Gentle Hands Home Care

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

At our last inspection we rated safe as good, this rating remains unchanged. The service was safe and people felt safe receiving support. There were sufficient staff to meet their needs. On the whole, people now had regular staff. Staff and leaders took appropriate actions to ensure people were not left at risk of harm. Care and support was delivered by competent and trained staff. Where people required assistance to manage their medicines, staff did so safely.

This service scored 72 (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.

Staff knew people well and understood how to provide the care they needed. Paper copies of information were printed off for people and care staff, to access. Staff used a mobile phone app with a prompt system, to carry out key care tasks for people and to keep them safe. Care staff recorded the care provided to each person by writing the details onto the person’s ‘Daily running record log’, and the ‘MAR record log’ (Medicine administration record). These are paper records which were left in the person’s home until the end of the month.

Staff worked with partners, for example, district nurses and commissioners, to provide appropriate care to people.

Systems were in place for assessing, managing and monitoring safe systems of care. In addition to checking written records at the end of each month, the managers met with people receiving the service regularly, when they were providing support. We saw incidents and notifications were reviewed and were told they would be made to the Local Authority and the Care Quality Commission appropriately.

People’s care was provided safely and people confirmed they knew how to raise a concern and felt they would be listened to. However, two people described poor experiences of care. None of the people we spoke with had any current concerns about safeguarding. One person said: “I was worried about having care at first, but the staff that come are good. I would be happy to recommend them”.

Staff understood their responsibilities in relation to keeping people safe. Staff had received training in safeguarding and understood how to identify signs of potential abuse, and how they should report any concerns. Staff understood how to escalate concerns further, if they did not feel action was taken.

The provider ensured safeguarding policies and procedures were available to all staff. Staff completed safeguarding training in line with requirements. We found safe systems in place for when accidents and incidents occurred to ensure occurrences were investigated in a timely manner and referrals to seek advice and support sought from external agencies when required.

People and/or their relatives were involved in identifying areas of risk in people’s lives. Most people said they were involved in arranging their care package. One person, advised they had not had a review or meeting about their care they could recall. When this was raised with the managers, they assured us there were regular review meetings held with other professionals about this person and the person had been involved.

Managers assessed and monitored risk and shared this with staff. Some staff felt this could be improved to ensure changes were highlighted. Processes were in place to ensure any risks were mitigated and raised with appropriate agencies.

Care plans contained information about risk. The digital system used, meant changes were communicated from the office to staff electronically. Managers introduced a further audit of care plans and risk assessments by the senior management team to ensure care records were person centered, contained clear guidance for staff and any changes escalated and recorded.

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

Staff provided the required support for people and their relatives. One relative felt that over the last few months there had been a lack of consistent staffing, and this had affected the timings of the calls, impacting on their planned activities for the day. Another person, who had only recently joined the service felt they had regular staff who attended them at the expected time. People’s feedback included; “Some staff are more competent than others” and “The staff are lovely and kind, will do whatever is asked of them; they are never difficult or awkward”.

One of the staff had some concerns about current staffing levels, the workload they had, which meant managers had to go to calls when no staff were available. Managers were aware of the staffing issues which had impacted on the continuity of care delivery. They now had a small team of 6 staff who seem to be fairly stable, and found being involved in some of the calls rewarding and had ensured their oversight of packages. Staff records showed, they had received appropriate training. The provider carried out workplace observations to assess current work practices and identify any training opportunities.

Staff were recruited safely and trained to meet individual’s needs. Records confirmed the required checks were completed. The manager’s explained recruitment was difficult and was limiting the potential growth of the company as they did not want to take on more packages until they had staff available. In the past, they had used agency workers but had stopped as they recognised the importance of stability with regular staff. The provider carried out probation meetings and occasional supervision meetings. The manager explained that as the support team was still small the support provided was informal, including phone calls and catch ups with individual staff members. Staff scanned in and out at calls by using their phones, we reviewed two weeks of rota records and saw the deployment of the staff to visit people and provide care did not always match according to the schedules agreed with the person.

Infection prevention and control measures were in place. One person’s relative said staff had always worn gloves, aprons and other personal protective equipment (PPE) as needed. Where it was included in their care plan, people were supported to keep their homes clean. Staff disposed of used PPE safely to reduce the risk of infection.

Staff were aware of their roles and responsibilities around infection control. No adverse feedback was received from staff, they confirmed PPE provisions were always available for them. Staff undertook training about good infection prevention and control to ensure people were protected from catching, and/or spreading infection.

People who required help to take their medicines, were generally satisfied with the support they received. One person felt there were occasions when the timing of the call had affected the provision of their medication that day. Staff followed safe administration procedures and ensured supplies of medicines were consistently available.

Staff were trained in medicines administration and had their competency assessed. Staff were aware of the support people needed to receive their medicines safely. They told us, ‘tasks’ alerted them to any actions required and the care plans had the necessary information to support people with their health needs.

People’s medicines were being managed safely where staff were responsible for administering. Training records confirmed staff were trained in medicines, they had competency spot checks and the MARS records were audited. Policies and procedures were in place, to guide staff in managing medicines safely. An external audit completed by a local Medicines Optimisation Team had raised no specific concerns in how medicines were managed overall.