Exclusive Care Services

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• 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

People were supported by staff who had been appropriately trained and supervised. There were sufficient care staff to meet people’s needs. Staff were given travel time between calls to ensure they spent the full amount of time at calls. Staff understood how to report accidents and incidents and understood their responsibilities to report any safeguarding concerns. Care plans contained detailed risk assessments for people and staff understood the care they needed to deliver.

This service scored 47 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff understood what they needed to do if an accident or an incident occurred. One told us, “If someone has an accident or was on the floor, I will check to see if they are breathing and call 999 and ask for an ambulance. I would stay with them until it arrived. I would need to call the office and fill in an incident form.” The manager told us they would ensure that people’s care plans would be updated with any changes in care as a result of any incidents.

Incidents and accidents were recorded with action taken to reduce further occurrences. We reviewed the incident and accident reports and found that steps had been taken to reduce the risks.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe and well cared for by staff. Relatives said they felt assured by the staff attending to their loved ones. Comments included, “They care for me, no complaints” and “We have got two really nice (care staff) that come.”

Staff understood what they needed to do to protect people from the risk of abuse. One told us, “If I suspect any safeguarding concerns, I would report them immediately to my supervisor and I would make sure it is followed up.” The manager told us, “We discuss [safeguarding] in team meetings, we did a discussion around the table, and they (staff) ask us questions. In a safeguarding we will report that straight away.”

Staff received safeguarding training and there was a whistleblowing policy that staff could access. The manager was now investigating all allegations of abuse and reporting to the local authority.

People told us they felt staff managed risks associated with their care in a safe way. One told us they used a walking aid and staff walked with them when they attended the call. A relative told us, “(Their family) was originally having falls, she was discharged from hospital, and they put in a care package and she’s more steady.”

Staff understood the risks associated with people’s care. One member of staff told us, “People’s risks are mentioned in their care plans. Our first priority is to keep people safe. We make sure we attend to them in line with any tasks and if there are any issues we report them immediately.” The manager told us, “The risk assessments are reviewed monthly, but we do them more frequently if needed.”

There were now detailed risk assessments in relation to people’s needs. We saw these were frequently reviewed and where there were any changes, staff were contacted to notify them of this change. This ensured that staff had the right information and guidance to enable them to provide appropriate and safe care.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives told us there were sufficient staff to meet people’s needs. They said the calls were never missed and that staff stayed the duration of the call. Comments included, “They always stay [the whole call], it’s always longer because we need to finish our conversation” and “It’s an hour [call] which is plenty of time and they don’t rush off.” They told us if carers were running late, they are contacted. People and relatives felt staff were competent and effective in their role. A relative said, “I would say across the board, (family member) has not had one incident with staff where she’s said to me that they didn’t do something.”

Staff told us they felt there were sufficient staff to cover the calls. They told us they were given travel time in between calls to ensure they arrived at the next call in good time. One member of staff said, “We are given enough travel times between calls. The allotted time with people is enough and we still have time to chat with them. If it’s not enough, then we go back to the company and ask them to review that person’s needs.” The manager told us that staff received a full induction before they delivered care and would do spot checks to check on the effectiveness of staff. They said, “We have spot checks, weekly or 2 weekly, we also do supervision and observational supervisions.”

Staff now received training specific to the needs of people they were supporting. We saw staff now received on-site observational checks, one to one supervisions and plans were in place to ensure all staff received an appraisal. The provider operated effective and safe recruitment practices when employing new staff. This included requesting and receiving references, staff right to work in the UK and checks with the disclosure and barring service (DBS). DBS checks are carried out to confirm whether prospective new staff had a criminal record or were barred from working with people.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The majority of people did not require medicines to be administered. However, people and staff said staff would prompt people to remind them to take their medicines. One person said, “They have to ask me every morning, I had forgotten to take it one morning so they have to ask me.”

Whilst the majority of staff did not administer medicines, they told us they had received training to do so if needed. One member of staff told us, “For medicines we have to following the medication policy. If people have an adverse reaction we have to report it. I have my medicine competency checked twice a year.” The manager told us, “I am now doing weekly medicine audits and only 1 person is currently being administered medicine.”

The provider and manager had now ensured that where people required to have their medicine administered, there was detailed Medicine Administration Records (MAR) in place. The MAR included a photo of the person, details of any allergies, and how the person preferred to take the medicine. Where ‘as and when’ medicine may be needed, there was guidance on place on when staff should offer this. All staff received medicine training and were now competency assessed to ensure they provided medicine in a safe way.