Fam Daily Care Ltd

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

People were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. Staff understood their responsibilities to protect the people in their care. Individual risks to people had been assessed and recorded in their care plans to keep people safe. Incidents and accidents were documented and reviewed to prevent re-occurrence. There were systems in place for the monitoring and prevention of infection. Sufficient staff were available to meet people’s needs and a robust recruitment system was in place.The service had appropriate arrangements in relation to management of medicines.

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.

Relatives confirmed there was a learning culture at the service. They told us they were confident, if they raised any concerns, that appropriate action would be taken to minimise the risk of repetition. A relative explained the service managed the complexities of people’s care well and kept families updated if any issue arose.

The registered manager told us they understood their responsibility under the Duty of Candour. They said, “Honesty, transparency, also apologising if we are wrong. If [person] has a fall, you have to inform the family. It’s about building confidence. We report to the local authority and CQC.” The registered manager gave an example of lessons learnt when a person using the service was being assessed by another service. The representative from the other service demanded the person stand up when they were unable to weight bear in a forceful manner. The registered manager happened to be present when this occurred and told us the lesson learnt was to ensure a person was never left unsupervised when being assessed by another service provider. The registered manager took action and reported this incident to the local authority and family. Staff confirmed lessons learnt from accidents, incidents and complaints were shared with the staff team. A staff member told us this was shared, “So we can all take correction from it and improve.”

There was a system in place to record accidents and incidents, which documented actions taken and lessons learnt.

Relatives told us they were satisfied with the arrangements for their relative transitioning into the service. A relative explained, they had to go abroad due to an emergency so was supported to organise their relative entering the service quickly. Another relative explained that staff were very good with supporting their relative to transfer into the service and this helped the relative to settle in well.

The registered manager told us there were systems in place for people transitioning into and out of the service. They said, “If somebody is transitioning in, we ensure we have a robust assessment of their needs by visiting and making sure the person is part of that meeting and make sure the family are involved. We speak to nurses and the former GP. I make sure all areas are covered. If moving to another service we make sure we have time to speak with them [the new service and], give them information they need to know. We also keep in touch with families to make sure they are doing well.” The registered manager told us, if there was the opportunity, they would arrange for staff to shadow at the other service and vice versa. Staff understood the process of assisting people to transition into and out of the service. A staff member explained for people transitioning into the service, “We try to know what their needs are first, prepare the bed and a chair for them to relax and assist them to move in. We take a record of the report from the person who brought them in.” This staff member explained for a person transitioning out of the service they helped them to pack up their personal items and medication; the manager and a colleague accompanied them to the new service and gave a handover to the receiving staff.

The management team worked closely with the local authorities which paid for the care packages to ensure they had enough information to enable them to meet people’s needs.

The provider had a system in place to gather care needs information when a person was transitioning into their service. Likewise, the service followed a similar process to pass on relevant care needs information when a person was transitioning into another service.

People told us they felt safe with staff and living at the service. Relatives told us their relative was safe at the service and a relative said, “Very safe with staff. Staff watched [relative] like a hawk.”

The registered manager explained how they knew staff understood the safeguarding procedure and said, “Normally we randomly ask the questions, and we stress in supervision. We do supervision monthly now but before we were doing 6 monthly.” The registered manager told us there had been no safeguarding concerns since the service became operational. They understood their responsibility when there was a safeguarding concern and said, “I would investigate and whoever is involved would be suspended. Or would call them in one by one and speak with them and make them understand such issues. We would let the local authorities know and communicate with the families. Of course I would call CQC.” Staff knew what actions to take if there was a safeguarding concern. Comments included, “It is my duty to make sure they are not being abused in any way and it is my duty to report to the local authority”, “We may want to report something we see that we don’t like. I believe I can report to CQC. I can go to the police” and “My major role is to keep [people using the service] safe. I will report to my line manager and even then, I will report to the local authority. Whistleblowing is reporting a concern that may lead to harm to the service users.”

Staff were observed to protect people from potential risks of harm, for example, checking who visitors were and who they were there to see.

The provider had a process in place to inform relevant authorities if there was a safeguarding concern.

Relatives confirmed the service took steps to minimise the risk of harm or injury their relative may face. A relative said, “Yes, they do. [Relative] is not allowed to go out on their own as has various [health] conditions.”

The registered manager explained the risk assessment process and said, “Normally we identify what is the object of risk, who is going to be affected, analyse the risk to know the depth of the risk and after that we try to put in place measures to reduce the risk and we review to see if the measures are working.” Staff understood their role in risk management. Comments included, “I will help in identifying the risk and minimise the risk. The risk assessments are in the system”, “My role is to ensure the service users are safe. To read it [risk assessment] and understand it” and “Finding and pinpointing the possible risks and the consequence, who it might affect and how it should be prevented.”

During our inspection we saw people were relaxed and comfortable in the presence of staff.

