Primrose Healthcare 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 remained as 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.

Processes were in place to learn from accidents to prevent further occurrence. The registered manager told us, “We would call in the staff for a meeting. Sometimes face to face meetings, sometimes video call meetings. Sometimes it will result in retraining or 1:1 supervisions, sometimes a conversation about what went wrong and what can be done better.” Staff confirmed this, with one staff member stating, “When accidents or incidents occur, I complete the required documentation promptly and accurately. Lessons are shared through team meetings, handovers, and management feedback. Risk assessments and care plans are updated where required to reduce the likelihood of recurrence. Reflective practice is encouraged so we can continuously improve.” Good record keeping aided this, with accident and incident folders clearly detailing what had occurred, any actions taken, and lessons for improvement.

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 provider used an electronic call monitoring system which enabled them to track visits in real time. This displayed when staff had ‘clocked in’ to a care visit at a person’s home, or if there was any lateness. Any discrepancies were followed up with staff as they occurred. This ensured people received their prescribed care when it should happen.

Staff told us they informed the provider’s office and people if they were running late due to traffic so they were kept up to date. One staff member told us, “Electronic call monitoring systems record when staff arrive and leave a service user’s home. However, I believe it is my personal responsibility to arrive on time and complete my full shift, as service users rely on consistent care. I always plan ahead, allow extra travel time and communicate immediately if there are any unexpected delays.”

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.

Staff were aware of their responsibility to safeguard people from harm and abuse. One staff member told us, “I complete mandatory safeguarding training and refresher courses regularly. I follow the company’s safeguarding policy and report any concerns immediately to protect people from harm or abuse.” Another staff member added, “I keep up to date by completing the safeguarding training provided and attending team meetings where safeguarding is discussed. I know that if I ever see or suspect abuse or poor practice, I must report it immediately to the manager so it can be dealt with properly.” Safeguarding concerns were clearly documented and reported to the appropriate authorities so they could be investigated.

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.

On the whole, care plans and risk assessments contained the information required for staff to be aware of people’s care needs. This included information around their health, mobility, and personal care needs. One person told us, “[Staff are] very helpful. They understand my health issues and adapt to how I am when they visit. If I am too weak to have a shower they give me a strip wash.” Where we did identify areas in which further information was required in care plans, these were addressed in a timely manner by the registered manager. We were fully assured by the action taken and this had not had a negative impact on people.

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

Assessments of people’s home environment were made prior to care being delivered. These identified any potential risks to people and staff such as trip hazards and if fire alarms were in place. This allowed the provider to ensure any risks identified were minimised to prevent an incident occurring.

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 and their relatives felt staff were appropriately trained. One relative told us, “Staff seem well trained and know what they have to do for [family member] without asking.” Another relative said, “Carers seem quite experienced and confident in what they do.” Staff were up to date with their mandatory training in various areas of care delivery such as pressure area care, nutrition and hydration, and moving and handling. We did identify that some carers were delivering care to people with diabetes without having specific training in this area. However, we did not identify that this had had any impact on the person. We informed the registered manager who told us this would be resolved.

On the whole, staff arrived on time and stayed the full length of the care visit. If there was an event that caused lateness, this was communicated to the person. One person told us, “Staff stay as long as I need them. I get a phone call if they’re running late. It cannot be helped if they have had an overrun with previous client.” A relative said, “Always punctual, tends to be in a time slot. Last week we got a call to say carers had a flat tyre couldn’t get there and they offered to send another carer.”

Staff were safely recruited into the service. This included gaining references from previous employers and a Disclosure and Barring Service (DBS) check. This confirms if potential new staff members have any convictions and are of good character to work with people who required care and support.

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 followed safe infection prevention and control (IPC) practices. One staff member told us, “I wash my hands properly, wear personal protective equipment (PPE) correctly, keep the environment clean, and dispose of waste safely.” Another staff member added, “I follow infection control training, wash my hands regularly, and use PPE [personal protective equipment] such as gloves and aprons when providing care. I also follow the guidance and policies in place to help keep people safe.”

PPE stock was kept in both people’s properties and the office. Staff were able to collect more stock from the office if required, and senior carers also supported with monitoring stock levels.

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

Medicine administration records (MAR) were completed in full. The registered manager told us, “The system won’t let you log out unless you’ve confirmed [medicines] has been done.” People and their relatives confirmed this, with one person saying, “They make sure I take my medication 3 times a day and always order and collect the medication for me.” A relative added, “Carers makes sure [family member] has their medication before they leave.” Audits of MAR were completed monthly to identify any shortfalls or discrepancies.