Glenavon Care 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

At this assessment we looked at 5 quality statements: safeguarding, involving people to manage risks, safe and effective staffing, infection prevention and control and medicines optimisation. At this assessment we found concerns about safety were listened to, investigated and reported to the relevant authority where required, however the provider did not always notify the Care Quality Commission when incidents occurred at the service. The provider submitted the relevant statutory notifications retrospectively after our assessment visit. Information was shared with staff to learn from and make improvements to the quality of service people received. Staff had been recruited safely and there were enough suitably trained staff to meet people’s needs. People’s medicines were being managed and administered by trained staff whose competencies were regularly undertaken and there were effective infection prevention and control measures in place.

This service scored 66 (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.

All people spoken with told us they felt safe, and they and their relatives had no concerns about their safety when staff visited them. Comments included, “They [staff] are very conscientious and thorough, they noticed when mum had a pressure sore and reported it to the office,” “They [staff] have the right attitude, when they arrive, I feel confident to let them get on with the care. If [relative] has any bruises or spots they let me know. They stay in bed for safety reasons and their bed is at floor level to prevent falls.” And “They [staff] look after me, they are good to me.”

Staff confirmed they had received safeguarding training and demonstrated they knew how to prevent, identify and report allegations of abuse. They were confident the management and office staff would take appropriate action if concerns were raised. A staff member told us, “Safeguarding is about protecting people’s wellbeing and health. If I suspected any signs of abuse, we have a line of management to report to, general manager and directors and CQC if we need to.” The management team were aware of their role and responsibilities to safeguard people from harm and abuse.

The provider had systems in place to ensure all safety concerns were investigated and action taken to ensure people’s safety. Records showed the provider had made appropriate safeguarding alerts to the local authority when necessary, however not all incidents which had occurred had been reported to CQC. The provider submitted the relevant statutory notifications required after our assessment visit.

People told us they were being cared for safely and how staff understood their specific needs and how best to support them. Comments included, “Two carers come to help me with walking, with my frame and using my wheelchair,” “Two staff use a hoist, my [relative] has a hospital bed, the staff have received training.” And “The staff have all received training in how to use the overhead tracking, pressure relieving mattress and hoist.”

Staff understood how to manage risk to people’s wellbeing. Staff told us they read people’s risk assessments and were kept updated of changes to people’s care requirements. Staff told us they had received specific training in moving and handling to support people to move around their homes safely. A member of staff said, “A client I support, is at risk of becoming unwell if they do not have their meal on time. I wasn’t able to get to them on time once as I was held up, so I informed my manager who was able to get another carer to attend. We prioritise all risk service users.”

Risks to people’s health and wellbeing had been identified, assessed, reviewed regularly and updated when required. We saw detailed risk assessments and guidance for staff to follow. The providers digital care planning platform also provided additional prompts for staff to complete. For example, people who received catheter care, staff to wear gloves, wash their hands, observe the site entry and what to look out for and report if they had any concerns on each visit.

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

We received positive feedback from people and relatives about the timing of their care calls. People told us they were not rushed by staff and were happy with the care they received. Comments included, “Normally they [staff] are on time. If they are running really late, they ring the office, and they ring me. They will stay for the right amount of time,” “[Relative] tends to have the same people now. They know them and trust them. They [staff] arrive on time, and they do the full time they are here, they call me if they are running late. We have had no missed visits.” And “They [staff] are always on time, barring emergencies, and they let me know. There is no problem with my carers whatsoever. They certainly make sure I am feeling okay and comfortable, so no problem.”

Staff we spoke to told us they had sufficient travel time between visits. Staff told us there were enough staff to provide all planned care visits. Comments included, “We are fully staffed as far as I am aware. Our rounds are planned so that people’s homes are not far from each other which allows enough time to travel between clients. I have a regular round. We stay most of the time, if a person’s family are there once we have finished and completed everything, they may ask us to leave,” “We are not short staffed, I am not pressured to cover shifts. If someone does go sick unexpectedly the office staff will come out and cover. We have travel time; our rounds are very well planned.” And “The clients are not far from each other so travel time is short. I provide all the care the client needs and spend as much time as is needed with them.”

Systems were in place to ensure there were enough suitably qualified, skilled and experienced staff. Safe recruitment practices were followed. We checked the recruitment records for 6 members of staff and all the required pre-employment checks had been completed. This included disclosure and barring service (DBS) checks and obtaining up to date references. Where we found only 1 reference on some staff personnel files, the provider had risk assessments in place as to how the member of staff would be monitored to mitigate any risk to people using the service. There were dedicated office staff assigned to monitoring the call data in real time 7 days a week from 06.30 to 22.30 to ensure all planned care visits were provided. A monthly overview was kept of any late/missed calls with any actions taken, people we spoke to told us they had not received any missed calls.

People and relatives, we spoke to did not share any concerns in relation to infection prevention and control. Comments included, “They [staff] always have their gloves and apron on as well,” “The staff who come to us have everything. Just outside [relatives] room there are gloves, masks, aprons, wet wipes, everything is there.” And “The staff have access to masks, gloves and apron. They also wear a uniform.”

Staff were able to tell us how they use personal protective equipment (PPE) in accordance with best practice guidance. One member of staff said, “We wear PPE, face masks, gloves and aprons. If you are washing a client, we were taught how to remove and dispose of PPE safely. We use different gloves for all different tasks, food preparation, cleaning and personal hygiene. There is always enough in every person’s home. Every Thursday we are asked to check PPE stock and the office will provide more if we need it.”

Staff had undertaken infection prevention and control training and were provided with personal protective equipment (PPE) which could be collected from the office. The provider had an up to date policy in place to support effective infection prevention and control and was following current guidance.

People told us they received their medicines where required and on time. Comments included, “I have my inhalers. I have to have help to use them. I have pain relief tablets which they [staff] give to me in the morning and my inhaler twice a day, and the blue one [inhaler] when necessary.” And “They [staff] give me my medication three times a day in a little beaker. I have a bottle of water here.” A relative told us, “Carers record the medication on a chart, they always ask [name of person] if they have any pain and give them pain relief when they need it.”

Staff told us they had completed training to administer people’s medicines and confirmed that their competency was assessed at regular intervals. One member of staff said, “We receive mandatory practical and online training around medication. We also have yearly refresher training. I always ensure I read the MAR chart for any changes before administering medication. The senior carer regularly visits to spot check my work and to go through the MAR chart, audit it and give feedback.”

There were appropriate systems in place to help make sure medicines were managed in a safe way. We saw that audits were completed monthly, and any issues were dealt with promptly. We were assured that lessons were learned and shared with the staff team following any medication error or incident. The provider had a designated staff member monitoring the electronic e-mar app in real time to minimise the risk of medication omissions. For example, if a staff member left a visit without administering a person’s medicines the system would alert the office staff. Office staff would then call the staff member to ensure they returned to the person’s home to complete the task. We saw that people’s care plans contained clear details about the medicines they took, as well as when and how they required them.