Charlesworth 247 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 received safe care and support. Staff understood how to identify and act on any concerns about people’s health and safety, including potential signs of abuse or neglect. The registered manager took appropriate action where required. This included making referrals to relevant agencies such as the CQC and local authority safeguarding teams. There were enough trained and competent staff available to support people safely. Staff told us they had enough time to complete all care tasks at each call. Staff felt supported and received regular supervision of their role. People and their relatives were involved in their care planning. Care plans identified risks and provided staff with guidance on how to support people in their chosen way. Staff told us care records provided the information they needed to provide safe care.

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.

Staff had a good understanding of the how to identify any concerns about people’s safety. They knew how to report concerns both internally to senior staff and externally to other agencies such as the local authority safeguarding team and the CQC. A staff member said, “When we go into someone’s house and visit our clients we look for unexplained changes in their behaviour and personality, if they come across anxious or withdrawn it would be reported straight away to our manager; our concerns are logged in the daily notes that we do at every visit.” Another staff member said, “Potential signs of abuse can be something physical such as a bruise, it could also be financial. In these cases I would contact the manager and let them know. As a carer it is important we do not make any judgements ourselves, we ensure the client’s needs are being met while we are providing care.” The registered manager had a good understanding of the regulatory requirement of their role to ensure concerns about people’s safety were investigated and reported to the relevant authorities. They were able to explain what action they would take and how this reduced the impact on people’s safety.

Relatives told us their family members were safe when staff supported them in their homes. One relative said, “[My family member] feels very safe in their care.” Another relative said, “[My family member] feels safe: the carers are really nice ladies. I have no complaints or concerns.” A third relative said, “[My family member] feels very safe and often looks forward to the visits and the chats they have with a new face.”

Staff had received safeguarding training. This enabled them to identify the potential signs of abuse and how to report it. A safeguarding policy was in place. This contained the appropriate information for staff and senior staff to follow should there be a concern about a person’s safety. Records showed referrals had been made to the relevant authorities where required. Internal investigations had been completed and the outcomes of the investigations had been used to help aid staff learning and development. For example, a medicine error had been identified. It was acknowledged the staff member had made an error and appropriate re-training/guidance was provided and all other staff reminded of their responsibilities to reduce the risk of recurrence. The provider ensured people’s rights were respected and care provided in accordance with the Mental Capacity Act 2005. Where people had been identified as being unable to make a decision about their care needs, an assessment had been made and decisions taken in their best interest. Discussions were held with relatives and other relevant people where required. We did identify a small number of assessments that lacked specific detail about the decision being made. This could place the person at risk of receiving inconsistent care that could affect their rights. The registered manager took immediate action and have amended their assessment process. We have seen evidence of this process and are satisfied that people’s rights were not unlawfully affected.

People and relatives told us they were involved with care planning and were aware of the risks relating to their care. A relative told us staff were accommodating and they told them if they felt a decision was not in their family member’s best interest. They told us staff always spoke with them and their family discuss the implications of any decisions made.

Care plans contained essential information for staff to be able to provide safe care and support. Risks to people’s health and safety in areas such as personal care, medicines and pressure care had been assessed and the required action to address the risks had been agreed. Regular reviews of care took place with people and their relatives to ensure the current care provision continued to meet their needs. Staff were currently providing support for a person who required a hoist and help with exercises. The staff had discussed the risks involved with the person and the care and support was agreed. The person can now use their specially adapted equipment to move around their house and can read books in their living room. This was important to this person. Environmental risks had been discussed with people and recorded within their care records. Agreements on how to make a person safe in an emergency had been agreed and recorded. This helped to keep the person safe.

Staff told us the care records provided them with sufficient information to provide people with the care they needed. They were aware that the care and support needs had been discussed with people (and relatives where appropriate) and risks to their health and safety had been identified, assessed and plans put in place. The registered manager told us they were confident that people received care and support in accordance with their preferences.

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

There were effective processes in place that enabled the registered manager to regularly review the numbers of staff available to ensure calls were conducted on time. Staff logged in when they arrived at a person’s house and logged out when they left. This also enabled the registered manager to monitor how long calls were taking and whether people could reduce the number of calls they needed, or, if calls needed to be increased. This process was working well and ensured people continued to receive safe care that met their needs. Staff received regular training. Staff training requirements were monitored, and any gaps or training needs addressed quickly. We did identify a small number of staff who were required to complete refresher training in some areas. The registered manager was aware and had provided a plan on how this was to be addressed. This would ensure people continued to receive care from well-trained and competent staff. Staff received regular supervision of their role. This included one-to-one sessions with a senior member of staff and observations of their practice. Records showed any areas of concern or development were highlighted and discussed with staff. This ensured that people received care from well-trained and competent staff. Staff were recruited safely. Checks on staff identification, right to work, past employment and criminal records were completed before people commenced their role. Inexperienced staff completed a robust induction which included the opportunity to complete the Care Certificate. An externally recognised qualification for staff in the adult social care sector. All inexperienced staff shadowed an experienced member of staff until they were deemed competent to conduct their role alone. These processes helped to ensure people received safe care from competent and suitable staff.

Staff told us there were enough staff in place and had enough time allocated on each call to provide people with safe care that met their needs. A staff member said, “I think there is enough staff, obviously there are sickness and bereavements that are unexpected, but a call goes out and we all pull together and take extra shifts if necessary. The manager recruits as and when she needs to.” Staff felt well-trained and supported in their role. A staff member said, “We do online training which keeps us up to date with the latest legislation. For practical training we have a training room where we have the use of a hospital bed, how to use a hoist and slide sheet correctly. All of this is useful knowledge for when we are working together or singular in clients’ homes.” Another staff member said, “We have one to one supervision with a senior carer where we can freely speak if something is working or not for us.” The registered manager told us they felt they had sufficient numbers of staff to manage the service effectively and to provide high quality, safe care for people.

People were provided with safe care by consistent, well-trained, competent, and experienced staff. Staff arrived on time for calls; on the rare occasion they were running late, people and/or relatives were always informed. Relatives told us they felt there were sufficient well-trained and experienced staff in place to provide safe care for their family members. This offered them reassurance that when they were not available for their family members, staff were able to provide the care they needed. A relative said, “My [family member] is happy with the carers who arrive on time and stay the full duration.” Another relative said, “They arrive on time, and we know who will be coming because we have a rota.” Relatives also told us staff were well trained and understood their family members’ care needs. A relative said, “The care package he has is very good and the care Charlesworth provide is perfect for his needs at the moment. [My family member] enjoys their company when they come.”

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.