Visiting Angels Care Also known as Visiting Angels

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 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. Accidents and incidents were logged and investigated. Staff discussed incidents in meetings in a way which focused on openness and improvement. A staff member told us, “We learn from when things go wrong and are offered additional support or training if needed.” The registered manager was open and honest throughout the assessment and implemented immediate improvements when shortfalls were highlighted.

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 were regularly supported to access appointments with support from staff to manage their health. There were clear pathways and guidance in place for people’s health and care needs, setting out when staff might become concerned about a person’s wellbeing and need to make a referral to a partner agency. A professional told us, “The service communicated with us in a timely manner for [person’s] 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 service had safeguarding systems and processes to protect people from abuse and neglect. The provider shared concerns quickly and appropriately. People told us they felt safe when receiving care from the service. A person commented, “I feel very safe. I am being looked after well. The carers are friendly and they know how to look after me.” A relative told us, “[Loved-one] is safe when the carers are with them, the carers are very kind and supportive.” Staff understood what safeguarding meant and felt confident to raise concerns. They told us they would escalate issues promptly and believed leaders acted quickly. Staff had access to safeguarding training and the service’s policies advised them on how to respond if they witnessed poor practise. We assessed whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). We found mental capacity assessments decision specific and reflected people’s individual abilities to make decisions about their care and support.

The provider did not always work well with people to manage risks. Although processes were in place to assess risks, these systems were not always effective in ensuring risks were clearly documented and appropriately highlighted within people’s care records. While we did not identify any immediate risk of harm, we found variations in the quality of risk documentation across different people’s care records. For example, for a person who had recently joined the service, there was a lack of risk assessments and limited information relating to their health conditions, medications and equipment. In contrast, other care records contained detailed and informative information that supported effective risk management.

We received mixed feedback from staff regarding whether care plans contained sufficient information to support safe care. Some staff reported important details were not always clearly recorded and risks were not consistently highlighted. One staff member told us, “Sometimes with a new client I have had very little information on the persons care record, there have also been calls with no tasks to complete at the call, so a new carer doesn't really know what to do.” Another staff member commented, “Yes, care records are sufficient in the information they display.” This information was shared with leaders, who took immediate action to update the person’s care records. They also outlined the improvements being made to ensure care documentation was accurate, consistent and fully in place going forward.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Equipment was available to support people to mobilise safely and to receive personal care. Staff were trained in the safe use of equipment and completed regular competency checks to ensure people were supported appropriately and the risk of harm was minimised. The service had a dedicated area within the main office where equipment was available, allowing staff practice to be observed as part of training. People’s home environments were assessed to identify potential hazards, and these assessments were reviewed regularly to help ensure people and staff remained safe. Staff understood how to identify and report environmental risks and were confident these would be addressed promptly.

The provider made sure there were enough qualified, skilled and experienced staff. They worked together well to provide safe care that met people’s individual needs. Staffing levels were suitable to meet people’s needs, and rotas showed appropriate cover was in place. The required recruitment processes and checks were completed when recruiting new staff.Staff training records were reviewed and showed mandatory training was up to date, including learning disability and autism training, and training specific to individual needs where required. Performance management processes and recruitment policies were in place and aligned with current guidance. People told us they felt staff were knowledgeable about their roles, telling us, “The carers are well trained and very professional.”

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. Staff had access to enough personal protective equipment (PPE) to allow them to carry out their role safely. Staff told us, “When I’m working, I always wear the appropriate PPE (apron masks and gloves).” Staff had also completed training in infection prevention and control (IPC) and knew how to implement good practice within their role. A person told us, “They [staff] wear fresh PPE each time they visit me.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Although we found no evidence people had come to harm, improvements were required in relation to the service’s knowledge and application of ‘as and when required’ (PRN) medicines. We were not assured that staff always had access to clear and consistent information about when these medicines should be administered. We identified conflicting information within Medication Administration Records (MAR) charts and care records regarding whether people were able to manage their own medicines independently. However, people told us they had no concerns about how their medicines were managed. One person said, “They do all the medication in the morning. There have been no issues.” Another person told us, “There are no problems with my medication. I can ask for paracetamol if I feel I need some. They are very diligent at applying barrier cream to my skin after they have washed me.” We found staff had completed appropriate medicines training, and their competencies were assessed regularly to ensure safe practice.