AAA Homecare Limited - Teesside

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

This is the first inspection for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm. The registered manager had established systems to identify safety events and ensure these were investigated thoroughly and any lessons learnt were embedded in to practice. They worked with people and partner organisations to maintain safe systems of care and this was based on openness and honesty. The registered manager and staff worked closely with people to understand what being safe meant to them as well as with external professionals around the best way to achieve this aim. Risks relating to people's environment were assessed so people and staff remained safe. Recruitment practices were robust with an electronic system with prompts, which aided compliance. There were enough staff to deliver the care package and systems were in place to ensure new care packages could be supported with adequate numbers of staff. Medicine management was effective. Staff who administered medicines had the appropriate training. Staff followed appropriate infection control measures. The registered manager ensured staff were trained to use equipment and understand how to check items were fit for purpose.

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 told us they were involved in all aspects of the design of the care package and how it was delivered. They found staff were competent, caring and treated people in a dignified manner. One relative said "We were involved with the plan of care. Yes, at one of the reviews it was decided to increase the visits to 4 a day due to safety issues."

The registered manager told us that they promoted a service where they encouraged people and staff to speak up about any concerns. They said, "We are one team so if someone makes a mistake, we all take that on board and learn from it together. There is no blame as we are one team." All staff we spoke with said they felt able to speak with the registered manager. One staff said "They listen to my concerns and provide feedback, making me feel valued and involved in improving the quality of care."

The registered manager promoted an open and honest culture at the service. They regularly reviewed the systems and processes in the service to determine if improvements could be made. Action plans were used to identify and monitor where changes were required and how these could improve the service. Learning from accidents, incidents and safeguarding was shared with the staff team via meetings and coaching. The registered manager had an effective system in place to monitor the quality and safety of the service and ensure people achieved positive outcomes had been put in place.

People told us they felt safe and they experienced a smooth transition when the staff took on their care package. One person told us, My care plan was done with me and the registered manager. He also came to the hospital when my wife was in so he knew her care needs when she was due to return home." People told us that the service visited them at home to assess their needs and the environment. One person said, "We have been with AAA for about 3 months and they did a full house survey looking at steps, trip hazards and her electric chair."

The registered manager had a range of policies and procedures to manage risk and monitor the safety of both people and staff. Staff understood when people required support to reduce the risk of avoidable harm, and risk assessments were in place. One of the team leaders explained the assessment process to us and how the home visit and assessment from care managers was the "bare bones" of the start of the care plan development.

We were told that communication and response from the service was very good. One commissioner told us, "AAA picked this package up at short notice and went out of their way to help [Name] when we were struggling to get a provider to travel out of the town. The registered manager worked quickly and efficiently with us to get the package sorted to enable the person to return home."

Systems were in place to ensure people transitioned to the service in a safe manner and there was continuity of care. Over the last six months the registered manager had been gradually building the foundations of the operation and only taken care packages when they were confident they could met all aspects of the care and support required. Care packages were only accepted when the registered manager and staff were confident the person’s needs could be met. The registered manager ensured care plans contained pertinent information about people’s needs and preferences to enable staff to provide appropriate care.

Everyone we spoke with said they felt safe with the service and staff provided by AAA Homecare Limited - Teesside. One relative said, "Yes she is safe, they get her up and get her showered. AAA are like a light at the end of a very dark tunnel!" Another person using the service said, ”Yes I'm safe and I would contact the office if I felt that I wasn’t."

Staff said they had training and a good understanding of what to do to make sure people were protected from harm or abuse. Staff were able to tell us actions they would take should a concern be raised with them. One staff told us, "If I thought a person I was supporting needed safeguarding I would speak to my team leader and manager. I would monitor the situation and document all concerns."

The registered manager had safeguarding systems in place. They showed us their safeguarding policies and procedures and told us how they operated an open door policy to encourage people or staff to raise any concerns.

People told us they were happy and confident with how the servcie supported them to manage risks.

Staff we spoke with told us they were kept up to date with changes to risk via the use of the app that is used to record all care needs. One staff said, "Any changes are communicated through Careberry application and updates from my manager or colleagues, ensuring I’m always aware of the current needs and risks." Staff reported there were enough care workers to meet people's needs and they work together effectively to provide safe care that meets people’s individual needs. They found the provider had systems in place to mitigate the risks of people

The registered manager had an effective system in place to monitor the quality and safety of the service and ensure people achieved positive outcomes. Systems were in place to ensure staff understood when people required support to reduce the risk of avoidable harm, and risk assessments were in place. The registered manager was continuing to work through risk assessments to make improvements to detail and to ensure the electronic app process was developed to the exact requirements of the service.

People told us staff had the skills and knowledge to carry out their role effectively. They found staff were trained in delivering all the care and support they needed. They were confident staff could carry out their role safely and competently.

Staff told us they have received training around adopting safe working practices and following best practices guidance. They felt safe working at the service and had access to all the appropriate equipment they needed. The registered manager had recently ordered moving and handling equipment so that staff could have training onsite. Team leaders told us they were involved in providing an induction for new staff which included coaching in the use of equipment.

The registered manager had processes in place to ensure the office was fit for purpose and staff could access equipment as needed. The registered manager made sure staff had received training to support people who had equipment in their homes, which included how it was cleaned and safe. They understood what risk assessments were needed to make sure staff followed health and safety guidance. Also the provider had policies in place for this and lone working procedures.

People told us the care package met their needs and there were always enough staff to deliver it. One staff told us, "Yes they are well trained, they know what they are doing and always come on time. They wouldn’t need to ring me saying they were running late as they are never that late and they never miss seeing me."

Staff fed back to us they felt there was enough time and staffing at calls to meet people's needs but that travelling time could be an issue, we raised this with the registered manager for review. Staff reported they worked together effectively to provide safe care that meets people’s individual needs. One staff member told us, "The induction was thorough and covered essential areas like company policies, safeguarding, health and safety, and an introduction to the role. I felt well-prepared to begin my duties."

Robust and safe recruitment practices were in place, and these made sure staff were suitably experienced, competent and able to carry out their role. Recruitment, disciplinary and capability processes were fair and were reviewed to ensure there was no disadvantage based on any specific protected equality characteristic. We saw evidence confirming when there had been changes to individual’s packages of care. The provider had worked closely with partners to ensure these changes were delivered safely. The staffing levels and skill mix ensured people received consistently safe, good quality care that met their needs. Staff received the support and training they needed to deliver safe care. This included supervision, coaching and support to develop, and improve services where needed. Staff received training around all aspects of care including condition specific training. A team leader told us, "A new client got a slide sheet and I hadn't seen one so the OT gave me training and I was meeting staff there on each visit so I could show them how to use it correctly."

People told us staff followed expected infection control practices.

Staff confirmed they received training on infection control procedures. They told us they had all the equipment they needed to reduce the risk of spreading infections.

The registered manager had systems in place to mitigate the risks of people and staff from catching and spreading infections. We saw evidence to confirm staff had received infection prevention and control training and their practices were regularly checked.

People’s medicines were managed in a safe manner. One person told us, "They are very competent and know what they are doing, some even came to my mums' funeral and you don’t forget things like that! The carers do the medication which is in blister packs and locked away."

Staff told us that they received training in how to safely administer medication.

The registered manager completed regular checks to ensure medicines had been given as prescribed and records were accurate. Staff were trained in medicines management and processes were in place to assess whether staff were competent to administer people’s medicines. Staff were given clear guidance on when to administer medicines. We saw at the start of our visit that some records relating to 'as and when' required medicines needed further improvement, however by the end of the assessment period of one week, these were all updated and in place for people.