Caremark Hinckley Bosworth Blaby & Leicester

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 62 (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 mostly had a proactive and positive culture of safety, based on openness and honesty. Lessons were learnt to identify and embed good practice. However, governance processes did not always identify service delivery shortfalls, leading to some issues going unresolved for prolonged periods of time.

The providers governance systems and oversight of staff scheduling did not identify issues with staff travel time or the fluctuation of people’s visit times. This meant that opportunities to identify and make improvements were missed.

Systems and processes were in place to record, report and investigate incidents to ensure learning took place and improvements were embedded into service delivery.

Throughout this regulatory assessment the provider was open and responsive to feedback. Leaders demonstrated commitment to ensuring a positive learning culture that promoted safe and dignified care.

People and their relatives we spoke with as part of this assessment told us that they felt confident concerns would be responded to. However, some people expressed they didn’t always raise concerns because they didn’t want to come across as complaining. Records indicated the provider acknowledged and responded to concerns when raised.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. For example, when people’s health deteriorated and they required admission to hospital, the provider ensured ambulance staff clinical health care professionals had all the necessary information needed to keep them safe and that they understood people’s care needs.

The provider worked with people and those close to them to establish a plan of care, and to promote a smooth experience when people moved between services, to mitigate any risks and to ensure continuity of care. For example, when people transitioned from their previous care provider to this service, assessments were completed and information was obtained from relevant stakeholders such as family members, social services and from those who were providing care to ensure they received all the necessary care that remained person-centred.

The provider actively engaged with health care professionals to ensure that people’s care met their needs appropriately.

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.

People told us they felt safe and felt comfortable raising concerns with their care staff and leaders. One person told us, “I always feel safe with the care staff.” Another person told us, “I feel safe, I have a good laugh with them [care staff].”

Staff received training on safeguarding and understood how to recognise and report signs of abuse. Staff spoke fondly about the people they supported and demonstrated care to keep them safe

The provider had systems and processes in place to maintain effective oversight of safeguarding concerns. This ensured safeguarding concerns recorded, reported and any follow up actions were completed.

The provider worked with people to mostly understand and manage risk. However, due to concerns with the scheduling of people’s care visits, the provider could not always be assured that people received care in a timely manner.

Assessments were completed in people’s own homes to ensure care routines were safe and met people’s needs and preferences. One person told us that they had recently received a visit from the Field Care Supervisor to observe and assess their safety when mobilising. However, fluctuations in people’s care visit times sometimes meant that people did not always receive care in a timely manner. One person told us they sometimes had to stay in bed for longer periods than preferred.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. This sometimes included enabling people to care for their beloved pets, support to remain in contact with distant family members, or supporting people to attend events and access their local community to promote wellbeing and social inclusion.

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

Mobility equipment was checked to ensure it was safe for daily use and that annual servicing was completed.

Environmental risk assessments were completed in people’s homes to ensure spaces were appropriate for care delivery, and to promote safe living environments for people. Safe working environment was staff were also considered during this assessment.

The provider had a dress code policy in place that considered people’s safety. For example, the dress code considered if staff members were wearing jewellery or had long nails as these can pose a risk to people when providing care.

People received care from well trained staff that met their needs. However, staff were not always provided with travel time between care visits meaning they were sometimes rushed. One staff member told us, “We don't always get enough travel time. Sometimes I start earlier than my rota tells me to allow extra time. The rotas sometimes mean we have to rush.” Care times often fluctuated, and people were not always informed of when to expect care staff to arrive. One person told us, “They come in the morning, which can vary from 9:00 to 11:45. They don't let me know when they are coming. Tends to muck up most of the morning.” Another person told us, “I don't know what time the carers are coming or who is coming.” We completed an independent review of the providers care time data and this corroborated these concerns. We raised these concerns with the provider and they responded by promptly implementing scheduling restrictions that would ensure people’s care visit times would be more consistent and staff would receive suitable travel time between visits. The provider also made considerations on how best to notify each person of their planned care schedule. The provider acknowledged that it would take some time to roll out and embed these changes into their service deliver.

Staff received regular face to face and online training relevant to people’s care needs. This included delegated healthcare training with specific care needs such as Stoma care and Percutaneous Endoscopic Gastrostomy (PEG). The provider had set up spaces within their office for both theory based and practical learning. Assessments were routinely completed to ensure staff competency with specific health care tasks, such as moving and handling, PEGs, and administering medicines. Staff were given opportunities for further development and learning. For example, two employees had progressed from care related roles on to rota co-ordinator positions, and the provider was proactive and encouraging staff to enrol onto health and social diplomas.

Safe recruitment procedures were in place to ensure staff were suitable for their role. These included background reference checks, criminal record screening, and employment interviews.

New staff completed a workplace induction that included the completion of The Care Certificate: a set of standards developed for the health and care support workforce, to support their induction and development. The Care Certificate provides a framework to ensure that all care and support workers have the same introductory skills, knowledge and behaviours to provide compassionate, safe and high-quality care, in their workplace settings.

The provider had appropriate infection prevention and control (IPC) measures in place. For example, staff use of personal protective equipment when providing care and support. One person told us, “They [staff] use gloves and a apron when they support me to wash.”

Staff were received training in relation to IPC and the staff we spoke with as part of this assessment understood how to maintain IPC through the use of PPE and effective hand food hygiene.

There were clear roles, responsibilities and procedures around infection prevention and control that meet current and relevant national guidance that were set out in the providers policy and procedures.

The provider mostly ensured that medicines and treatments were safe and met people’s needs, capacities and preferences. However, there were some examples indicating this was not always consistent.

Medicine administration records were mostly well maintained. However, we did find one example when the wrong administration code was being used, and there were other examples whereby there was no record to indicate if ‘as and when required’ topical medicines had been administered. People’s daily records had been completed which provided further insight into what care had been provided.

Fluctuating care visit times resulted in some people receiving their medicines at different times each day. Whilst there was no indication of harm occurring to people, but this was not in line with best practice in relation medicine administration which promotes consistency.

We identified one person who was not receiving their medicines as prescribed due to call visit times not being aligned with their personal preferences. We raised this with the provider who took immediate action to consult with health professionals and review their medicines. Health professionals confirmed that no harm had been caused and changes in their medicine routines were put into place that better suited the person’s needs and enabled them to maintain their independence.

Staff received training in relation to safe medicine administrations and competency assessments were used to ensure safe practices were maintained.

The provider’s systems and processes helped maintain quality assurance in relation to medicines. For example, records indicated that medicine audits were effective at identifying and correcting shortfalls. However, we found that not all audits were completed in line with the providers policy resulting in some areas for improvement being missed.