Galilee Care

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 changed to inadequate. This meant people were not safe and were at risk of avoidable harm. The service was in breach of legal regulation in relation to people’s safe care and treatment, the ways people’s medicines were managed safely, poor infection controls and people not being protected from the risk of neglect and abuse. Breaches also related to the lack of robust recruitment processes, staff not being deployed effectively and staff not always being trained and assessed as competent to deliver care. Care calls were often late, staff were often not given travel time which meant they were rushing care, and they did not stay for the full length of the call.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The leaders did not ensure that lessons were learnt to continually identify and embed good practice. There were incidents that were not always recorded as such by staff including where a person had fallen from climbing over their bed rails and had injured themselves. Where incidents were recorded, although we could see the actions taken at the time, there was no analysis of these to look for themes and trends. For example, where care staff arrived at a care call and found people had fallen, there was no reviews of these falls to consider whether this related to care calls being late. This was despite there being multiple examples of calls being late based on the care call data and rotas.

The leaders did not work well with people and health system partners to establish and maintain safe systems of care. They did not make sure there was continuity of care, including when people moved between different services. The provider told us they accepted packages of care when people were being discharged from hospital. However, they said they had not spoken to the person or their representative to fully understand the person’s needs and preferences around the care they required. One relative told us, “The assessment has never been done.” The relative said when their family member came home from hospital, care staff turned up several hours later and, “They were not aware of any of her needs.” The provider also took on short term packages of care however, again a full assessment of their needs was not undertaken. A senior member of staff told us, “We have had so many clients come and go we just haven’t had time (to review people’s needs). We don’t do full plans for the 6-week packages.” This placed people at risk of not receiving the appropriate and safe care that was needed.

The provider did not work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not concentrate on improving people’s lives or protecting their right to live in safety, free from avoidable harm and neglect. We saw from incident forms that at time’s staff were finding unexplained bruising on people. There was no evidence this was investigated by the leaders to determine the cause of the bruising. People fed back that at times staff were rough with them, one person told us, “There are some staff who I feel manhandle me and treat me very roughly.” The poor treatment at times by staff was also reflected in complaints that people had made to the service. Between June 2024 and December 2024 there had been complaints about staff being ‘rude and abrasive’ towards people. None of these concerns had been raised as a safeguarding to the local authority. One relative told us of whether they felt their loved one was in safe hands, “I don’t have that sense of assurance.”

The provider did not work well with people to understand and manage risks. Staff did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. All the care plans we reviewed had a lack of risk assessments associated with people’s health needs. This included but not limited to the risk of falls, health conditions including diabetes, epilepsy, choking, moving and handling, constipation malnutrition and dehydration. A senior member of staff told us they had not had time to review people’s risk assessments. People and relatives fed back that staff were not always safely managing risks associated with their care. Comments included, “My [family member] was slumped all the way over when I came home, I called them, there were no pillows on the bed” and “I have requested not to lay [family member] down fully as she can’t reach drinks overnight in that position, but this doesn’t take place.” Staff told us there was not always information in people’s care plans around risks and also said the care system was often not accessible. They told us, “Sometimes you are told to go to an address and given the key safe number, but that’s all the information you are given. You have to figure out the rest when you’re there.” This placed people at risk of harm as risk had not been assessed and staff were not always ensuring they provided safe care.

The provider did not always detect and control potential risks in the care environment. The risk assessments relating to the people’s home environments were generic and lacked guidance for staff. This meant that when staff arrived at a call, they did not have specific information about the potential risks. We noted that 1 person had a fire in their house due to leaving a pan on the hob, however, there had not been a specific risk assessment undertaken in relation to this.

The provider did not make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not work together well to provide safe care that met people’s individual needs. We saw from care rotas staff had not always been provided travel time in between calls. This was impacting on the length of time staff stayed at the call. People fed back staff were frequently not staying for the full length of the call which they told us impacted them as staff were rushing their care. Comments included, “They [staff] rush around, half did the job and said they had other people to see” and “Very rarely they stay for the full time.” People also fed back that not all staff were effectively trained. One relative told us, “I’ve asked them to stop sending new people. Most that come are trainees, they have some that are really, really good and some that get by.” We found instances where carers were undertaking care tasks they were not trained or assessed as competent to do. For example, in relation to supporting people with their feeding tube [a way to give food, fluids and medicines directly into the stomach]. This placed people at risk of unsafe care. One member of staff told us, “I wouldn’t say the training is good.” Supervisions with staff were not effective, they lacked discussions with staff on their objectives and areas for development.

People were at risk as the provider had not ensured that all new staff were thoroughly checked to ensure they were suitable to work for the service. There were gaps in staff's employment that had not been explored by the provider. The references received did not always relate to the member of staff’s most recent employer and 2 recruitment files only had 1 reference.

The provider did not assess or manage the risk of infection. Multiple people and relatives fed back that staff were not always adhering to good infection, prevention controls (IPC). One person told us staff supported them with a medical procedure, they said, “After [the procedure] they have to wash the syringe, there have been occasions they [the equipment] don’t look very clean.” Other comments from people and relatives included, “One or 2 times my pad hasn’t been changed on the bed in the last week, I have had to change it myself which is difficult” and “When I was cleaning I found a loo roll rolled up by the sink, I opened up this blue roll and there was faeces, the bin was also overflowing with rubbish.” Although staff had received IPC training, this was not effective in ensuring safe practice which placed people at risk of getting infections.

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found where people required prescribed topical creams to be applied, there was no medicine administration record (MAR) in place for staff to record when this had been applied. There were care plans that lacked information on whether the person would be self-administering their medicines or staff were required to do to this. This meant there was a risk that staff may not give the medicine if they believed people were taking this themselves. There were multiple gaps on people’s MAR charts, and it was not clear from the care records whether the person did not require medicines from staff on that occasion, or whether staff had forgotten to give the medicine. One person told us a member of staff had left before giving them their medicine. They said, “I can’t reach my meds, I was in bed. At lunch the same one came, and I said to them I didn’t have medication, she just said ‘oh’.” This placed people at risk of harm.