Ranger Home Care Ltd – Main Office

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 changed to good. This meant people were safe and protected from avoidable harm.

The service was previously in breach of legal regulations in relation to people’s safe care and treatment, safeguarding service users from abuse and improper treatment, and fit and proper persons employed. Improvements were found at this assessment and the provider was no longer in breach of these regulations.
 

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.

Staff recorded incidents and accidents which were followed up appropriately by the provider. There was evidence of learning from incidents, actions taken to prevent re-occurrence and communication with staff. Staff confirmed they received feedback from management. The provider updated care plans and risk assessments with learning from these. One example of learning was from falls. Tools such as ISTUMBLE were put in place following falls incidents. ISTUMBLE is an NHS-accredited clinical decision tool and mobile app designed for carers and healthcare professionals to safely assess older adults after a fall. The provider was also working towards improving their falls protocol for staff to provide more detail and what to do in different circumstances to keep people safe.
 

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 well with professionals to ensure the best transitions for people being supported. There was evidence of hospital passports to better share information with hospital staff on admission. Relatives told us the service managed transition from a previous provider seamlessly.

Improvements had been made following our previous assessment. 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.

Relatives told us people supported were safe. Staff knew how to keep people safe, what to report and felt able to raise concerns if needed. The provider had made appropriate referrals to the local authority or notified CQC when required. The provider had effective systems to reduce risks related to people suffering financial abuse. This included using online communication so relatives could see people’s purchase receipts. This helped the provider to have a transparent approach to supporting people with their finances. The service provided information to people on how to complain. Relatives told us the provider had responded well to any complaints raised.

Improvements had been made following our previous assessment. 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.

The provider completed risk assessments when people started with the service which were updated in their care plans. People and their relatives were involved in how they would like their care to be delivered. The service planned to review care every 3 months, which could be completed by telephone or email if the person did not require a face-to-face meeting. There was evidence of reviews being completed and care plans being updated as a result.
The provider had considered the risks related to moving and handling, medicines, nutrition and hydration, environmental and falls. There was evidence of suitable risk assessments in place. Staff were aware of these and how to support people safely. The provider used a collaboration application to ensure staff were aware of important risks to people. This included providing a video of the risks of flammable lotions. The provider was able to check which staff had watched the video to ensure they were aware of these risks and how to manage them.

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

The provider assessed risks within a person’s home when first starting the package of care. Equipment used to support people was recorded on the online care system and was inspected in line with regulations to ensure it remained safe to use. Staff knew to check equipment before use. Staff were also aware of fire safety considerations and what to do in case of a fire or emergency.

Improvements had been made following our previous assessment. 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.

We reviewed 4 staff files during the inspection. The provider ensured people recruited had the right to work and police checks were carried out. The registered manager was able to provide up to date evidence showing full work history and explanation of any gaps during the inspection. This ensured only appropriate staff were recruited.
Staff received training to meet the current mandatory and best practice guidance. The provider had good oversight of staff completion of this training. They were also working to roll out more frequent practical refreshers for basic life support using office staff with relevant qualifications and experience. Some staff had completed various train the trainer qualifications to better be able to support care staff, check competency and deliver training if needed. Staff were regularly checked for competency such as moving and handling, and medicines administration. They were also given the opportunity to give feedback during regular 1:1 supervision.
A suitable flexible induction was in place. One relative told us following their feedback the provider had ensured extra shadowing until the staff member was confident to undertake the care. Staff feedback confirmed they felt well supported by the provider.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Improvements had been made following our previous assessment. 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.

People received their medicines as prescribed. Suitable ‘as required’ medicine protocols were in place, and staff knew when people needed them. New medicine was added to the provider’s online care system via a photo of the prescription label from online communication. The service checked new medicines with the GP where family indicated a change. This helped ensure the provider’s medicines records were up to date and accurate.
The service worked well with professionals to follow up any issues with medicines. There was evidence of obtaining a precedent letter from a GP to confirm actions needed if a person refused their medicine. The service and staff were clear about the need to check for harm if a person missed (including if refused) their medicines. This helped to balance people’s right to decline their medicines with keeping them safe.