New Age 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

Most people and relatives told us care was provided by a consistent staff team who knew people and their safety needs well. However, other people said they did not always receive care from staff who regularly cared for them. People were involved in deciding what care they wanted to maintain the safety and staff were provided with detailed guidance on what could trigger people’s emotional anxiety or distress. Staff were recruited safely and undertook safeguarding training, but would benefit from further guidance on how to escalate any concerns externally. Whilst most people were positive about the relationships they had developed with the staff caring for them, some safeguarding systems and policies need to be further developed, to ensure people were consistently protected from abuse and the provider and staff had a clear audit trail to demonstrate integrity when supporting people. People were supported by staff to maintain a safe environment within their homes and staff told us equipment was promptly maintained. People were cared for by staff who took action to reduce the risk of the spread of infection. Further development was required in how some areas of people’s medicines were managed and how consistently lessons were learnt and appropriate action promptly taken. Improvements were also required to systems for communicating information about people’s needs when they transferred to or from other social care settings, and to ensure staff were given consistent guidance in how to support people safely. The processes for ensuring care was provided as assessed and planned for some people living in areas which were geographically remote from the provider’s office required further development, to ensure all care calls were covered.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives had mixed views on how well lessons were learned. One relative told us there had been repeat concerns about how staff administered their family member’s medicines. However, one person told us they had identified an area for improvement with one aspect of their care. The person said additional training had been arranged for staff, which had led to sustained improvements in the care provided.

Care staff gave us examples showing how lessons learned were identified and communicated across the staff team. Staff knew there was a designated member of staff responsible for sharing lessons learned with the staff team.

The systems used to ensure all possible learning was promptly taken from incidents needed to be further strengthened. Where incidents had been entered promptly on the provider’s monitoring system, systems to ensure follow up actions were consistently done did not always work effectively. For example, in relation to a person experiencing a fall and an incident where a person was declining food. The operations manager agreed to add a further action to their service improvement plan to ensure all incidents were reviewed and specific follow up actions had been completed and any lessons arising communicated to the staff team. However, some processes were working more effectively. For example, where the provider had identified lessons to be learned, staff received an alert when they need to read lessons learned information. Recent lessons learned included the safe use of a key safe, ongoing assessment of people to identify emerging risks and recording of care tasks.

People told us they could rely on staff contacting emergency services if they needed their assistance. Some people said they also received the support they wanted to communicate information to their GPs. For example, when making routine appointments in relation to their healthcare. Relatives told us they were confident staff would let them know if their family member experienced any illness or incidents which resulted in them requiring care from other agencies. However, one relative raised a concern that New Age staff had initially said they would be able to provide additional support to their relative on discharge from hospital, but had subsequently not been able to provide the agreed care.

Staff monitored people’s safety and health needs and identified when people wanted support from other health and social care professionals. Staff gave examples showing how they supported people to obtain both emergency and on-going support so their needs would be met. For some people, this included New Age staff to continuing to support them once they had been admitted to hospital. Staff gave examples of effective information sharing with the emergency services and people’s GPs and district nursing teams. One staff member explained they had maintained contact with a person’s family and a hospital to understand what care the person wanted when they returned to their home. Another staff member gave us an example showing how they had supported one person who moved into a care home for the first week, after their needs had changed. However, staff told us information was not transferred if people moved to other social care settings. For example, care homes.

Other health and social care professionals told us New Age staff sought their views on the care required to support people. In some instances, this had resulted in health professionals providing training for New Age staff, so they would be able to meet people’s needs when they joined the service. One health professional told us, “They have been very flexible and adaptable to meet [person’s name] needs, rehabilitation goals and have adapted and how [staff] support them, which meets with our person centred service."

Systems for communicating information about people’s needs required further development when they transferred to or from other social care settings. For example, a member of office staff told us they did not have a system in place to support communication of information about people’s needs and preferences, when people transferred from New Age Care to care home settings. However, systems for communicating information to some health organisations was working to benefit people in receipt of care.

Some people and relatives told us there were concerns about the impact of some staff actions. For example, one person told us despite discussions with senior staff, staff arrived later than agreed to provide care. The person said, “I don’t feel they understand the distress it causes.” The person told us this situation had started to improve recently. A relative told us there had been instances where staff had failed to reassure and interact with their family member, which had increased their distress. The relative said, “No one has addressed that. [Person’s name] has been screaming out since Monday.” However, the majority of people and relatives told us there were good relationships with staff and said they had no concerns people may be experiencing neglect or abuse.

