Trimarge Care and Clean 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.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained the same.

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 Safe Care 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.

Lessons were not always learnt to continually identify and embed good practice.

Robust systems were not in place to learn from lessons following incidents.

An accident and incident policy was in place that detailed the process to manage accidents and incidents and to learn lessons. Records showed that accidents and incidents were recorded for a person who had a fall along with actions taken. Lessons learnt information had been completed. However, the information had not been analysed in full to mitigate the risk of re-occurrence as a falls risk assessment had not been completed to ensure the person was safe from falling when receiving care and support.

Due to lack of robust systems on learning from lessons there was a risk the person may not receive the support required to minimise the risk of falls.

The provider did not always manage or monitor people’s safety.

Systems were in place to capture information as part of the pre-assessment process to determine if the service can support people safely. This included speaking with the referring agency, the person and their relatives.

Records showed pre-assessment had been completed prior to supporting people to determine if the service can provide safe care and support and risks had been identified as part of the pre-assessment process. However, the information on risks had not been effectively used to create risk assessments to ensure people received safe care at all times. This meant robust systems were not in place to ensure information captured at pre-assessment stage were assessed and used effectively to provide safe care to people.

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.

There were processes to safeguard people from abuse and harm. The service had a safeguarding policy that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse, to ensure people were protected.

Staff had been trained in safeguarding adults and understood how to protect people from harm and who to report to when required. Staff were able to tell us the importance of reporting any concerns to the management team. They also felt they could be open to the management team if they had any concerns. A staff member told us, “Safeguarding is protection of the lives of service users and keeping them safe from any types of abuse. Different forms of abuse, financial, physical emotional. Report it by making sure you document it and then report to manager who will inform LA and CQC.”

The provider did not always work well with people to understand and manage risks.

Risks to people were identified and included on care plans. However, risk assessments were not in place to ensure identified risks were mitigated.

Records showed a person was at risk of falls and a person had a specific health condition. Risk assessments had not been completed in these areas to ensure people received safe care at all times.

We fed this back to the nominated individual who informed risk assessments would be completed.

Failure to have robust risk assessments in place meant there was a risk people may be exposed to avoidable harm.

The provider did not always detect and control potential risks in the care environment.

Robust systems were not in place to ensure assessment of the environment had been completed at all times.

Risk assessments had not been completed on people’s home environment at all times. Records showed that environmental assessments had been completed for one person. Information included details on risks or hazards within the environment to ensure care and support could be provided to people in a safe way and risks to staff and people were minimised such as on fire and electrical hazards. However, the same level of assessment had not been completed for another person, which meant potential risks within the environment may not have been identified when supporting the person.

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.

During our last inspection, we found pre-employment checks had not been completed in full to ensure staff were safe to work with vulnerable people.

During this assessment, we found improvements had been made.

Systems were in place to recruit staff safely. Pre-employment checks had been carried out such as on criminal records and identity checks and references had been sought.

Staff had received regular supervision to ensure they were supported in their roles. Staff told us that they received regular supervisions and were supported. A staff member commented, “Yes, get support from both management and colleagues. Manager is very friendly and is always prompt when it comes to responding to us.”

We found staff had been trained in a number of key areas such as with safeguarding and moving and handling. Staff completed the Care Certificate training. The Care Certificate isa set of 16 mandatory standards for healthcare and social care support workers in the UK, developed by Skills for Care, Skills for Health, and NHS England. Staff were also trained on specific areas such as on epilepsy and learning disabilities. A training matrix was in place that allowed management to have oversight of training including when refresher training was due.

The service used a digital system to monitor staff timekeeping. The system alerted management if staff were late for calls, which then the office could monitor. The system gave the service oversight of staff timekeeping. The data showed staff arrived to calls on time. A relative told us, “They turn up on time.”

The provider assessed and managed the risk of infection. Systems were in place to prevent infections.

An infection and control policy was in place. Staff were able to tell us the process of ensuring people were protected from infections such as good hygiene protocols and wearing personal protective equipment and that they had been trained in infection control. Records confirmed staff had been trained on infection control.

Audits had been completed on infection control processes to check systems were robust.

Robust systems were not in place to manage medicines safely.

The service used a digital system to record medicines administration. Staff signed the electronic medicines administration records (MAR) to show that medicines were given as prescribed. Care plans included the support people required with medicines and the type of medicines people needed support with.

Records showed there was a missed entry on a MAR chart. The nominated individual told us that medicine had been administered and due to technicality on the system this was not processed correctly as administered. The staff member confirmed they administered the medicine. We checked the daily logs of the person to check if medicine had been administered and did not get assurance from the daily notes that medicine was administered. The nominated individual informed they would be moving to a new system, which should ensure safe and effective record keeping on medicines and would ensure daily notes were completed correctly.