Caring Care 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 good. At this assessment the rating has remained 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’s systems for ensuring learning were in place following incidents required further embedding. Individual risk assessments and management plans were not consistently updated when incidents occurred. We spoke to the registered manager about this, and they confirmed after the inspection they had changed their processes to ensure this happened in every case. Staff were aware of how to report incidents and could describe how they had learning from incidents shared with them. Records showed staff had information given to them in staff meetings about incidents and the learning which had been drawn from them. When incidents occurred such as falls, staff logged these with the office and these were all reviewed by the management team. People and their relatives shared positive experiences of the support they received when things had gone wrong. For example, a relative told us, “[Person’s name] has not had an accident while they were there, but they did find them on the floor once and called me straight away.”

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. Partners spoke positively about the provider’s systems to regularly monitor people using the service and provide continuity of care. The provider worked with several local authorities and had different systems in place designed to support each local area. One partner told us the provider worked well with them to design the system and always were flexible and had staff available to support people all the time and often at short notice. Another partner referenced the high success rate the provider had with offering reablement packages of support with reducing or removing the need for ongoing support once the reablement concluded.

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 and their relative’s confirmed people were safe using the service. A relative told us, “The staff know what they are doing, and they are competent. [Person’s name] feels safe with them. They do a good job, and I can’t praise them enough.” Staff understood how to report potential abuse and had received regular updates to their training. The provider had a system in place to use a key word search on people’s care notes to check for any incidents which may have not been reported. Any safeguarding concerns raised were recorded in a log and monitored for their outcome and where appropriate learning was drawn from the incident and shared with staff.

The provider’s systems had not consistently ensured people’s risks and management plans were consistently person centred and referenced in the electronic care planning system. Risks to people’s safety had been identified and general guidance was in place for staff, however this was not specific to the person. For example, where people were at risk of falls, they did not always have a detailed falls plan in place and where skin integrity risks were identified there was general guidance for staff, but it was not always specific, this had not had any impact on people as staff were well trained and understood people’s risks and how to manage them. The registered manager took immediate action to address this with the care plans we looked at and formed a plan to review all other care plans to ensure relevant risk assessments and management plans were in place for everyone who needed them. Other risk assessments were in place, accurate and specific to the person’s individual needs, however improvements were needed to ensure consistency. Staff were however knowledgeable about people’s risks and told us how they supported people to stay safe. People and their relatives also shared examples of how staff supported them to manage risks to their safety. A relative told us, [Person’s name] has a hoist and electric chair and there are always two staff making sure it is safe.” Another relative confirmed, “The staff hoist [person’s name] into a chair at lunch and hoist them into bed at night. There is always two of them, they come together and they leave together.”

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 and relatives told us staff supported people to maintain a safe environment. A person told us, “They are very good; they switch off the kettle and microwave at the socket.” Staff had access to a detailed environmental risk assessment and could describe how they supported people to stay safe. Regular checks were carried out to ensure staff understood any risks and were following the management plans in place to maintain people’s environment safely.

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. Staff were recruited safely and received an induction and regular updates to their training. People spoke highly of the support they received from staff. A person told us, “The staff are always on time. Once in 3 years they have had to call to say they were going to be late.” A relative told us, “I have nothing but positivity to say about the staff. They have been life changing. They always turn up on time, and they also look after [person’s name]. They have given them a bit of their life back; by caring for their spouse, [person’s name] doesn’t have to wash and dress their spouse, and they can have time to themselves.” Another relative told us, “The staff are more or less on time and if they are going to be late, they will let us know.” There was a live system in place with continuous monitoring to ensure staff completed the calls as people needed them. Reports were in place to check staff attended on time and stayed for the full duration of the call, where needed actions were taken to address any differences in the timings of call.

The provider had systems in place to manage the risk of cross infection. People told us staff followed safe practice for infection prevention control. A person told us, “The staff wash their hands and wear aprons and gloves if needed.” A relative told us, “They always wear gloves, apron and they have their uniforms on.” Staff had received training in minimising cross infection. Checks were in place to check on staff practice through feedback from people and spot checks carried out during calls to confirm staff practice was in line with local and national policies.

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. People and their relatives were happy with the support they had with medicines administration. A person told us, “My husband gives me my medication, but they [staff] will prompt him to make sure I get them.” A relative told us, “[Person’s name] has a blister pack, and they ensure they have the right ones at the right time. They are very strict with medicines.” Staff had received training in managing medicines safely and could describe how they offered support to people. Records were in place to show how medicines had been administered. Where people had refused medicines or there had been actions taken with relevant health professionals to seek advice this was not easily identifiable in the persons care records as a separate system was used to record these actions. The registered manager confirmed they will address this issue to ensure records are clearer.