Call4Care Services 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 changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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. Staff knew how to report incidents and told us they recorded what happened and called the management team directly to inform them. Relatives told us they were kept updated of anything that happened. Appropriate follow up action was taken to reduce the likelihood of the same thing happening again.

Documentation to support safe systems of care needed improvements. For example, when health professionals such as GP’s or dieticians provided updated guidance due to a person’s changing needs, these were not always recorded in the person’s care records. This meant care staff did not have access to up to date and accurate instructions. We did not find any harm caused due to this. People’s needs were assessed before care commenced so the provider could ensure staff were suitably trained and skilled to provide good support.

The provider worked with people, relatives and healthcare partners to understand what being safe meant to the person and the best way to achieve that. Staff had received training in safeguarding and knew what action they would take if they had any concerns. We saw the provider’s safeguarding records and made suggestions as to how these could be improved so that any safeguarding concerns could be logged, tracked and reviewed effectively. A relative told us, “[Family member] is definitely safe.”

The provider had systems in place to assess known risks to people’s health and care. For example, skin integrity and falls. Measures were in place to reduce these risks as far as possible. This ensured staff provided care to meet people’s needs that was safe, supportive and enabled the person to do the things that mattered to them.

Processes were not in place to ensure that all equipment had been assessed as safe to use. For example, when bedrails were used. There was no process to regularly record checks of equipment such as hoists or wheelchairs. During the assessment the provider put relevant risk assessments and checks in place. An assessment of risks in people’s homes which could impact upon people and staff was undertaken before the support commenced, for example, risks relating to fire safety, access and room temperature.

Improvements were needed to recruitment and training processes. We identified staff had not attended practical training to use specialist moving and handling equipment such as a hoist, although they had been shown what to do by an occupational therapist. Training was arranged and undertaken promptly when this was brought to the provider’s attention. Training had not been provided in some specialist areas of adult care such as dementia, dysphasia or skin integrity. We did not find anyone had experienced negative impact because of this. We found some gaps in recruitment files such as gaps in staff employment histories, but these were rectified immediately. Staff received regular supervision and appraisals and told us they felt well supported. Checks and references were undertaken to ensure staff suitability for their roles. There were enough staff to ensure people received the support they needed.

Staff received training in infection prevention and control. However, spot checks were not recorded to show that staff were observed by a senior staff member to check their competence and practice in this area. For example, in using appropriate personal protective equipment (PPE) such as aprons and gloves and following good hand hygiene. Staff told us about the PPE they used.

The provider needed to improve medicines processes to ensure that people’s medicines were consistently administered, recorded and overseen safely. We found that verbal advice from people’s GPs was followed, for example, if there were variations to how medicines should be taken. However, the provider had not requested any written confirmation or included information about this in the care plan. This increased the risk of medicines errors or misadministration. Some improvements were needed to the Medicine Administration Record (MAR) to ensure medicines recording was accurate and reduce the risk of any errors. Audits were undertaken but did not identify the issues we found. Relatives told us they were satisfied that safe medicine support was provided and staff communicated effectively with them about this.