Loving Angels Care (West and North Northamptonshire)

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

This service scored 66 (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.

The management team had systems in place to record and monitor accidents and incidents which were reviewed to identify any themes or trends. However, they relied on care staff to inform them of any incidents, as the care planning tool (PASS) they use does not automatically send notifications.

The registered manager told us they complete six monthly learning exercise and analysis all the concerns. We saw evidence of investigations being completed and meetings being held with staff to discuss areas of concern and where improvement was required.The management team responded well to all concerns we raised during this assessment and implemented changes where necessary. The staff we spoke with had the confidence to raise concerns and were mostly confident these would be acted on by the management team.

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.

People’s care records included detailed information about their on-going health and where appointments with other services were needed. Peoples care plans were available in their homes for visiting health professionals. However, these were not always kept up to date or person centred. For example, some care plans referenced hoists, even when the person did not require or have one. We discussed this with the registered manager, and they assured us that the care plans have been updated electronically, and they were in the process of rolling out the updated copies in people's homes.

Staff had access to the information they needed to seek appropriate medical attention from GP, district nurses and emergency services. However, we received feedback that staff were not always confident in ringing emergency services, the management team were aware of this and had taken measures to improve staff confidence.

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. Staff had received safeguarding training and those we spoke with demonstrated a good understanding and expressed confidence in raising concerns. The provider had systems in place to record, analyse and investigate safeguarding concerns. The service had a safeguarding lead responsible for overseeing all safeguarding concerns. We saw evidence of the management team working closely with the local authority safeguarding team.

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

At the last inspection we found risk assessments were not always in place or did not always contain the relevant strategies to ensure staff understood how to mitigate risks identified.

At this assessment the provider had made enough improvements and was no longer in breach of regulation.

People had risk assessments in place which were easily accessible to the care staff with copies also held at people's property. However, some were not relevant to the person, for example smoking risk assessments were in place for people who did not smoke. We brought this to the registered managers attention. Additionally, some risk assessments in people’s property were dated for renewal 2024. The registered manager assured us the renewals had been completed and confirmed the paperwork was updated during the assessment.

One person who had oxygen in their property, but there was no risk assessment in place. When we discussed this with the registered manager, they assured us a risk assessment would be completed. However, we did see appropriate risk assessments were in place for other specific conditions, such as epilepsy and for people who use feeding tubes (PEG).

Staff provided care to meet people’s needs that was safe, supportive and tailored to meet people's individual needs and preferences. For example, care call times were adjusted to enable people to attend their place of work or volunteer group. When people were on time critical medication the service sought guidance from their GP on appropriate actions and timescales in case the person was delayed in returning home for their medication.

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

People's care plans and risk assessments contained information which evidenced that the safety of people’s home environment had been considered. This also included guidance for how people would like to be assisted in an emergency, such as a fire.People told us staff checked their smoke and fire alarms weekly. We saw evidence of staff checking people’s equipment for the date of service renewal.

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’s individual needs were assessed, and appropriate staff were assigned to ensure they received the care they needed. Staff were allocated to the same people as much as possible and people appreciated that. One person said, "You can have good conversation when you know each other", another told us “They are generally only late, when it is a different carer."

During the assessment we reviewed 5 staff files, and found evidence of competency checks, spot checks and regular effective supervisions, as well as regular team meetings.

Staff told us they felt they had received the training they required for their role.

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.

Staff had received training in infection prevention and control, including the correct use of personal protective equipment (PPE). Staff told us there was always a good supply of PPE. Which they collected from the office as needed. However, they also told us that the time spent collecting their PPE was not paid for. A person told us "They are very respectful of our home, they either take their shoes off or they will wear covers on their shoes, they also wear gloves and aprons and dispose of them properly and they leave the house clean and tidy." During this assessment we observed staff using good infection control practices during personal care and PEG administration.

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

Staff received training and had their competency assessed. However, the competency assessment records required further information and clarity, for instance what was being observed. We discussed this with the management team who assured us they would implement these changes.

Where people required ‘time critical medicines’ such as medicines to reduce the symptoms of Parkinson’s disease, calls were planned and prioritised to ensure people received their medicines when needed. This helped to ensure people’s health and wellbeing was maintained through safe and timely medicine administration. Additionally, advice had been sought from the GP regarding timescales and actions to take if the person did not take their medication at the designated time.

The management team conducted regular audits. However, we were not assured that the weekly stock counts were accurate because care staff did not consistently record whether one or two tablets were administered for ‘when required’ medication (PRN). We discussed this with the management team, and they assured us that new procedures would be implemented to address the concern. Records showed when errors were identified during audits, the staff member were invited for a discussion and action plan was agreed upon to support improvement.

We found discrepancies regarding a person's ibuprofen gel, which was prescribed to be administered every 8 hours. On occasions there was only a 3-hour gaps between applications. We discussed this with the management team, and they provided assurances on how this issue would be addressed.

One person told us “They have been great with administering the meds”.