FiNN Homecare Ltd - Head Office

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 inadequate. This meant people were not safe and were at risk of avoidable harm.

The service was in breach of legal regulation in relation to people’s safe care and treatment as people’s medicines were not managed safely, staffing, as staff did not have training in place, fit and proper persons as there was limited assurances around employment and governance at the service.

This service scored 34 (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 did not have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not learnt to continually identify and embed good practice.

Incident and accidents had not been robustly reflected upon to drive improvement, as they had not been always effectively identified. The service did not have systems in place to identify incidents and accidents, such as audits of people’s documentation. An incident and accident log was in place, however, actions documented did not always ensure people were kept safe.

The registered manager told us there were no lessons learnt in place. This meant opportunities to learn lessons from incidents and take appropriate action were missed, and put people at risk of harm as we could not be assured the right actions were taken to keep people safe.

People and their families told us they felt able to raise concerns.

The provider did not always work well with people and health system partners to establish and maintain safe systems of care. They did not manage or monitor people’s safety.

People’s care and support documentation did not evidence it was planned and organised with people, partners, and professionals to ensure continuity. People’s needs had not been fully understood, as care plans had not been reviewed, and risks had not been escalated as required.

Information within people’s care plans was not a reflection of their current needs. This would not ensure important information could be shared with other professionals.

The provider did not work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from avoidable harm and neglect.

There was no oversight of safeguarding’s raised to evidence the action taken to keep people safe.

The provider had not ensured staff had the necessary training in place to keep people safe. One person had skin integrity concerns. Staff documented concerns with the person’s skin several times. There was no care note audit in place to identify these concerns, and staff had not escalated this concern to the management team.

We were not always notified about safeguarding alerts by the service as the registered manager was unaware of their responsibilities to notify the commission.

Staff were trained in safeguarding. People we spoke with told us they felt safe.

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.

Risks associated with people’s care had not always been assessed, identified or managed to ensure people received safe care. The provider failed to ensure assessments and guidance was in place to mitigate risks relating to people’s health needs.

People required support with equipment to reposition and move around their home. Guidance and information about how to safely support people and their mobility needs was not available to staff within the care plan.

The provider had not implemented guidance for staff to support people with their health conditions on a day-to-day basis or in an emergency. There was no evidence in people’s care plans to demonstrate they had been involved in discussions about risk.

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

Environmental assessments had been completed. However, fire risk assessments were not in place for people who required support to evacuate in an emergency.

We asked staff about specific people they supported, and their fire risk. Staff were unsure on how they would support people safely out of their home.

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.

Staff had not received adequate training to perform their role safety. Not all staff had received training in, mental capacity, catheter care, falls, fire safety, food hygiene and pressure care. Staff had not received training in, choking awareness, skin integrity, diabetes, seizure, first aid and Parkinson’s.

Some staff told us they couldn’t remember if they had received training in manual handling, whilst others told us training was out of date, or they had received training from previous care agencies. We heard staff felt they could benefit from further training “I think if we can have more regular training, that would help. Consistent training leads to more knowledge and how to put it into practice.” Some staff had good knowledge of people’s needs; however, some staff we spoke with were unable to explain what they would do to support people with specific training needs.

Systems were not in place to monitor recruitment procedures, to ensure staff were employed safety. The provider did not ensure a documented robust induction was in place to adequately prepare staff for their roles. There was no evidence of, staff application forms, there were gaps in employment which had not been identified, and staff interviews had only recently been introduced. There was no recruitment policy in place and staff did not have risk assessments for identified risks to support them in their role.

Supervisions, spot checks and shadowing prior to staff lone working had not been recorded for all staff. There were no competency assessments in place to ensure staff had the skill to deliver safe care. We could therefore not be assured staff had received appropriate support before starting in their roles.

We received mixed feedback from people who use the service, we heard “I feel they may be short of staff some of the time.” We also heard people enjoyed having a regular staff team and had developed good relations.

The provider did not always assess or manage the risk of infection.

Care plans identified potential risks to people, however, did not detail how to mitigate the risk to keep people safe. The provider had not carried out spot checks on all staff to ensure they were wearing appropriate personal protective equipment (PPE).

Where concerns had been raised regarding staff not wearing PPE, there was limited evidence action was taken to ensure staff were competent in infection prevention and control. The majority of staff had completed IPC training through completion of the Care Certificate and had completed handwashing training.

People told us, “They [staff] wear a uniform and always wear gloves for personal care.”

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

Staff had not received training to manage medicines safely and were not assessed to ensure they were competent.

The provider told us there were people who required time specific medicines, these medicines were not always documented as given at the correct time, which had the potential to impact on people’s health conditions.

Medication was jointly administered for one person by staff and the person’s family. There were periods of time, where staff were not available, the family had no access to the medication administration record [MAR]. Documentation to assess the risk of potential overdose had not been considered.

Where people required support to receive their medications through the use of a Percutaneous Endoscopic Gastrostomy [PEG]. Guidance in place was conflicting and did not ensure staff understood their responsibilities to administer medicines safely. Some medicines being administered to the person were not available on the MAR chart, and staff had not received PEG training to ensure they were safe to carry out this care.

Where people had when required medicines in place [PRN], protocols were not available to ensure staff had the guidance to understand when people required these medicines. Staff lacked knowledge around when to give PRN medicines. We spoke to one member of staff about a person’s PRN medicines. Staff told us the administration of the medicine was at the discretion of the manager.

One person was receiving support with suppositories without training or guidance in place. There was no MAR chart in place for this medicine, and the use of suppositories was not included within the person’s care planning.

Care plans contained conflicting information around people’s prescribed creams. There was limited information and or guidance on where creams were required to be applied, as there were no body maps in place to help guide staff, and creams were not always included on MAR charts.

Staff were supporting people to organise their medicines into dosettes. This meant staff were supporting people with secondary dispensing, which increases the risk of medication errors. This put people at risk of not receiving their medications as prescribed.