Delta Homecare

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 changed to 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.

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 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. Staff told us safety events and actions taken were discussed at the staff meeting to aid learning. A staff member commented, ‘‘The provider shares learning from incidents so we can prevent future risk and improve safety.’’ Lesson learnt reports included recommended actions to prevent re-occurrence and keep people safe.

The service 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 service completed an initial needs assessment before people started using the service. They involved people, relatives and their representatives to develop a care plan. The completed care plans were shared with staff to guide the delivery of care and support.

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 service worked closely with the safeguarding authority to investigate potential abuse and to help put protection plans in place to prevent abuse in the future. Staff told us they knew how to raise concerns and had completed safeguarding training to recognise signs of abuse or neglect and to follow the appropriate procedures to keep people safe. People reported they felt safe around staff and had been aware of who to contact if they had any concerns about abuse or neglect. A relative told us, “Yes, he is safe. I am around a lot of the time, and I see what goes on from afar.”

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. Where risk management plans were in place, these were not detailed enough to ensure staff had all the necessary information to deliver safe care and treatment to people. For example, the provider had not completed appropriate risk assessments on required specialist equipment such as wheelchairs and specialist mattresses. Additionally, the provider had not completed appropriate risk assessments for risks associated with accessing the community, skin breakdown, diabetes management, falls, mental health and behavioural risks, and sensory impairments. Failure to assess, monitor and mitigate risks placed people at increased risk of harm. We spoke with the registered manager, who informed us that they would update risk assessments where necessary and remind staff of the importance of completing them thoroughly to ensure people’s safety.

The service did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Staff had not ensured the regular servicing and maintenance of equipment. However, environmental and fire risk assessments had been completed to promote a safe environment for people using the service.

The provider did not make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not work together well to provide safe care that met people’s individual needs. There were no robust and safe recruitment practices in place to make sure all staff, including volunteers, were suitably experienced, competent, and able to carry out their role. For example, the service had not carried out Disclosure and Barring Service (DBS) checks or obtained appropriate references for some staff. A DBS check is a record of a person’s criminal convictions and cautions. The check helps employers make safe recruitment decisions.

Staff told us they had completed an induction programme before they were able to work independently. However, we found for some staff, there was no documented evidence of spot checks, competency assessment, supervision, appraisal, or induction to assess their knowledge or confirm satisfactory completion of their probation period. Additionally, all staff had out-of-date mandatory training. This included essential training required to meet specific care needs, such as Percutaneous Endoscopic Gastrostomy (PEG) feeding. PEG feeding is a method of providing nutrition through a tube inserted directly into the stomach, used for individuals who cannot eat or swallow safely. At the time of our assessment, the registered manager explained they were currently reviewing staff training and working towards improving staff’s compliance in this area.

The service did not always assess or manage the risk of infection. There were no policies in place and in line with best practice guidance around infection prevention control (IPC), outbreaks and personal hygiene. However, staff told us they understood IPC and wore personal protective equipment, such as disposable gloves and aprons, to help prevent and control the spread of infection to people. People using the service confirmed staff wore gloves and aprons during visits.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People had been consulted about the support they needed to take their medicines. The service had a policy and procedure in place for the administration of medicines. Staff completed the medicines administration record (MAR) when administering prescribed medicines. Staff told us they had undertaken training on administering medicines to ensure people received them safely.