People had risk assessments and risk management plans in place. These included personal emergency evacuation plans, fire, self-harm, epilepsy, confusion, high blood pressure, falls, constipation, choking, infection. People also had relevant health specific risk assessments such as epilepsy, constipation, confusion, high blood pressure and (in relation to Huntington’s disease) distressing symptoms. For example, for the person with epilepsy there was a description about what the person’s seizures looked like. There were then clear guidelines for staff about what actions to take in the event of a seizure such as placing person in recovery position, timing the seizure, to administer as required medicine if the seizure lasts 5 minutes and then call an ambulance.

Relatives told us they thought the environment was safe. A relative told us their relative, “Has a nice room. Got where it is being located as it encourages [relative] to exercise. Has a nice view.”

The registered manager described the environmental checks they carried out when they did their daily walk around the building and anything they noted of concern was acted upon straight away. The registered manager and deputy manager carried out regular building health and safety checks. Staff told us they felt the environment at the service was very safe.

We observed there were grab rails in the bathrooms and fire exit signs appropriately placed throughout the building. There was stair lift in place for the first flight of stairs for people with mobility difficulties. However, due to the low ceiling, this may be difficult for people of a certain height to use. We discussed this with the manager who agreed that anybody with mobility difficulties would be better placed in the downstairs bedroom.

The provider had a system in place to carry out safety checks. Records showed a gas safety check was completed on 9 October 2023, portable appliance testing was done during March 2024, an electrical installation check was completed on 13 April 2024 and legionella testing was done on 3 June 2024. We saw fire safety checks were conducted during March 2024 which checked the call bells, emergency lights and smoke alarm.

Relatives confirmed there were enough skilled staff on duty to meet people’s needs. A relative told us, “Always enough staff on [duty] and they were friendly. Staff had all the right skills.” Another relative said, “I think [registered manager] has the right staff and training now. The service has the right people in place.”

The registered manager explained there was enough staff on duty to meet people’s needs, there was currently no staff vacancies, and they did not use agency staff. They told us how they covered planned and unplanned staff absences. They said, “We have a lot of staff living locally and have a pool of bank staff. We book them cabs as an incentive. Myself and the deputy will step in if needed.” The registered manager told us they worked out the staffing levels according to the needs of the people using the service. They explained each day there was 2 staff working with a 3rd staff member starting later to support the 3rd person at a time of their choosing and there were 2 staff awake at night. The registered manager explained staff received an induction when first began employment which included a company overview and completion of 15 courses inhouse. The registered manager said they used private trainers and skills for care for induction and refresher training. New staff shadowed experienced staff for 1 or 2 days if experienced, but this was for longer if inexperienced. Staff believed there were enough staff on duty to meet people’s needs and allow them to take regular breaks. Comments included, “We have enough time to support [people] in any way that is deemed fit” and “Yes we do have enough staff.” Staff confirmed they had received training which they found useful in carrying out their job. Comments included, “I have recently completed the care certificate. The training is useful and more useful than what we did last year” and “I have done training from Care Skills; our supervisors do training for us; very, very useful.”

We observed there were enough staff on duty to meet people’s needs and nobody had to wait for assistance.

The provider had a safe recruitment procedure in place including carrying out checks on applicants before they began employment. The checks included identification, health, references, right to work in the UK and criminal records. People were supported by staff who had received suitable training.

Relatives had no concerns about cleanliness of the environment or infection control.

The registered manager explained how infection prevention and control measures were used within the service. They told us, “We use [personal protective equipment]; it’s very, very important. We take this very seriously. From the day [a new staff member] arrives, we train them in how to control infection.” Staff were knowledgeable about how to prevent the spread of infection. A staff member said, “I make sure I have my [personal protective equipment] on, and I always make sure I change my gloves and apron [moving on to support the next person]. Make sure everything is clean, and I am also clean.”

The premises were observed to be clean and fresh smelling. Staff were observed to wear personal protective equipment such as gloves appropriately. There were handwashing facilities available to people using the service, staff, and visitors.

The provider had an infection prevention and control policy in place. Staff received training in infection prevention and control, and this was up-to-date. The provider carried out quality checks of the cleanliness of the premises. These checks included spot checks of staff working to ensure they followed the correct infection control procedures.

Relatives told us they were satisfied with how their relative’s medicines were managed. A relative told us, “Staff managed [relative’s medicines] very well.”

The registered manager told us they talked to staff and reminded them about the importance of administering medicines safely. They also told us they had a good relationship with the pharmacy and the GP, and they were very helpful. The registered manager told us they made sure people received their medicines on time and had regular medicine reviews. Staff understood their role in ensuring people received their medicines safely. They explained their role included seeking the person’s consent first, observing the person does swallow the medicine and signing the medicine records.

We checked the medicines for one person and found these to be correct. There were no gaps in the MAR chart and the correct number of tablets were in stock. Where appropriate, people had guidelines in place for medicines to be administered as required. Details of when ‘as required’ medicines were administered were documented on a chart with the reasons for administering it.