Aurora Home Care Ltd

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. This key question was previously rated good. The key question is now rated 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 provider was in breach of the legal regulation relating to safe care and treatment.

This service scored 56 (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 work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. The service did not demonstrate a strong culture of learning from safety events. While staff were aware of risks people faced, there was limited evidence of structured lessons learned, analysis or improvements following incidents. The provider did not have in place clear systems for sharing learning across the team. Governance systems were still being developed, and audits were not embedded to identify trends or drive improvement. External partners had given clear guidance regarding which areas to improve and by when, and this had not always happened.

Systems to manage care pathways were in place but not fully effective. The electronic care records system lacked complete, individualised care plans and risk assessments. Staff relied on basic summaries and historical information rather than detailed, person-centred plans, which increased the risk of gaps in care, particularly for newer staff. There was a lack of effective formal incident reporting processes. These shortfalls meant the provider could not assure safe transitions or continuity of care.

Staff received safeguarding training and understood how to escalate concerns, but governance arrangements needed improvement. The registered manager recognised the need for more comprehensive safeguarding training, but this had yet to be delivered. There was no structured audit of safeguarding incidents, and the quality assurance system was still being built. While people generally felt safe on a day-to-day basis, safeguarding systems were not fully robust. There were appropriate safeguarding policies in place. One person said, “I am very safe here.”

People were not consistently involved in managing risks, and risk assessments were often not fit for purpose or absent. There was a lack of sufficient detail for specific conditions. This meant people were at risk should their conditions change unexpectedly, because staff did not always have relevant information about their condition. The registered manager took immediate action in order to improve this and reduce risks.

Reviews and auditing arrangements had not identified or acted on these shortfalls, and care records lacked information about positive risk taking (although there were elements of positive risk taking when we spoke with staff). The electronic records system had a scoring framework when assessing specific risks, but this was not consistently understood or applied by the service. There was no significant impact on people who used the service, because staff knew people well, but there was a significant ongoing risk of harm with the risk assessments as they were in place. The registered manager continued to make improvements following the assessment and we have asked them for an action plan to provide further assurances.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People who used the service confirmed staff were respectful and helped them maintain their home as they wanted. Staff helped people take pride in cleaning, cooking, tidying, washing, etc.The provider’s office environment was secure and met basic health and safety requirements, with accessible facilities and clear signage. No client information was visible to unauthorized personnel, and infection control measures were evident in the office setting. The provider had appropriate policies in place.

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. People confirmed staff were supportive and stayed to help them. Staff worked consistent shift patterns to ensure people had the 24 hour support they needed and could do the things they wanted to do.

The senior care co-ordinator demonstrated a sound understanding of the importance of the continuity of care for people using the service. Any unexpected staffing changes were managed effectively.

Staffing levels were sufficient. Recruitment checks such as DBS were in place, although some files lacked verified ID and references. Induction and supervision processes were positive, but there was a backlog of supervisions and gaps in face-to-face training for medicines and moving and handling. Despite these issues, staff demonstrated good knowledge of risks and care needs.

Infection control policies and procedures were in place. Staff had completed relevant training, and no concerns were raised by people using the service. PPE use and hygiene standards were maintained, and staff maintained appropriate handwashing practices.

Medicines and treatments were not always safe. The administration of medicines met people’s needs, capacities and preferences. While medicines records reviewed were generally completed well, an effective medicines auditing regime was not in place at the time of inspection. We identified some shortfalls that auditing should reasonably have picked up, for instance handwritten documentation lacking key details and not integrated into the main system.

Face-to-face medicines training had not yet been implemented, despite advice given by external partners. One staff member said, “We need more face-to-face medicines training to talk through the practical things.” People expressed confidence in the staff who visited them, and their knowledge of their medicines needs.