Around the Clock Healthcare - 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. This is the first assessment for this newly registered service. This key question has been rated 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. The service was in breach of a legal regulation in relation to people’s safe care and treatment.

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 knew how to report incidents and told us they logged these on the system and also called the management team directly. Appropriate follow up action was taken in response to incidents and to reduce the likelihood of the same thing happening again. Feedback confirmed relatives were able to raise issues and were confident these would be promptly resolved. One relative told us, “Things are bound to happen from time to time. There are no problems though, I’m satisfied with how things are dealt with.”

The provider worked with people, relatives 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. This included, when appropriate, working closely and taking direction from the parents of children and young people they were supporting. Also, adjusting care and support when there were updates from other health professionals such as GPs or community nurses.

The provider worked with families and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff had received training in safeguarding and described what action they would take if they had any concerns. We saw the provider’s safeguarding records and made suggestions as to how this could be strengthened. Relatives confirmed they did not have any safety concerns about care provided to their family members.

The provider did not have well developed systems to assess and mitigate risks to people’s health and care. Risk assessments did not contain sufficient information about known risks to individual people and how these could be mitigated. There was not enough guidance to support staff to deliver safe care. For example, in relation to safe moving and handling, reducing the risk of skin breakdown and safely supporting people with specific health conditions or needs. However, staff knew people and their needs well, so we did not find any harm was caused because of this. Relatives we spoke to confirmed staff knew how to manage people’s risks safely. At the time of the assessment there was no-one receiving care who showed distress while communicating a need or emotion so we could not assess the quality of the provider’s support in this area.

The provider did not always identify and assess potential risks in people’s homes which could impact upon people and staff. For example, risks relating to fire safety, access or room temperature. There were no assessments of equipment used to support people’s safe care or evidence of regular checks to ensure equipment was in safe working order. For example, this included bed rails, hoists and wheelchairs. Feedback from relatives and staff confirmed equipment was used appropriately and no concerns were raised.

Some parts of the recruitment processes required strengthening. For example, having clear and accurate employment histories along with references relating to previous care work. We could not fully assess staff training and skills as not all information was made available to review. For example, in relation to staff training to support people who received nutrition and medicines via an enteral feeding tube (Enteral feeding is a way of delivering nutrition directly to a person's stomach or small intestine). There were enough staff who worked well together to meet people’s needs. Staff arrived on time and stayed for the full length of time allocated to the visit. Staff received an induction when they started in role and shadowed more experienced staff as part of their learning.

Improvements were needed to ensure people were consistently protected from the risk of infection spread as far as possible. Staff received training in infection prevention and control but competence checks did not take place to ensure staff were confident in consistently following good practice guidelines. The provider did not submit all requested information about staff use of personal protective equipment such as gloves, hand washing/hand sanitiser and disposable aprons and we received some mixed feedback about this. The provider began to implement improvements during the assessment.

The provider did not have effective systems in place to ensure people’s medicines were administered, recorded and overseen safely. People did not have medicine care plans and accurate information was not available about the prescribed medicines being administered and creams being applied to people. Guidance was not in place for medicines prescribed to be given ‘as needed’ to ensure safe administration. There were a range of errors and gaps in recording on medicine administration records and there was no effective audit system or staff competence checks to identify areas of concern and drive improvements. However, relatives were satisfied that safe medicines support was provided and staff communicated with them effectively about this. One relative told us, “Yes, it’s always given on time, no concerns about medicines.” The provider started to implement improvements during the assessment.