Mulholland Care 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.

Incidents, accidents and safeguarding concerns were reported, reviewed and used to promote safer care. Records showed incidents were managed appropriately.

Staff told us they knew how to report concerns and were knowledgeable about the providers processes for reporting incidents and safeguarding. The registered manager shared learning through meetings, supervision and day‑to‑day communication.

The registered manager followed Duty of Candour when things went wrong. They issued apology letters, reviewed complaint documentation and shared outcomes with staff. They also notified external professionals, and kept families informed. This transparent approach helped maintain trust and improved how concerns were identified and resolved.

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 registered manager assessed people’s care and treatment needs before accepting them into the service. This ensured the provider could meet people’s needs and prepare for a safe and well‑planned transition.

The registered manager arranged pre‑admission visits where required and involved people, families, external professionals and staff in transition planning.

Relatives told us when people needed support, staff liaised with them to ensure any transition was managed safely and appropriately.

Staff acted promptly to make referrals to external professionals and to arrange health appointments. They recorded referrals, supported people to attend appointments where necessary, and made reasonable adjustments in line with the Equality Act 2010. These actions ensured people received timely access to appropriate professional support.

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.

The provider had clear safeguarding systems that supported staff to recognise and respond to potential risks of abuse or harm. Staff worked closely with people to understand their wishes and what helped them feel safe. People and relatives told us they felt safe with staff in their homes.

Safeguarding processes were embedded into day‑to‑day practice, and incidents were investigated in line with policy.

Actions were taken in a timely manner, and learning from events was shared to support safe practice across the team. This helped ensure safeguarding remained a consistent priority and that risks were understood and managed appropriately. For example, staff had become concerned about an individual who appeared to be self‑neglecting. They reported this issue to the registered manager, who immediately shared these concerns with the local authority safeguarding team, requesting an urgent review of the person’s care and support needs.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. We checked whether the service was working within the principals of the Mental Capacity Act. We found people’s capacity to make decisions had been appropriately assessed. Where people lacked capacity in relation to specific decision the service had consistently acted in the person’s best interest and appropriately involved relatives and professionals in decision making.

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 care records contained clear, detailed guidance for staff on their individual needs and how to meet them safely. People told us staff knew them well and communicated effectively with them and their relatives.

People reported staff were careful with the security of their homes. Staff followed the guidance in care plans, including using key safes appropriately and ensuring doors were locked when people had requested this as part of their care arrangements.

The provider balanced risk with promoting independence, supporting people to develop life skills such as cooking and managing money, with clear guidance in place should risks increase. For example, 1 person had a desire to sit in the sun whenever possible. Staff had explained the risks of this to the person and encouraged them to wear sunscreen and access shade.

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

Environmental risks were escalated appropriately, including referrals to the fire service for people at increased risk due to mobility or sensory impairments. Staff were familiar with people’s homes and supported them safely during moving and handling tasks, using appropriate equipment and applying the training they had received.

Comprehensive environmental risk assessments were completed for each person’s home, including individual fire safety assessments, to identify and manage potential hazards. Suitable equipment, such as walking frames and shower chairs, were available to support safe mobility and personal care. Staff were trained in the safe use of this equipment, and competency checks were carried out to ensure people were supported to mobilise safely.

Relatives were confident staff supported people to mobilise safely. They told us, “Absolutely spot on. [Staff] always take care when doubling up, [staff] never have a go on their own, which we find reassuring and “[Name] is cared for in bed. A moving and handling plan is in place, [staff] are competent. They are good at finding sores/breaks in [name] skin, writing it down, taking photos, going through to the district nurses. I can’t fault them at all.”

People had positive relationships with staff, and adaptations to the environment of people’s homes were requested and implemented to help individuals mobilise safely within their homes.

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.

At the time of the assessment, the provider had a staff training matrix that did not clearly or fully represent staff competence. We discussed this with the registered manager, who informed us they were in the process of rebuilding the training matrix and strengthening their monitoring and oversight systems. We saw evidence staff spot checks and direct supervisions were taking place, and the provider was carrying out regular assessments of staff competency.

Records confirmed staff had received regular supervision. This provided structured opportunities to review performance, reinforce safe practice, and support staff development.

The provider had safe recruitment and vetting systems in place. Necessary recruitment checks had been completed to ensure staff were suitable for employment in the care sector. New staff received a comprehensive induction and training to enable them to carry out their role.

Staffing levels were planned to meet people’s assessed needs. Where a care plan identified 2 staff were needed for support, the rota clearly identified 2 staff members allocated to the visit at the appropriate times.

People and their relatives’ reported staff were responsive, and understood the individual needs of their loved ones. Comments included, “The carers are definitely confident, professional and always well trained to do the work.”

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.

Leaders carried out regular spot checks to ensure staff demonstrated consistently safe and compliant Infection Prevention and Control (IPC) practices. Staff had access to appropriate personal protective equipment (PPE) and were also provided with company uniforms to support good hygiene standards.

People told us staff were respectful of their homes and surroundings and consistently supported them to maintain clean and hygienic environments. Staff received annual IPC training, alongside individual discussions to identify and address any gaps in knowledge or skills.

People and relatives told us, “[Staff] are very good with that. They have always got gloves and aprons on. They put on gloves and do a particular task and if they do something else, they change their gloves” and “As soon as they [staff] come in, they wash their hands. They wear aprons and gloves and have their hair tied back.”

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff had received appropriate medicines management training, and leaders completed competency assessments to ensure staff were suitably skilled and confident in their roles. Medicine records were personalised, clearly detailing how each person wished to be supported, any known allergies, and any requirements for medicines to be administered in a specific format.

There were effective systems to ensure any changes to people’s prescribed medicines were communicated, documented, and implemented without delay. Relatives told us, “No issues with medication” and “They give [name] medication in a little pot. No issues”.

Staff worked closely with healthcare professionals to maintain safe and accurate medicines support. The provider used nationally recognised resources to benchmark policies and practice against sector guidance. The leadership team reviewed all policies annually as standard, and more frequently if incidents or updated regulatory information required earlier review.