De Vere Care Partnership -Chelmsford

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

We identified a breach of the legal regulations. We were not assured there was enough staff to meet people’s needs as information from the call monitoring system identified concerns with staff being in two places at once and shortened visits. Staff had not all received a robust induction, or all the required training needed to meet people’s needs, whilst staff told us they felt supported all staff did not receive consistent supervision. Whilst people told us they felt safe the provider had not reported safeguarding concerns to CQC. Care plans contained detailed risk information, however we were not assured staff had the relevant skills to manage all risks safely. Medicines were managed safely.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

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 when their regular staff were in their homes. One person said, “I have the same carer twice a day they make me feel very safe especially when I have a shower. I trust them 100% and enjoy their company.” Another person said, “They’re always there for me to help because I’m more or less housebound. They’re quite attentive. They do make me feel safe.” People told us when their regular staff were not available the delivery of care was not always consistent. A person told us, “I am fine with my regular staff as they would not let me fall. I am very wary with non-regular staff as they don’t know what they are doing, and communication is difficult.” Another person said, “Until recently I was getting regular carers, and I knew them well. I’m now getting different carers visiting me at all times of the day who I don’t know.”

Staff had received training in how to safeguard people and knew how to raise any concerns with the management, however, not all staff were aware of how to report concerns externally if required or what whistleblowing was. A member of staff said, “I see the situation and let the next of kin and the coordinator know. I would call 111 or social services.” Another member of staff said, “I would report to the office or go to social services. Whistle-blowing is raising concern if any abuse is seen. The company has a process.” Other staff were not always clear about all reporting processes, a staff member told us, “We had safeguarding training before starting work. If we suspected abuse, we would report to the company. I am not sure where to report externally or what whistleblowing is.”

Safeguarding policies were in place, but more work was needed to ensure staff understood all reporting procedures. The registered manager had reported concerns to the relevant safeguarding agency but failed to notify CQC. During the assessment, a concern was identified about staff moving and handling practices and we raised this as a concern to the local safeguarding team. Whilst there was a process in place for the oversight of safeguarding concerns this failed to fully explore individual concerns or give detailed information about any potential trends or themes. Following the assessment the Provider updated their safeguarding policy.

People told us they were involved in planning their care and managing risks. Care plan and risk assessments were detailed. One person said, “I never have a need to panic when the carers are around as I trust them. They help me mobilise and keep me as active as I can be, I have 4 calls a day and the carers support me in getting out of bed and walking with me a short distance they give me plenty of encouragement and motivate me, without them I do not attempt to walk on my own as I don’t feel confident..” A relative said, “My loved one feels very safe when they are transferring them as they constantly check to see if they are comfortable.” While the people we spoke with expressed that they were generally happy with their care, our assessment found elements of care did not meet the expected standards.

Staff told us risk information was recorded within care plans and they had the information needed to support people safely. A staff member told us, “We use hoists and Sara steady, we had 2 days training on how to use the equipment, and we have spot checks. We get the care plan first and we read this so we can read all about risks. I usually go with a staff member that knows the round first.” Another staff member said, “I read the care plan, and it is all mentioned in there. The company calls me to let me know any changes to risk.” However, we were not assured staff had received all the training required to manage all risks safely, gaps were identified in staff training about some people’s needs as recorded in safe and effective staffing.

During the assessment, we reviewed people’s care plans and risk assessments which provided information about potential risks to people. Processes were in place to review care plans and risk assessments with people. However, we identified a manual handling concern with a person the registered manager believed had stopped which had potential to cause harm. This meant we were not assured all risks involved in this had been fully communicated to the person and staff.

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

Overall feedback from people using the service was positive, however, we did receive mixed feedback about the timings and duration of calls. A person told us, “I have two carers who turn up and stay their allotted time. The carers often stay longer if they need to.” Another person said, “They come in 4 times a day. There are two of them each time…There’s the odd time they’re a little bit late, but most times they’re very good.” However, other feedback we received was not as positive. A person told us, “The 2 carers who are coming are ok, apart from the fact that they only stay for 15 minutes which is not long enough really. It’s all very rushed.” A relative said, “When they do arrive, they stay no longer than 15 minutes. We were told our visits would be for 30 minutes and in the 5 weeks we have never had 30-minute visits.”

The staff we spoke with were positive about working at the service and told us there were enough staff. A staff member told us, “There is enough staff and I do my best to be on time.” Another staff member said, “There is enough staff here. I am not aware of any missed calls, lateness does happen with traffic, and the office calls people. We call the office, and they will sort out this issue.” Whilst staff were positive about working at the service, the commission analysis of electronic call monitoring indicated concerns around, the timing of calls, call duration, unlogged calls and late visits as recorded in the process section.

Data from the call monitoring system did not demonstrate people received timely and safe care which met their needs. Analysis of the information provided by the Registered Manager showed, at times, staff were logged in at two locations simultaneously, not all calls included travel time and other calls showed travel was immediate; arriving/leaving at the same time. 50% of calls were less than the duration of the time agreed for the care to be provided. Staff files did not demonstrate the induction process was robust. We saw training questionnaires were unmarked and not all staff files contained competency skills assessments. Although staff told us they felt supported and had received supervision, however, it was not clear in 2 staff supervision records what actions had been taken to address concerns identified during their supervision session. We identified not all staff providing catheter care or percutaneous endoscopic gastrostomy tube (PEG) care had the training required to support people. For 1 person receiving PEG care, we identified 8 staff where the registered manager could not demonstrate they had completed training. Five people who were receiving catheter care did not always have staff who had catheter care training. Records were contradictory and did not demonstrate if training was up to date or not. For example records for February 2024, showed 33 staff had completed catheter care training, but in March 2024 records did not show the same staff having completed catheter care training.

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.

People were positive about the support they received with their medicines. A person told us, “I receive my medication when I should take it and I am aware of my medication so would know if anything was missing.” Another person said, “I get [my medicines] at the right time and the staff know about medicines and what I need them for.”

Staff told us they were clear about their roles and responsibilities relating to medicines, particularly regarding the safe administration of medicines. One staff member told us, “I do medicines. I have online training and practical training for medicines. The office comes out and does a spot check. They watch us administer medicines.” Another staff member said, “We have good training, and they check our competencies.”

The provider employed a medicine monitoring officer who had good oversight of medicines. They carried out an end-of-day audit and told us they were alerted by an electronic system if medicines were not administered or were late. This allowed them to contact staff immediately to find out why medicines had not been administered. Medicine policies and procedures were in place and regular audits were carried out.