Violets Homecare Services Limited

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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 safe when receiving care and protected from avoidable harm. Staff were recruited safely, and there were sufficient numbers of staff to meet people's needs. However, people expressed dissatisfaction regarding the consistency of staff people. Not all areas of risk had been identified and processes put in place to mitigate further risks.

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.

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 their care and support was managed and provided safely. One person told us, “They are polite and well trained, so I feel safe.” A relative said, “[Family member] feels safe and I am also satisfied because the care workers are professional.”

Staff we spoke with told us they felt comfortable to report unsafe practice. One staff member informed us, “I am kept up to date with changes and as part of my role when I am on call, I will send any safeguarding alerts I need to.” Another staff member commented, “I would report if I saw any signs of physical abuse or if the service user told me something that was affecting them mentally. I would contact my manager to report this.”

The provider had suitable adult safeguarding systems and procedures in place. The registered manager maintained and monitored records of concerns to help ensure these were responded to effectively and learnt from. We saw safeguarding training was completed by all staff. The provider reported safeguarding concerns as required to the relevant agencies.

People told us they felt that staff supported them to maintain their safety. For example, 1 person said, “Their professionalism makes me feel safe.” A relative commented, “[Family member] is safe in the presence of the care worker.”

Staff were aware of the risks to people identified in their care plans. One informed us, “Risk assessments are in the service user’s individual care plan which is kept in their file at their home. It shows any risks in their home, risks when moving and helping with care, health risk and medication risks to be aware of.”

Risk assessments were in place for a range of issues including the environment, medication and moving and handling. However, risk assessments were not in place for all identified areas of risk. For example, we saw that 1 person had previously had a grade 2 pressure sore and had been assessed to have poor skin condition. In addition, they were also being cared for in bed. This put them at risk of developing a pressure sore. There was no risk assessment in place to mitigate the risks of developing a pressure sore and no guidance for staff about how to monitor the risks. We found that in 2 cases people had a history of falls but there were no falls risk assessments in place. Care plans did not fully detail the guidance staff needed to reduce risks to people. For example, the care plan for a person who was at risk of developing a pressure sore lacked detail and the only actions recorded in the care plan was, ‘repositioning’. It did not detail how often the person needed to be repositioned, how this was to be completed and whether there was a turning chart in place. We did not find evidence people had been harmed as a result of this lack of detail, as people told us staff assisted them well when needed and kept them safe.

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 told us that staff provided them with care and support safely and that staff were kind and caring. One person said, “They are great. I would give them 9 out of 10.” Another person commented, “The management team is respectful, kind, and friendly. 10 out of 10 and we are grateful.” A relative told us, “[Family member] is quite happy. The carers are really courteous. They keep an eye on [family member] and keep them safe. They are always very polite and [family member] can talk with the carers.” People told us they were not always supported by a consistent group of staff. One person said, “I like to have the same carer, however occasionally they change, and they cannot guarantee I see the same carers.” A relative commented, “When [family member] sees a different carer on the weekends, they become irritated.” Another relative informed us, “[Family member] requested the company to send the same care workers every morning because they dislike having different carers. There is no consistency.” A third relative told us, “[Family member] dislikes different carers in the house because of their dementia.”

Staff told us they felt staffing numbers were sufficient to meet the needs of people and keep them safe. We spoke with 1 person responsible for scheduling the care calls. They told us, “Yes, we have enough staff. We have plenty of bank staff who give us their availability the week prior to the Rota being sent out. Staff have travel time in between calls and staff are placed in geographical teams so we try to ensure consistency.” Staff told us they were well supported in their role. One staff member told us, “I had a full induction, and I get regular training, both on-line and face to face. The office staff do spot-checks, where they turn up unannounced and observe my practice. I receive regular supervision and can go to the management with any concerns. I do feel well supported.”

We saw that an ongoing schedule of training was in place, to ensure staff kept up to date with good practice. New staff completed an induction period, which included shadowing more experienced staff to get to know people, as well as covering the basic training subjects. Records provided evidence that staff had regular one-to-one supervisions and annual appraisals. Staff’s performance was monitored and managed well. Safe recruitment practices were followed for staff working with children and adults. Checks were carried out including references and the Disclosure and Barring Service (DBS).

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.

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