Blue River Home Care Waltham Abbey Also known as Blue River Home Care Greater London

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 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.

The service was in breach of legal regulation in relation to people’s safe care and treatment. The registered manager did not always ensure that risks to people’s health and safety were fully assessed. Risk assessments were incomplete and did not include all relevant risks identified. Care plans were not consistently detailed, accurate, or up to date to effectively guide safe care delivery.

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 did not always demonstrate a proactive and positive learning culture that consistently led to improvements in care. Although staff told us they reported concerns and incidents, systems were not always used effectively to ensure learning was embedded across the service.

The registered manager reviewed accidents and incidents to identify where actions were needed, however this learning was not consistently reflected in care plans or risk assessments, which were not always updated to reflect changes in people’s needs. This meant opportunities to learn and improve were not always fully realised.

Staff spoke positively about their roles and the support they received and were able to describe how they responded to people’s needs in practice. However, the provider could not always demonstrate how learning was systemically shared or used to drive continuous improvement across the service.

Although the service demonstrated good communication with healthcare professionals and other partners, this was not always reflected in people’s care plans. Assessments undertaken before people received care from the service were not recorded as formal documents, which meant there was a lack of clear documented evidence to support safe planning and continuity of care.

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 for example with the local authority and community nurses. The registered manager told us, “We had a safeguarding situation where we suspected financial abuse so we involved the police, it was very challenging, a court order was put in place. We were the first people to spot what was going on.” Care workers demonstrated an understanding of safeguarding and had received relevant training.

The provider did not always work well with people to understand and manage risks. People's care plans and risk assessments were not personalised and lacked the information staff needed to provide support safely. For example, risk assessments in relation to seizures and falls were not consistently robust. Despite this, staff were able to demonstrate a good understanding of people’s individual needs and risks through their knowledge of those they supported. This provided some assurance that in practice, risks were being recognised.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. While some care plans and risk assessments were in place, these were not consistent or up to date and did not always identify all potential hazards. For example, one person’s care plan stated, ‘Carer to ensure I use the stair lift correctly and it’s fastened well’, however there was no follow up or individual risk assessment in relation to this. This meant staff did not always have clear guidance on how to manage risks safely.

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. Staff told us they were supported with an induction and were given the opportunity to shadow more experienced staff when they first started working. One care worker told us, “I feel confident with the training I receive. One to one’s and supervision are usually once a month. [Registered manager] comes and does spot checks to check everything is ok. She also phones.” Another care worker said, “We have online training every year.” A third care worker stated, “If I need to go off sick there is always cover for me.”

Checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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. One care worker told us, “I have enough PPE (Personal Protective Equipment). It’s always there. We always have it. If it’s running low, we can always get it. Everything is provided when we need.”

The provider did not always demonstrate that medicines were managed safely and in line with people’s needs. Staff had received medicines training which was confirmed through records. Not all people required support with their medicines, as some self-administered or were supported by family members.

People who were supported with their medicines by the service told us they received their medicines as prescribed. However, some people were unsure how or where this was recorded, and records were not always consistently maintained. This meant the provider could not always evidence how medicines were managed, monitored and reviewed to ensure safe and consistent practice.