Care staff gave us examples of actions they had taken to keep people safe. This included escalating concerns for people’s physical safety and mental well-being to other agencies. One staff member told us, “I would speak up if I felt something was wrong, you need to do the right thing in humanity.” Staff were confident their immediate line managers would take action to protect people, should this be required. Care staff had received training in how to safeguard people and knew how to identify potential abuse. However, we found some staff did not always know the range of external organisations they could contact to escalate any safeguarding concerns to. For example, Local Authority safeguarding teams, the Police and CQC.

Systems and policies need to be further developed to ensure people were consistently protected from abuse and the provider and staff had a clear audit trail to demonstrate integrity when supporting people. The provider’s escorted visits trips and holidays policy did not guide staff to ensure any financial contribution made by people was considered for immediate repayment, if travel was delayed, or inform staff to keep an audit trail of this. The escorted visits trips and holidays policy referenced seeking alternative funding streams. A procedure required developing to inform people which alternate funding streams are used and to clearly record what, if any, contribution they are required to make to any trips. Systems to ensure any concerns raised by people or relatives are promptly addressed need to be strengthened. The provider’s safeguarding policy should reflect the breadth of Local Authorities staff may be required to refer to. The provider may wish to consider expanding their gifts and legacy policy and staff handbook, so staff are provided with clear guidance on any expectations in respect of funding for their own meals and or contribution to trips and holidays.

People were positive about the way their day to day safety was managed and told us staff talked to them about their safety needs. One person told us, “Staff remind me to use my equipment. If anything is not right [staff] soon check and put it right.” Another person said they had received assistance from staff when mobilising around their home, and now felt increased confidence doing this. Other people told us staff worked at their pace and did not rush them.

Staff understood people’s risks and gave us examples showing how they supported people to manage these. This included risks in relation to falls, people experiencing anxiety and poor skin integrity.

Processes did not always ensure staff were given consistent guidance in how to support people safely. For example, the texture of food people required, or how to ensure people were supported to move safely around their homes. In addition, we found the range of care plans did not always reflect the breadth of support people had received from staff. For example, in relation to when people were supported to travel away from their homes. Systems did not always work promptly when staff escalated concerns people may not be eating enough. However, processes were in place to identify people’s risks and to provided staff with some guidance about how to reduce risks to people. People’s care plans evidenced people’s involvement in risk management, as there was detailed information about what could trigger people’s emotional anxiety or distress. Support plans also made clear what people were able to manage independently and when staff should offer support.

People told us staff supported them to maintain a safe environment within their home, which helped to reduce the likelihood of trips and falls. One person told us, “[Staff] do make everything very tidy and nice.” Another person said staff were careful to make sure the equipment they needed to move round their home was always within reach.

Staff told us they were encouraged to raise any concerns about the safety of people’s homes, equipment needs and their work environment so these would be addressed. One staff member gave us an example of raising a concern about the functioning of a lift located within a person’s home. The staff member said this was swiftly resolved.

Processes were in place to identify and mitigate any environmental risks within people’s homes and in the immediate vicinity when people’s care needs were assessed. This helped to promote people’s and staff’s safety. Systems were in place to check equipment required to support safe care was regularly serviced.

Most people told us they could rely on staff arriving when expected to provide their care. New staff were introduced to them during shifts whilst working with more experienced staff. However, some people and relatives told us this not always happen. One person told us the staff attending their care calls was sometimes different from the planned staff, and this caused them distress. One relative told us, “There have been some occasions where the staff have not turned up. [Staff] apologise, leaving voice mails, but don’t resolve it.” The majority of people and relatives told us people were supported by a consistent staff team. One person said, “Generally I see the same care staff and we have become quite good friends and have some fun, [we] laugh at the simplest of things.” This was not everyone’s experience. One relative said their family member had been regularly supported by care staff who did not know them well. The relative said new staff had been sent in for three consecutive days and told us, “[Person’s name] needs continuity. These staff have not done shadowing, do not know how to do the food and medication. [Person’s name] gets scared of new faces.” People told us staff had the knowledge to use the equipment needed to care for them. One person said, “The training is all fine from my point of view, you can see they have been trained, they are continually training.”

