Careuk247 Home Care Cambridgeshire

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 requires improvement. At this assessment the rating has remained 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 and the ways people’s medicines were managed safely.

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 promoted a culture of safety based on openness, honesty and a willingness to listen to concerns raised by staff. Opportunities remain to strengthen governance systems to support a more proactive approach to identifying, monitoring and mitigating potential risks moving forward.

The registered manager shared examples of learning lessons when things went wrong. Reviews and investigations were completed, when required, which helped improve practice and staff knowledge. Staff told us they received good communication from office staff and felt able to approach them with any concerns.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care, including when people moved between different services.

Pre-service assessments were not consistently thorough and did not always provide a complete picture of people's needs, preferences, and individual wishes, including detail of the level of involvement and support they wanted from carers. This meant there was a risk, care packages may not have been fully tailored to people's circumstances from the outset.

We also found staff carrying out assessments had not always received the appropriate training for this role which further increased risk. The provider should review assessment processes and ensure those staff undertaking assessments are suitably trained and competent to complete comprehensive and effective assessments.

Whilst the provider responded to the concerns identified during the assessment, we could not be assured that improvements had been fully embedded or that effective oversight arrangements were in place to sustain these changes and reduce the risk of recurrence.

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 identified quickly and appropriately.

Since our last assessment, the provider had strengthened its safeguarding reporting procedures. We saw evidence of the provider working with other professionals to promote the safety of people. Staff knew how to report concerns internally, and to the local authority.

Staff had completed safeguarding training and were able to explain how concerns should be reported. Safeguarding information was available, and the registered manager and staff demonstrated awareness of their responsibilities. Staff understood the principles of the Mental Capacity Act 2025 (MCA) and the importance of supporting people to make their own decisions wherever possible.

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments and supporting protocols were not always in place or sufficiently person-centred. For example, 1 person living with epilepsy did not have a suitable care plan or risk assessment that reflected their individual needs. Care plans were not suitably detailed to reflect skin integrity concerns and staff recording was not always descriptive of their findings. We found further examples where health conditions were not appropriately assessed to consider risk reducing measures for activities, such as moving and handling.

People who required support to use specific medical equipment did not always have clear guidance in place within their care plan. This meant up to date information was not available to guide staff, and we found care plans sometimes contradicted the actual support and assistance being provided to people.

The provider had agreed to undertake a delegated health care task for an individual requiring support with a specialist clinical need. We found robust clinical oversight was not in place, nor had it been identified as required by the provider. This meant staff competency assessments had not been completed in all instances, where skill and knowledge should be routinely assessed by a competent person.

We found care plans and risk assessments lacked sufficient details about the specific actions staff should take to manage and mitigate risks, and risks were not always clear due to lack of detail, or them not reflecting current care provision. The provider used a main care plan electronic system, however also had stand alone electronic care plans for specific needs. These standalone care plans were not referenced in the main care plan, which posed risk of staff not referring to these. One person told us, “9 times out of 10 I have to tell [irregular staff] what to do.”

Whilst we found no harm had come to any person during this assessment, risk of harm was present due to a failure to ensure records and care plans clearly and consistently reflected people’s needs.

Whilst the provider responded to the concerns identified during the assessment, we could not be assured that improvements had been fully embedded or that effective oversight arrangements were in place to sustain these changes and reduce the risk of recurrence.

The management and senior staff team assessed people’s home environment for risks. These assessments included individual rooms, access requirements and action to take in the event of an emergency.

People and their relatives told us there had been improvements in staff support. Specifically, in the security of their home and how environmental risks were managed. The provider-maintained oversight of specialist equipment to ensure safety checks were completed on a timed basis.

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 provided positive feedback about their regular care staff and told us when they had consistency of carers, this helped them feel comfortable and supported. Staff received regular supervision and annual appraisals. Training records showed staff had completed most core mandatory training modules. However, specific training was required to ensure staff had the necessary knowledge and skills to support people with specific health conditions which is further commented on in the well-led section of this report.

Senior staff undertook spot checks to monitor the standards of care people received, and to check staff worked in line with the providers procedures.

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. People and their relatives told us staff were mindful of infection control procedures when entering their homes.

Staff told us they had access to appropriate personal protective equipment (PPE) to support safe care delivery and reduce the risk of infection. Records showed staff had completed infection prevention and control training, providing assurance they had the knowledge required to follow safe working practices.

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were not involved in planning.

Medicines processes were not always safe. We found records did not always clearly identify how medicines should be administered and by who. Nor were clear care plans in place which provided information about the purpose of each medicine, or any potential side effects to monitor for. Without this information, staff may not identify medicine-related concerns promptly, which could increase delays in responding to changes in a person’s health and wellbeing.

Where staff, people or their relatives had a role in the administration or ordering of medicines, this was not clearly recorded within the care plan. We also found an instance whereby staff were administering medicines from a container which had not been safely set up by a pharmacist. This meant risk was present due to staff administering medicines from an unsafe and unapproved system, and they could not be sure of what they were administering.

People required staff support to administer their medicines in various ways, to support their wellbeing and safety. We found formal authorisations to administer medicines were not always in place and had not been identified by the providers own governance systems. The registered manager obtained these during the assessment timeframe and ensured specific records were updated.

Where medicines were administered through patches applied to the person's skin, systems were not followed to ensure the site of administration was rotated. This could cause the person to experience skin irritation and may have affected the absorption rate of the medicine leading to a variable dose of medicine being administered. Whilst medicines audits were completed by care staff, there was insufficient evidence of physical checks by senior staff or management to verify the accuracy of records and provide assurance that medicines processes were being effectively monitored. This gap in oversight meant areas for improvement were not identified by the provider to ensure appropriate actions were completed.

Whilst the provider responded to the concerns identified during the assessment, we could not be assured that improvements had been fully embedded or that effective oversight arrangements were in place to sustain these changes and reduce the risk of recurrence.