Leaf Care Services

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

Staff received all mandatory training and some other training, but there was a lack of oversight to ensure all staff had received the specific training to meet all the needs of people they cared for. People did not always feel their concerns were listened to, but felt if they had serious concern this would be addressed. They felt they were supported safely. Risk assessments were in place to help ensure people’s care needs were meet and minimised any risks they faced. This included for medication. Their needs were identified at the start of the care being provided and reviewed regularly afterwards. There were enough staff to meet care calls. Measures were put in place by the registered manager to try to address the identified shortfalls during the assessment.

This service scored 62 (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 gave mixed feedback on raising concerns. Some people said when they raised concerns they had no feedback and these were not addressed, however, they felt if there was a serious concern it would be addressed. There was a concerns and complaints system, but it was not being implemented to capture informal complaints and concerns. This was addressed by the registered manager during the assessment. There were whistleblowing policies and speak up posters to encourage staff to raise concerns. Staff confirmed this and said safeguarding was discussed as part of their supervision. Lessons learnt were identified by the registered manager from such things as formal complaints and safeguarding incidents. These were discussed at staff meetings and had led to change. For example, plans were developed with people to be used in the event of the main family carer unexpectedly being unavailable to ensure the person was kept safe and cared for.

People and relatives said they were visited when they first started to use the service on the day, or before, to ensure everything was in place and to make sure they were aware of what would happen. One relative told us, ‘Leaf care are really good. [Person] came home at 8 am and the manager was out by 11 am and sorted what we needed and let us know what to expect and when the carers were coming and left all the paperwork’. Health care professionals were positive about how the packages of care were set up and how the staff listened to the guidance for working with people to meet their needs. They felt the team were polite and professional, which led to smooth transitions of care. There were systems in place to ensure reviews of care took place regularly. Staff told us care plans were in place when they first visited a person. They would be informed by the office, or someone would meet them at the new person’s home to show them how they liked things to be done.

People and relatives said overall they felt safe being cared for by the staff. They said, ‘They are nice to me, and I am safe with them’. Staff were aware of how to raise safeguarding concerns and had received training. Staff who had raised concerns which had been safeguarded, felt they had been supported during the process. There was a safeguarding log in place, however, the system in place was not clear on identification, actions taken and outcome. Mental capacity assessments were taking place and were following good practice and well documented. However, there was some inconsistencies within records on people’s capacity status and if a power of attorney was in place. The registered manager made changes to the systems to ensure it was more robust as part of the assessment.

People and relatives told us the care plans and risk assessments were in place and regular reviews took place via spot checks. Regular telephone calls from the office to people were made to check on the care provided. Appropriate risk assessments were in place to ensure staff had guidance to manage and mitigate risks to people. However, we did identify gaps and inconsistencies within the care records, for example a person had creams applied but these were not documented within the care plan or risk assessment, and another person was at high risk of bleeding from their gums, but this was not reflected within their oral health care plan. Staff said if they identified any changes needed in the care, they would contact the office who would ensure updates were made and communicated around the staff team. High risk audits were completed by senior carers each month to review care and ensure all risks were identified and appropriate referrals made.

Risk assessments were in place for people’s home which included such things as pets, smoking, and other hazards. Lessons learnt from events had been included to improve safety. For example, reminders to check airflow mattress. Monthly workplace reviews of offices to ensure they were safe places for staff to work in had been implemented. Lone working was discussed with staff during supervisions and staff told us they had an alert on their phones which they had received training on to use in an emergency.

People and relatives gave mixed responses about the levels of training of staff, but the ones who had consistent, regular carers were happy with the care provided. One said, ‘well some know what to do, the new ones don’t, and I have to tell them but there are some very good ones’. There was poor oversight over whether all staff attending calls had the appropriate training to meet the person’s needs. However, in most cases they worked with another carer who did have the required training. There was ongoing recruitment to ensure there were appropriate numbers of staff. Staff told us they had appropriate inductions on starting which equipped them for the role and felt supported. Some staff were trained as champions in such areas as dementia, end of life, medication, mental health & wellbeing, moving and handling and reablement to help support staff to develop skills and abilities in these areas. Following our assessment the registered manager improved the oversight of the training and carers allocated to people to ensure they had the required training.

People and relatives were happy with the level of cleanliness by staff. They said staff wore gloves when providing care but not all of them wore aprons. The registered manager had identified this and felt this was an education issue about when aprons should and should not be worn. Infection control audits were being completed which covered such things as hand hygiene, cleaning, chemical use and personal protective equipment (PPE) glove wearing. Staff were provided with sufficient PPE and could access PPE when required.

People who were provided with medication support were happy with the care provided. They gave examples of when staff had identified issues, such as repeat prescriptions not being sent and informed relatives to ensure this could be resolved. There were appropriate medication policies and systems in place. Staff received training and competency checks, and medication errors were investigated. There was a medication champion who was responsible for completing monthly medication compliance audits. Staff had worked with health care professionals to review people’s medication, so they didn’t stay on medication longer than needed.