practical training if required. The provider’s training matrix confirmed what training staff required and when they had last undertaken this training. During our inspection improvements continued to be made to ensure staff were up to date with any refresher training they required. Staff had bespoke training provided to them such as how to support people with their stoma care, dementia, end of life and Parkinsons. The provider ensured staff had a sufficient induction working with other more experience staff so they were familiar with what was expected of them within their role.

The provider ensured staff had suitable checks completed prior to staff supporting people being employed by the service. This included references and identification checks.

Staff felt supported with supervision, team meetings and observed direct practice reviews and all felt it was a nice place to work. One member of staff told us, “Excellent, really supportive.” Another member of staff told us, “Really good, supportive. They’re so good.” The provider had oversight of when staff supervisions, appraisals and observed practices were due.

People were supported by enough staff, who they knew. People were happy with the support provided by staff. When asked if staff were consistent, people told us, “There is a supportive team of 2 staff” and “I get the same carers.”

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.

They ensured staff had access to personal protective equipment (PPE) and that staff received training in how to use this equipment and prevent infections. Although, some staff required refresher training in infection control those staff we spoke with were able to demonstrate how to use their PPE correctly and safely. People confirmed staff used their PPE. They told us, “They use their gloves and aprons,” and “Of course it’s the first thing they do when they come in is put on their aprons and gloves.” The provider also had a quality assurance system in place where senior staff undertook observations of care staff using their PPE. Any areas of improvement were identified through these quality assurance reviews, this included if staff needed to attend refresher training.

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. Although, during the inspection we identified some improvements were needed to risk assessments and medicines administration information.

People received their medicines safely from staff who had competency reviews and who had received training. People’s care plans confirmed if they needed support with their medicines and risk assessments were in place where emollients posed a possible fire risk. Although, risk assessments were in place for emollients that posed a fire risk, some improvements were needed to ensure all possible environmental risks had been considered and documented. Improvements were also needed to ensure medicines administration charts documented exactly where people were to have their topical cream applied. We raised this during our inspection and immediate action was taken to make improvements to this documentation.

The provider had a quality assurance system to monitor the documentation of medicines and staff competency. Actions were taken when shortfalls were identified.