- Homecare service
Alina Homecare Specialist Care - Bournemouth, Christchurch & Poole
Report from 16 August 2024 assessment
Contents
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
Improvements had been made which meant there were now sufficient numbers of qualified, skilled staff to ensure people were cared for safely. People received medicines as prescribed and improvements had been made to the medicine management process in line with current guidance. Systems were in place to learn from events within the service with clear lessons learned processes. People were supported by staff who knew them well, continuity of care was enabled. Safe procedures were in place to ensure people were protected from harm and staff knew how to report potential abuse. Risks were identified, assessed and associated guidance for staff promoted safe ways of working. Infection prevention and control measures were robust.
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.
Learning culture
People and their relatives told us they enjoyed where they lived, felt supported by their staff team and felt safe. Staff knew people’s preferences and provided support in a safe and calm way. Staff were knowledgeable, learned lessons when things went wrong and followed safety guidelines as required.
Staff said they felt confident to discuss different ways of working with the registered manager and staff team. These discussions would then lead to positive changes in ways they cared for people. Incidents were recorded on an electronic care planning system. These were then reviewed by the management team and preventative actions taken to reduce reoccurrence. A member of staff told us,” The management team are all approachable. I’m fully supported. I’m just an email or phone call away and they always get back to me.”
Health and social care professionals told us care staff knew people very well and provided care and support in ways people preferred and which ensured and maintained their safety.
The provider had an electronic system where incidents and accidents were recorded by staff. Any emerging themes or trends could be identified and lessons learned. The system enabled the registered manager and management team to review, analyse and fully discuss incidents with staff, implementing changes to prevent a recurrence.
Safe systems, pathways and transitions
People and their relatives said the service supported them well and in partnership with health care professionals including doctors, physiotherapists and dentists. One relative said, “They look after [person] so well. I’ve no complaints. When [person] went into hospital, they went in and supported her there, there was always someone from Alina helping [person]. They are really good at managing her health.”
The service worked collaboratively with health and social care professionals. The registered manager told us the provider employed 2 nurses who provided effective clinical support. Staff worked well with external professionals to ensure people received the individual care and support they required. A member of staff said, “We always listen and involve people’s doctors, physio’s etc, so people get the best care.”
Health and social care professionals provided positive feedback regarding their interactions with the service. One professional said, “They absolutely make sure people are safe. I have no concerns at all, they are generally very good and work well with us, we all work together well to make sure people are safe.”
There were clear processes in place to ensure people’s current information was safely shared with health and social care professionals. People had ‘health passports’ in place which were completed in an ‘easy read’ format to ensure specific health needs were shared between services.
Safeguarding
People told us they felt safe with their care staff and enjoyed where they lived. One person said, “Yes I feel safe, I like it here.” A relative told us, “I feel [person] is very safe, they look after [person] so well.” Another relative told us, “[Person] is safe, they are so happy and they love it where they are. [Person] is a different person now; they love it there.”
Staff spoke knowledgably regarding the different types of abuse and how they would report suspected abuse. Staff understood how to ensure people’s rights were fully respected, had received training in safeguarding adults, and completed the required refresher training. A member of staff discussed different types of abuse, they told us, “Some types of abuse are emotional, financial and physical. I would report any abuse to the duty manager or branch manager and explain the situation. I’m confident they will take action. I’ve not had to raise any concerns but I have been advised from them and always got advice. Our system is so good”. The registered manager clearly explained the process they and staff followed to ensure concerns were raised correctly.
There was a safeguarding and whistleblowing policy that gave staff clear guidance to follow in the event they needed to refer any concerns to the local authority. Safeguarding incidents had been reported to the local authority and CQC.
Involving people to manage risks
People and their relatives told us the service involved them in the assessment and planning of their care and support to maintain people’s safety. One relative said, “They did assess [person], and its ongoing. I was involved with the social worker and the staff and went to several meetings. I was fully involved in all assessments. I speak to [person’s] key workers and they know [person] really well.” Another relative told us, “They do manage the risks…the staff keep [person] very safe.”
Risks to people and the service were managed effectively, ensuring people were protected and their wishes were respected. Staff demonstrated comprehensive knowledge about how people preferred their care and support to be received, ensuring they were supported safely and as they wished. The registered manager told us, “We assess the risks really clearly and our system supports us to do that. For example, we assess the staffing mix by knowing the staff and understanding their skills, we can then pin point them to a specific client.”
We observed staff working in safe ways with people. Where people were supported to move and transfer with equipment, this was used in a safe way by staff.
Detailed, personalised risk assessments were in place. People’s risks were assessed before they started to use the service and were updated as needed. These considered risks relating to the environment as well as any risks to the person and one-off events such as holidays. People were supported to take positive risks and were involved and included in their risk assessments. This ensured a reduced risk of harm with the least possible restriction to people’s freedom, and independence.
Safe environments
People told us they felt safe and enjoyed where they lived. One person said, “I like my home and I like my garden.” Relatives told us they were confident staff were trained and had completed thorough assessments of people’s home environments to ensure safety. One relative said, “The bungalow is safe and lovely, no problems and suits [person] so well. [Person] has a beautiful bedroom.”
