Patience Healthcare (Aapna) 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 kept safe and protected from bullying, harassment, avoidable harm, neglect, abuse and discrimination. They were respected and their freedoms protected in line with legislation. When people raised concerns, they were listened to. The registered manager, and other staff, took prompt and effective action to keep people safe. Staff protected people from the risks they faced. The registered manager ensured there were enough skilled staff to meet people's needs.

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.

People felt listened to and included. People and families were involved in discussions when staffing or other matters needed to change. One relative said, “I usually flag up any issues and the carers work with me to solve them – we work as a team.”

Staff knew how to report concerns and confirmed they could do so in an environment in which openness was welcomed. Staff felt confident raising any issues and that they would be dealt with appropriately. This had improved in the past year – the registered manager and operations manager had demonstrated a supportive and open approach in which staff could raise any issues.

The provider acted on immediate concerns promptly. There were some good examples of reflection on incidents and improvements in practice as a result. In one instance there needed to be more focus on what lessons could be learned from an individual situation, and greater exploration of potential risks. The registered manager was responsive to our feedback in this area and demonstrated improvements after our site visit.

People told us staff were patient and took the time needed to explain any changes and to engage with them to review and plan care. One said, “I decide what I want them to do and I ask them to do it. The carers treat me with dignity and respect and they understand my needs.”

Staff helped people, who may have been anxious about health and social care, to access the services they needed and to understand them more.

External professionals confirmed they had respectful and trusting relationships with staff. Staff had the knowledge and language skills to ensure people, the majority of whom could not speak English as a first language, were enabled to receive the support they needed from other health and social care providers. One social care professional told us, “Although this person was reluctant in allowing support, [Staff member] was very confident in communicating any concerns they had and offering tailored support.”

The provider had reviewed policies and had a range of measures in place to help establish if and when people needed more help to access a range of health and social care pathways.

People felt safe and described staff members they could trust and rely on. One said, “I have been receiving the service for the past two or three years, and everything has been excellent for me thanks to the care service. I have no concerns.” This was representative of the kind of feedback we received from a range of people and relatives.

Staff received regular safeguarding training and were confident they could raise any concerns should they need to. Staff understood what warning signs to look out for. External partners gave positive feedback about how the provider had reacted when there had been any safeguarding concerns. One said, “I was able to speak with the manager the same day I received the concern and was given the information and details required for me to close the case to safeguarding. The manager also offered additional information and offered to send training records as evidence.”

Safeguarding processes and policies were in place. The safeguarding policy was in need of review. For instance it did not contain clear information about who to contact, and information around some core areas of risk, such as self-neglect and mate-crime. The registered manager was responsive to opportunities to increase their learning around safeguarding. One investigation the provider had undertaken needed to do more to explore whether there were wider issues of risk. The registered manager responded quickly to our feedback to ensure all people were safe.

People were involved in risk planning and reviews. They confirmed the service regularly checked that there were no new risks. One person said, “I like to do everything I can do myself. They support me to do that and I am in control of my own care.”

Staff felt they were given the right information to understand the risks people faced and to help them reduce those risks. One staff member said, “I’ve got to know the people. We have meetings, there are files in the clients home and then we have a phone app.”

Care plans and risk assessments were in place but some needed further review and detail, particularly with regard to diabetes and epilepsy. Relevant information staff needed was not always in one coherent place - it was stored in different areas of the electronic records system. The registered manager and team were responsive to feedback, signposting to best practice, and they made improvements during the inspection.

People did not raise any concerns about how staff supported them to remain safe in their home environment. One person said, “They know how to leave everything and always clean up.”

Staff undertook risk assessments of people’s homes prior to providing care, to ensure people and staff were not placed at undue risk. People were supported and encouraged to be as independent as they were able to maintain their homes.

Policies and procedures helped ensure people were not put at undue risk through poorly maintained surroundings. There was sufficient time planned in and there were risk assessments to protect people and staff safe.

People were well supported by staff who arrived when they expected, and stayed the full duration of their planned visit. Analysis of a month of calls also demonstrated this. One relative said, “I’ve never had a time problem - someone is here usually within 5 minutes of my time.” Another said, “They are rarely late and if it gets near 20 minutes we always get a phone call.”

The registered manager and leadership team ensured staff were adequately supported to get to and from calls, with the right information. Analysis of a month of calls demonstrated there were very few delayed calls. Staffing levels were appropriate to meet people’s needs safely. Partners gave positive feedback about the provider’s reliability in being able to meet people’s needs, even at short notice. They had confidence in the ability of staff.

The provider used an electronic call monitoring system to ensure staff logged in and out of calls. Where there were late or potentially missed calls, the office staff were proactive in following up with people and staff – there were no instances of staff not logging in or out and people confirmed calls were never missed.

People and relatives raised no concerns regarding infection prevention and control (IPC). They had confidence in the standards of hygiene maintained by staff.

The registered manager ensured there was ample PPE and related equipment available for staff. Staff supported people to maintain their own homes.

The provider had IPC policies and processes in place, in line with current practice. Staff were regularly reminded of their obligations and received IPC training.

People told us they always got their timed medication at the right time and that staff understood the importance of this.

Staff received regular medicines management training and their competence regarding medicines administration was regularly checked. Where errors were noted or improvements required, this was shared with staff. External professionals gave positive examples of where staff had worked with them to ensure people’s medicines needs were met. For instance, reviewing and reflecting on a misunderstanding to ensure staff had the right skills to support people with their medicines. One professional said, “We have monthly multi-disciplinary team meetings regarding medication and they engage well.” Another said, “They provided tailored support around medication.”

There had been recent improvements regarding medicines. The provider has access to GP Connect. GP Connect allows authorised health and social care staff to see a person’s GP records. This meant if there was a change in a person’s prescribed medicines, the provider could see this and act on it immediately, rather than relying on seeking this information through a family member and GP. Medicines errors were rare as the electronic system did not allow staff to move on until tasks were completed. The registered manager was responsive to feedback about the need to continually review and improve practice, specifically around the need to improve medicines auditing. At the time of inspection these were not detailed enough regarding what good practice looked like in medicines administration.