Staff confirmed they were not allowed to care for people until their DBS and references had been checked and they had completed shifts with more experienced staff. Office staff responsible for recruitment demonstrated knowledge and understanding of safe employment processes, including for the overseas staff. Staff with responsibilities for organising care calls understood the importance of maintaining continuity of care staff. Staff told us they were encouraged to develop their skills. One staff member said. “They are on your case about training, they push you in the right direction.” Another staff member told us, “[New Age] train us. They call us to the office and give us training and give us all the information we need to know.” Staff said there were enough staff to care for people and they were not put under pressure to do additional work. One staff member told us, “With New Age they ask you if you are available, and it is no pressure if you can’t. They give you choice.”

The system in place to check long serving staff completed their required learning required further development, to ensure staff completed training in line with the provider’s expectations. The process for ensuring care was provided as assessed and planned for some people living in areas which were geographically remote from the provider’s office required further development, to ensure all care calls were covered. However, systems were in place to promote the safe recruitment of staff. A process had been put in place to give a member of office staff delegated responsibility for overseeing the induction of new staff. The provider had processes in place to ensure staff who could only work limited hours did not exceed those hours. There was a system for allocating care calls and for monitoring these. A process was in place to provide cover for care calls from office staff locally, if required.

People we spoke with said they could rely on staff to take action to reduce the risk of the spread of infections, including using PPE and disposing of items as people wished.

Staff knew what actions to take to reduce the likelihood of people experiencing infections. Staff were supported to provide good infection control through training and had access to the PPE and equipment required to manage this. Staff advised us the systems in place for alerting them about any infectious outbreaks were working well.

Processes were in place to guide staff to manage people’s risk of infections. Systems were in place to prompt staff to undertake routine cleaning within people’s homes to aid the prevention of the spread of infections. Processes were in place to provide staff with the PPE and resources they required to promote good infection control. Systems were in place to undertake checks on staff infection control practices.

Most people managed their own medicines, or with support from family members. People said staff respected their right to manage their own medicines which helped to promote their independence. One relative told us staff did support their family member with medicines, but said staff were not clear about the medicines which needed to be administered to their family member, and they had not been able to resolve this with senior staff.

Some staff told us they experienced problems with recording people’s medicines because of the way rotas and care people required was uploaded onto their electronic care recording applications. One staff member explained this meant they were not always automatically able to record care provided, including medicines administered. The staff member told us it usually took the intervention of a senior member of staff to resolve this. This increased the risk people’s medicines may not be recorded correctly and the potential people would either receive too much or not enough medicines. Whilst staff told us they were not allowed to administer people’s medicines until they had been trained and observed as competent in administering them, we found instances where errors in how people’s medicines were recorded. This included why people had or had not been administered their medicines. However, staff gave us examples showing how people’s independence in managing their medicines was respected, with risk assessments in place, where appropriate. Staff said they were provided with the information they needed so they knew if people or their relatives were involved in ordering, obtaining, administrating and returning unused medicines. Staff gave us examples showing how they were promptly updated when people’s medicines were changed.

Systems to ensure the risk of harm to people who were administered medicines by staff required further development. Processes to advise staff what medication needed to be administered to people needed to be improved. This included systems to ensure medication tasks uploaded to staff’s rotas and applications were accurate, so these could be effectively monitored. Systems for promptly checking people had their medicines as prescribed need to be further developed. Processes for checking people’s medicines administration were not always fully documented and needed improvement. For example, the code “X” was used on medications administration records, but there was not always explanations of why this code was used. Policies and procedures to support staff to understand how to safely transport, manage and administer people’s medicines when travelling away from their home had not considered how to reduce risks to people. For example, a standard risk assessment did not consider what action to take if people were travelling when they required time critical medicines. There was no prompt for staff to consider what arrangements were needed for temperature sensitive medicines. The guidance for staff in the event of any problems with medicines did not tell staff how to escalate these to New Age senior staff. Risk assessments needed improvement to tell staff of the likely consequences if individual medicines were not available. For example, how this would impact the person and what action staff could take to support people and reduce people’s risks, should the medicines not be immediately available. Risk assessments did not prompt staff to discuss possible contingency arrangements with the nearest possible source of assistance prior to travel, so people and staff could plan to ensure risks to people were managed. However, processes for ensuring staff knew of any changes in people’s medicines were working well and people’s medicines were reviewed at appropriate intervals.