A member of staff said, “I feel supported, my team leader [name of staff member] she is an amazing person to talk to. There is always someone to talk with. I feel comfortable they will understand as they work in the field and they are all understanding. I’ve got a very good team.” The registered manager understood they must ensure an ‘as safe as possible’ environment for people and staff. Staff felt fully supported and had access to support via the telephone when they needed, including outside of normal working hours.
The environment was visibly clean and well maintained. Equipment was checked in accordance with manufacturers recommendations. Fire safety procedures were in place.
People had personal emergency evacuation plans in place which highlighted the support people would need to evacuate the premises in an emergency, such as a fire. Environmental risk assessments were carried out to ensure staff had a safe working environment in people’s homes.
Safe and effective staffing
There were enough trained staff available to support people safely. People were supported by a regular staff team who knew them well. One relative said, “There are enough staff, it’s a lot better with staffing, at one time they were struggling but now they are doing very well with staff. There are enough staff for [person] and they are fully experienced and know how [person] likes their care.” Another relative told us, “There is a small, stable team of staff to support [person], they do know [person] really well. I have met all the staff; they are all very nice. They work well between each other.”
Staff told us they enjoyed their work and felt they worked well together as a close team for the benefit of people they supported. One staff member said, “I do enjoy my job, I love my job. I have full support… I’ve done a management training course which has been really helpful. “Another member of staff told us,” I definitely feel supported in my role. I can raise any problems at any time they will help me. We are all treated equally.” A third member of staff said, “I feel I get enough support; I have really learnt a lot. There are enough staff to keep people safe. I am enjoying this job. “The registered manager told us, “Staffing levels are well within safe levels to ensure people are supported safely. We have a dedicated recruitment team. We have a good mix of staff; recruitment is always ongoing.” Staff told us they received enough training within their induction and ongoing training courses to help them carry out their roles effectively. One staff member said, “The training is very good and it’s thorough. I have no issues with the training. All the training is client led to ensure their safety.” Another staff member told us,” The training is really good, they go above and beyond, they have a lot of specific courses such as, Makaton. We did have a client with a specific condition and we had specialised training for that which was really good and made us understand their condition.” Makaton is a communication tool with speech, signs and symbols to enable people with learning disabilities to communicate.
Staffing levels were in accordance with the provider’s policy and staff rotas. Staff supported people with kindness and patience and did not rush when providing their support and care.
Since our previous inspection, the provider had made improvements to staffing levels. At this assessment, we found there were enough staff to meet people’s needs. Staffing levels were continually reviewed to balance the staff numbers with care hours available. Training records showed staff were up to date with their mandatory training and attended refresher training to ensure their knowledge and skills were up to date. Supervision and appraisal records confirmed staff received the support they needed to deliver safe care. Procedures were in place to ensure the required checks were completed prior to staff commencing employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.
Infection prevention and control
People and their relatives told us the staff worked in a safe and clean way, wearing personal protective equipment (PPE) when appropriate. They said staff were knowledgeable regarding infection control procedures and ensured people were kept as safe as possible from avoidable infection. One relative said, “They still use all their PPE, they are always clean and [person] is always clean and tidy with hair and nails done and always looks lovely, they look after [person] well.”
Plentiful supplies of PPE were always available for all staff. Staff were aware of the importance of cleanliness and hygiene. One member of staff told us, “We have all the PPE, gloves, aprons and masks. We collect it from head office. We have not had any problems, it’s all available.”
People were supported to maintain their own personal hygiene and staff were attentive with cleaning. Personal protective equipment (PPE) was worn appropriately by staff.
Measures were in place to prevent and control infection. Staff had received training and used their PPE effectively when needed. Spot checks were completed on staff to ensure they were following the providers infection control policy.
Medicines optimisation
People told us they received their medicines when they needed them. Clear guidance was available for all staff to ensure a good understanding of people’s medicines, symptoms and why specific medicines were required. One relative said, “The do all [person’s] medicines. It’s all written down in the book, its all done for [person]. They do [person’s] cream to keep their skin good. Skin can break down if [person] is sitting all the time but their skin is good.” Another relative told us, “Staff help [person] with their medicines, [person] takes them really well. Staff give them to [person] and they take them. They know exactly what [person] needs and when.”
Staff who administered medicines had received up to date medicine training and had their competency checked. A member of staff told us, “I administer meds to people, we get yearly medicine training and then the competency checks. I shadow staff (to check they are administering medicines safely) and sometimes contact the office to get staff extra medicine practice. We use scenarios using (sweets) as practice, this works well.” A second member of staff said, “I administer medicines and I order all the medicines. We do medicine audits monthly, it’s a good system for us.”
Improvements had been made to the medicine management processes and medicines were administered as prescribed. Medicines were safely managed, stored and administered, there was a medicine policy in place. There were protocols in place for administering PRN (as required) medicine and staff spoke knowledgably about administering PRN medicine. Where people were administered topical creams, instructions were available which provided clear guidance for staff.