Profad Care Agency Limited

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 changed to good.

Good: This meant people were safe and protected from avoidable harm.

This service scored 69 (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 always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

People and their relatives told us they felt comfortable speaking with staff and the office. They were aware of how to make a complaint and felt confident to do so. One person told us, "The office is very good. I would approach the office with any concerns. Or I would approach Adult social services. No concerns. If I was not happy, I would look for another service”.

There was a system in place for recording incidents and accidents. However some required further information and clarity to evidence all actions taken, this was discussed with the registered manager during this assessment.

Regular staff meetings took place, and staff told us they felt their induction was appropriate.

The service had an action plan in place which we were told would be further developed to be a live document which would support the service to add concerns as soon as identified.

The provider 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.

Prior to people receiving care their needs were assessed by the service to ensure they could be met. People's care records reflected their needs and provided guidance for staff to support them safely.

People received their care and support from a consistent team who knew them well which supports good continuity of care. One person told us, "My (relative) was caring for me and they had a friend who knew about the service. Someone came out from Profad. They spent a couple of hours covering all I needed." Another said, “Was in the hospital and they came out and did an assessment. They came out for an hour. They asked about medication and what (relative) likes for breakfast among other things like what they like to do. (staff member) is very good. If I raise anything, (staff member) takes care of it. We feel really lucky."

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 with staff and would raise any concerns with the office if needed. Staff had received safeguarding training and demonstrated understanding of how to recognise and respond to safeguarding concerns giving recent examples. The registered manger understood their responsibilities to report safeguarding matters to external agencies. Systems were in place to record and monitor safeguarding concerns, and staff had access to relevant policies, including safeguarding, Mental Capacity Act, equality and whistleblowing, through the provider's electronic system.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People and their relatives were generally confident risks were identified and managed to help them remain safe. One person told us, "I am at risk of choking and have been referred to Speech and Language Therapy (SALT)” A relative told us, "Originally a few falls. (Relative) had physio. I uploaded exercises (relative) needed to carry out. I have only seen in the care notes that this was carried out a couple of times. I will follow up."

People had relevant risk assessments in place including falls and emollient creams, and these were available to staff via electronic devices.

Staff understood how to access and use risk information and contacted the office when connectivity issues affected access.

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

An environmental risk assessment of people's homes was carried out as part of the pre assessment, to identify whether the person's home was safe and suitable for staff to provide support.

One person told us, "We have decluttered. They look at her environment all the time." another said, “They make sure I have a safe environment”.

Equipment used was checked regularly and all within service date.

Staff had received training in health and safety as well as fire and moving and handling.

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.

We reviewed staff files, training records, induction and supervision information. We found the provider mainly followed safe recruitment processes and staff received training, observations and regular spot checks. Evidence of Disclosure and Barring Service (DBS) checks were in place. DBS checks provide information including details regarding previous convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

Gaps in staffs’ previous work history were explained, and references were in place, however, not all referee email details had been verified. We discussed this during this assessment, and the registered manger assured us this would be addressed going forward.

Training matrices confirmed staff training was in date. Staff told us they felt they had received appropriate training, with a mix of on-line and face to face training.

People and their relatives told us they felt that staff had been appropriately trained. One person told us, "They are trained to support me and use the hoist. They always turn up. They clock in and out." Another said, "Yes, they have the training. Odd occasions running late. Will call if stuck at the previous call. Always notified. None has left early. Even if they are done, they won’t leave."

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 told us staff used personal protective equipment (PPE) appropriately when they received support with their care.

One person told us, "They clean up after supporting me. They wear gloves, aprons and masks." Another said," Make sure we are clean. They wash the bowl that they use for the strip wash. They clean down the sides after they have made breakfast. They wear aprons and gloves."

Staff told us they had adequate supply of PPE and had received infection prevention and control training. There was an infection control, policy in place.

Staff had completed medicines training and competencies were regularly assessed. People's care plans detailed clearly whether support was required with medicines and not all people required assistance.

People spoke positively about medicines support and staff responsiveness. One person told us, "They do my prescribed medication. My relative gives me my vitamins. No issues. I get the medication from the chemist. The carers will pick up if my medication needs to be replenished. They let me know and we ring the pharmacy or Profad management to do it for me. They found that I had a sore on my heel. I got some cream, and the district nurse ordered me some boots to wear at night. This was added to my care plan”. Another said, "They are medication trained, no concerns."

As needed medicines (PRN) protocols and body maps were in place, although some PRN records lacked clarity when to contact GP and review dates these were updated during this assessment. However, the provider did not always ensure medicines were administered as prescribed. This included a lack of evidence that some medicines were given at appropriate times in relation to food or caffeine, missing opening dates on medicines, and the absence of specimen signature sheets in line with the provider's medicines policy. While medicine audits were in place, they had not identified these issues. The registered manger took immediate action to address these concerns during this assessment, but further improvement was needed to ensure consistent and effective medicines governance.