Aston Home 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.

This is the first inspection for this 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.

This service scored 59 (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.

People and relatives, we spoke with overall confirmed when they raised concerns, the provider took action to put things right. One relative told us, “I have raised things, and the carers have dealt with it.”

Staff we spoke with confirmed the process they followed if any accidents or incidents occurred, including raising it with senior staff and ensuring required documents were completed. Staff confirmed they were encouraged to be open, and information was shared during team meetings. Staff members we spoke with were confident the provider would take action following them raising concerns and share learning.

The provider kept a record of any accidents and incidents which took place and completed a monthly review to ensure required action was taken. The records also detailed anything implemented to reduce the risk of the incident reoccurring.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored.

People and their relatives confirmed staff raised concerns and external health care professionals’ input was sought where required and staff followed any advice or guidance provided. For example, 1 relative told us, “The Occupation Therapist (OT) assessed [Person’s name] with the carers there, so they knew how to support them in line with the OT guidance.”

Staff confirmed they followed advice from external professionals to ensure people’s needs were met.

People’s care records detailed where external health and social care professional input was sought, and recommendations and advice were clearly documented for staff to follow.

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. We found however, the provider did not always share concerns with us in line with their requirements.

We were informed by the local authority of some safeguarding referrals which we had not been notified of, we informed the provider of this and requested safeguarding statutory notifications be made to us retrospectively.

People and their relatives’ confirmed people were safe with the staff members supporting them. One relative told us, “Oh yes, [Person’s name] is safe, I would know about it if they were being mistreated. We had a few issues to do with equipment, and we got that sorted. We had a few issues with the care staff taking the front door key instead of putting it back in the key safe, but once raised, the provider dealt with that, and now everything is going well.”

Another relative told us, “[Person’s name] feels safe with the carers, they are happy with the care.”

Staff we spoke with confirmed the process they followed to report any concerns or risk of abuse. This included informing the office, to ensure management was aware and documenting the information. One staff member told us, “Safeguarding is very important, if we see any abuse physical or mental, we call the office, inform the manager, for any concern regarding the service user and document it all.”

The provider did not always work well with people to understand and manage risks. Staff did not always have enough information to provide safe and supportive care to meet people’s needs.

People’s care plans did not always contain enough information about people’s identified conditions to ensure staff knew how to identify and respond to any risks. We found, where one person had a medical procedure to support with their food intake, where feeding through oral intake was not adequate, their care plan did not include specific instruction to support this need. There was no record to detail the signs or symptoms related to this condition to inform staff to monitor any risks. We informed the provider, who confirmed they would review people’s care plans to ensure they contain required specific information.

We also reviewed another person’s care record which included details of catheter care, however, there was no further information detailing how staff support with this care or the risks associated with this need.

We did review some people’s care records which provided staff with clear information and guidance to meet their identified risks and needs.

People and their relatives overall told us they felt staff knew how to respond their risks and could safely support them. One person told us, “Staff know me pretty well and what needs I have.” One person, however, told us, “I am not 100 percent sure that staff know me, they don’t all understand, the staff I see regularly, they know what I need and want.”

Staff we spoke with confirmed they knew how to support people and identify any risks associated with their conditions and needs. Staff told us they would raise any concerns and monitor people’s risks in line with their care plans. One staff member told us, “If I have any concerns regarding people I support, I document it and monitor, for example skin integrity, I ensure it is in the notes.”

The provider detected and controlled potential risks in the care environment. Whilst they made sure facilities and technology supported the delivery of safe care, equipment checks were out of date.

The provider’s system in place was not effectively informing the provider of the upcoming service dates for equipment stored and used within people’s homes. Whilst the provider is not responsible for the equipment, effective monitoring of service dates should be in place to ensure the safety of use.

People’s care records included Personal Emergency Evacuation Plans, which provided staff with information to safely support the person in the event of an environmental emergency.

People’s care records also included up to date reviews on environmental risk assessments which has been completed to help keep people and staff safe during visits.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Staff received support through supervisions and worked well as a team.

We found although some staff received online training to support one person with a specific condition, the provider did not ensure staff received in depth training where their skills and competencies were checked prior to delivering this aspect of care. The person was receiving care from the service during our office visit but throughout the remainder of our assessment the person was no longer receiving care from the service.

Staff did receive training in a range of topics which they completed regularly, and they had supervisions to discuss their role and any development opportunities.

Staff recruitment records demonstrated required checks were completed prior to staff employment.

Staff files contained the completion of equality and diversity monitoring forms, which were reviewed by the provider and the provider was also awarded the Disability Confident Committee which ensured their recruitment process was inclusive and accessible.

The provider kept a record of the planned call times and the actual call times to ensure staff attended calls on time and stayed for the duration of the call. We analysed the data for 9 people and found 87% of calls commenced within 15 minutes of the rostered start time and when required double handed care was very well planned, with most care staff arriving together as scheduled.

People and their relatives’ confirmed people were mostly supported by regular staff who arrived on time and stayed for the duration of the call. Some people and their relatives confirmed they had a mix of regular staff and different staff. One person told us, “The staff I see regularly know what I need and want, my only concern is I have 4 calls a day, 2 are the same staff but the others are less consistent.”

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.

We found, where people were supported with the administration of topical medicines, their care records did not inform staff to change their gloves when applying different creams. We informed the provider of this, and following the office visit, the registered manager sent copies of people’s body map records which included this instruction.

People we spoke with confirmed staff wore PPE when delivering care to them. One relative informed us, they noticed when 1 member of staff was not wearing an apron, they raised this with the provider who actioned this. The relative confirmed the member of staff now wears an apron when required.

Staff confirmed they had access to personal protected equipment (PPE) as and when needed and during our office visit, we observed staff collecting stock when required.

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

We received mixed reviews from people and their relatives in relation to medicine management. One person told us, “My mediation is in blister packs, then if I need any creams, they [Staff] do all that, they are really good.”

One relative told us, “The staff are doing a good job, particularly with their medicines, I asked the carers to make sure they have an extra tablet, they have been brilliant, having meds right I cannot fault it, if the staff thought there was problem, there is a note pad they can let me know.”

Another relative told us, however, “I ask the staff to inform me if the medicines are running low, so I can order this in advance, but they are not checking and letting me know, I have informed the provider.”

People’s medicines were stored within their home and their care records detailed where staff were to administer. We saw where ‘as required’ medicines were listed and recorded within people’s care records.

We reviewed the provider’s medicine audit which demonstrated the required action taken following medicines incidents. For example, the audit identified a missed dose of medicine, the provider took action to reduce the risk of further incidents by having a supervision with the staff member and ensuring the staff member completed a refresher in the medicine training.