Bateleur HC 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.

This is the first assessment for this service. This key question has been rated 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 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 confirmed the registered manager was supportive, approachable and committed to delivering high-quality care. Staff told us there was a positive, supportive and learning culture, where incidents were openly reported, appropriately investigated and used as opportunities to improve practice and prevent recurrence.

Staff meeting records demonstrated that service delivery, identified areas for improvement and learning opportunities were discussed. Actions were agreed, allocated and monitored to ensure continuous improvement and good outcomes for people using the service. This showed the registered manager promoted an open culture and actively engaged staff in developing and improving the service.

Incident management procedures and monitoring records showed how incidents were reported, investigated and learning opportunities identified. An example of this was how care call monitoring had identified expected care visit times were not consistently being met. Action was taken to review the scheduling rota to ensure staff had sufficient travel time.

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. However, improvements were required in the provider’s pre-assessment process.

People told us they were involved in a pre-assessment process where their individual care and support needs were discussed before care commenced. People also confirmed they participated in meetings to discuss their care package and any changes required to ensure support remained appropriate. One relative said, “Yes, they [management team] did assess my relative before they started to have care.” Another person told us, “I’ve attended review meetings with social services and the manager of the service.”

The provider had a pre-assessment and care review procedure in place. However, when we reviewed a sample of these records, we found some information lacked sufficient detail and other relevant information was missing. Although we did not identify any evidence that people had experienced a negative impact as a result, incomplete records presented a potential risk that people's needs may not always be comprehensively assessed, reviewed or accurately reflected within their care planning documentation.

We discussed our findings with the registered manager. They acknowledged improvements were required to strengthen the assessment and review process and ensure records consistently captured people's needs, preferences and outcomes and agreed to do this.

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 receiving care and raised no concerns about their safety. They confirmed staff wore a uniform and identification badge, which helped assure them of staff members’ identity and their association with the provider. One person said, “I feel safe. There are enough carers, I don’t know who’s coming out of the six regular staff I have, but one of those will come.”

Staff had completed safeguarding training, had access to the provider’s safeguarding policy. They demonstrated a clear understanding of their responsibilities to protect people from abuse, neglect and avoidable harm. Staff were aware of the actions they should take if concerns arose and understood the importance of reporting and escalating safeguarding issues promptly. One staff member said, “We have a duty to support and protect people from abuse and avoidable harm including self-neglect. Any concerns I would record and report to the manager.”

Care records evidenced the actions taken by staff and the management team when safeguarding risks, concerns or allegations had been identified. Records showed concerns were appropriately documented, investigated and escalated where necessary. For example, the management team had participated in multi-disciplinary meetings with relevant professionals and made safeguarding referrals to the local authority when required.

At the time of the inspection, the person using the service did not have a Community Deprivation of Liberty Safeguard (DoLS) in place that imposed restrictions on them for their safety.

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. However, we identified risk assessments and guidance for staff lacked sufficient detail.

People raised no concerns about how known risks were managed. One relative spoke positively about how well staff supported their family member during times of emotional distress.

Although we found no evidence people had come to harm or experienced a negative impact as a result, incomplete risk assessment records presented a potential risk that care may not always be delivered consistently or in line with people's assessed needs. This risk was reduced because people were generally supported by a regular team of staff who knew them well and had completed relevant training to meet people's needs safely.

We concluded this was primarily a recording issue rather than a failure in the delivery of care. This was because staff consistently demonstrated a good understanding of the risks associated with people’s care needs, and how to manage and reduce these. We discussed our findings with the registered manager, who responded positively and took immediate action to begin addressing the concerns identified.

Staff demonstrated a good understanding of the risks associated with people's individual care and support needs. For example, they were able to describe the signs and symptoms that may indicate a person was becoming unwell or developing an infection, including those associated with catheter care and diabetes.

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 were positive and appreciative of how staff supported them with safety issues relating to their living environment. A person said, “They’re [staff] all very courteous, they will point out things, they’re good at spotting dangers.”

Risks associated with people's home environments and any equipment used to support care delivery had been assessed and managed. Appropriate measures were in place to help minimise potential risks to people and staff, supporting the safe delivery of care within people's homes.

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 told us they received care from a regular team of staff who knew them well and understood their individual needs and preferences. This included arrangements for new staff to be introduced before providing care independently, helping people feel comfortable and reassured. People and their relatives described staff as well trained and competent in their roles. People also told us they had not experienced missed calls and that late calls were infrequent. They confirmed the service communicated effectively and contacted them if staff were running behind schedule. One relative said, “They [staff] know what they’re doing and they are trained.” Another relative told us, “They’re [staff] very, very nice. Sometimes they’re late but they ring beforehand.”

At the time of inspection, there were sufficient numbers of staff employed to meet people's assessed needs safely. Recruitment records demonstrated staff had been recruited safely, with appropriate pre-employment checks completed before they commenced work.

The provider had systems and processes in place to ensure staff received the training, support and oversight necessary to provide safe and effective care. Staff completed an induction and refresher training across a range of subjects relevant to their roles and responsibilities. Compliance with the mandatory training requirement on learning disability and autism was met.

Staff were provided with regular opportunities to discuss their work performance, training and development needs through supervision and team meetings. The management team also completed spot checks of care delivery and competency assessments in areas such as medicines management and moving and handling, helping to ensure staff maintained the skills and knowledge required to carry out their roles safely.

Staff spoke positively about the support they received from the management team. One staff member said, “We have staff meetings formally monthly and informal meetings and communication to talk about new care packages, changes to people's needs. Supervision is helpful, refresher training is ongoing as is spot checks and competency assessments.”

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 raised no concerns about infection and prevention and control (IPC) practice. They confirmed staff wore personal protective equipment (PPE) as required.

Staff told us and records confirmed, staff had completed IPC training, they had access to the providers IPC policy and spot checks included a competency assessment and review of their knowledge and practice associated with IPC.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Where people received support with their prescribed medicines, they told us they were satisfied with the arrangements in place and raised no concerns. One relative said, “Medication is done by staff and that works well.”

Staff told us, and training records confirmed, they had completed medicines training and received refresher training to maintain their knowledge and skills. Records also showed staff had undertaken competency assessments to ensure they could administer medicines safely and in line with the provider's policies and procedures.

We reviewed a sample of medicines care plans and risk assessments and found these contained detailed and personalised guidance for staff. This included information about people's prescribed medicines, the support required, administration instructions and any specific risks or safety considerations. This helped ensure staff understood how to support people safely and consistently.

The provider had effective systems and processes in place to monitor medicines management. Medicines Administration Records (MAR) were regularly audited and reviewed to help ensure people received their prescribed medicines as intended and that any omissions, errors or concerns were identified and addressed promptly. This supported the safe management of medicines and reduced the risk of medicines-related incidents.