Bloomsbury Home Care – Essex Mid

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

People were safely supported and risks to their care were mitigated effectively. Medicines were managed safely where required. There were enough staff to meet people’s needs, and they had been trained and supported to understand their role. The provider understood their responsibilities to keep people safe from harm and abuse. The provider took appropriate actions and had systems in place for learning when things went wrong and making improvements. Staff followed infection control policies and procedures.

This service scored 75 (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 any issues raised to their manager. The manager had an overview of all accidents, incidents and complaints which had been responded to or investigated where required. Lessons learned were shared across the organisation to continually identify and embed good practice. People and relatives told us they could raise any issues they had concerns about. A person told us, “No complaints. Procedures are put in by the regular manager and the office manager, so it is well managed.” A relative told us, “We have made a complaint, it was sorted and no harm done. The team leader comes to the house regularly, they are well managed.”

People’s care and support needs were fully assessed by the manager and team leaders prior to the start of their care package to ensure the service could meet their needs. People confirmed this and told us, “Yes, they came round and were here a long time, about 2 hours,” and “I was quite impressed as they were here within an hour of [person] coming out of hospital.”

Processes were in place to support people to transition into other care services when required.

The majority of people and relatives told us they felt safe with the staff who supported them. Comments included, “We feel very safe”, “[Person] is very safe and the carer's are very patient with them”, and “I am very safe as they are all very nice, it`s like a friend popping in. I get lonely so I look forward to them coming.”

Staff understood their responsibilities to report concerns about abuse and whom to report to. Comments included, “If I had concerns, I would tell my team leader. I would escalate to the office manager if I did not feel listened to or let CQC and Social Services know.” And “. If I suspected abuse, I would follow the safeguarding procedures by reporting concerns to my line manager or the designated safeguarding lead internally. If necessary, my concerns may be escalated to external bodies like social services or the CQC.”

Policies and procedures regarding safeguarding and whistle blowing were in place. The manager told us staff had full access to policies and procedures through an app on their devices. Staff had received safeguarding training, and the manager kept an overview of any safeguarding concerns. Where safeguarding concerns had been raised either by the service, partner agencies or via the local authority, appropriate processes were followed to ensure they were investigated with any action taken and outcomes.

People and relatives told us they were fully involved in the delivery of their care and any potential risks to their safety.

The service had a small consistent team of permanent staff to support people which meant staff knew people well and were aware of any associated risks relating to their care and support. A member of staff told us, “We get enough information about a person, and this will develop further as we get to know them. Risks to people include people at risk of falls or prone to falls. I will prompt person to use their walking frame. Support and walk with them to enable them to maintain their independence and mobility.”

The service had systems in place to assess people and any associated risks. Care plans contained detailed guidance for staff in how to manage risks associated with people’s care and support. Risk assessments were reviewed and updated to ensure they remained reflective of the current needs of the person

Most people did not directly comment regarding to a safe environment as it was their home, however the majority did comment they felt safe. One person told us, “I think a member of staff came to check things and to see what equipment was needed.”

Environmental risk assessments were carried out prior to a service being provided. These included, ensuring the lighting was sufficient, any equipment in use, maintaining the security of the home and any space constraints or risks caused by the room layout. People’s care plans included a fire evacuation plan with clear guidance for staff to follow in the event of an emergency.

No concerns were raised about staffing levels or scheduled call times. Although a few people told us they did not always have the same carers providing their care and support. Comments included, “I get different carer`s but this is starting to settle to 3 or 4 carers, and I know them.” And “I have a team of 3 to 4 carer`s and they are never late, 10 minutes at most. I`ll say you can leave but they generally chat to me as they are very friendly, and I enjoy the chat.”

Staff spoke positively about working at the service and did not raise any concerns regarding staffing levels. One member of staff told us, “There are no concerns around staffing. I have enough time with the people I support.”

Systems were in place to ensure there were enough suitably qualified, skilled and experienced staff. Safe staff recruitment processes were in place which included the completion of appropriate pre-employment checks such as references from previous employers and disclosure and barring service checks (DBS). This helps employers make safe recruitment choices. We checked the recruitment records for 3 members of staff and all the required pre-employment checks had been completed.

People and relatives, we spoke to did not share any concerns in relation to infection prevention and control. Comments included, “Staff wear gloves, aprons and shoe covers,” “They [staff] wear gloves which they change when doing food.” And “They [staff] wear a uniform and shoe protectors and will wear a mask if one of them has a cold.”

Staff had undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. A member of staff told us, “I wear PPE when required, such as gloves and aprons during personal care and masks if needed. PPE is disposed of correctly in clinical waste bins or as per infection control guidelines. There is usually enough PPE available.” The provider had an up to date policy in place to support effective infection prevention and control and was following current guidance.

People told us they received their medicines where required and on time. Comments included, “The carer`s do my tablets and never miss anything,” “I take my medication myself, but they are there to prompt me and remind me.” And “[Person] gets their tablets before they eat in the morning, they [staff] never miss.”

Staff told us they had completed training to administer people’s medicines and confirmed that their competency was assessed at regular intervals.

There were appropriate systems in place to help make sure medicines were managed in a safe way, although we found further improvements could be made to the signing or coding to a person’s medication administration record (MAR) when hospitalised. This is to ensure a clear audit trail identifies the person is in hospital and the use of a relevant code informs the reader why the medicines have not been administered during these times. This was discussed with the operations director who advised they would look into requesting an additional code for staff to enter onto a person’s MAR chart for clearer recording purposes. This issue had been rectified post assessment by the service’s electronic call monitoring provider.

The provider had a designated member of staff who audited a sample of medicines audits monthly. We were assured actions were taken and lessons learned following any medication error or incident. The provider had a designated staff member monitoring the electronic e-mar app in real time to minimise the risk of medication omissions. For example, if a staff member left a visit without administering a person’s medicines the system would alert the office staff. Office staff would then call the staff member to ensure they returned to the person’s home to complete the task. We saw that people’s care plans contained clear details about the medicines they took, what the medicines were for as well as when and how they required them.