Michael Batt Foundation Domiciliary Care Services

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 protected from the risk of harm and abuse. Staff received safeguarding training and understood their duty to keep people safe. People were involved in understanding and formulating plans to reduce the risks associated with their care. Risks associated with peoples on going care needs were identified and acted on. There were sufficient staffing levels and oversight to ensure people’s needs were being met and people received their medicines as prescribed.

This service scored 47 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People knew how to complain if needed. The provider had ensured that people were aware of how to complain and supplied people with information on the providers complaints procedure, which was accessible to their individual communication needs. One person indicated to us that they knew how to make a formal complaint.

The registered manager and provider explained how systems had been put in place since our last inspection to record and analyse accidents and incidents, complaints and safety spot checks. However, the system was still in its infancy and needed time to be fully embedded within service provision. The CQC sets out specific requirements that providers must follow when things go wrong with care and treatment. This includes informing people and their relatives about the incident, providing reasonable support, providing truthful information and an apology when things go wrong. The provider and registered manager understood their responsibility under the duty of candour to be open and honest when things went wrong.

At our last inspection we found the provider was failing to operate an effective system to identify, record and analysis accidents and incidents within the service. At this assessment we found the service had improved, the registered manager and provider had developed systems to capture accidents and incidents and complaints. However, although improvements have been made with regards to learning from incidents, these systems were not yet fully embedded. Therefore, the provider still needs to demonstrate it can fully embed and sustain these improvements.

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.

One person we visited was able to communicate how they felt safe receiving care from the service. This was confirmed through our observations of the person receiving care.

The registered managers and provider understood their responsibilities to identify, report and investigate allegations of abuse. The registered manager, deputy manager and operations manager were able to articulate the systems and processes and how these systems were aligned to the providers policies and procedures.

At our last inspection we found the provider was failing to operate an effective safeguarding system that reported, acted on and investigated concerns. At this assessment we found the service had improved, the registered manager and provider had developed an operating system to fully capture, and report safeguarding concerns appropriately. However, although improvements have been made with regards to safeguarding systems, these systems were not yet fully embedded. Therefore, the provider still needs to demonstrate it can fully embed and sustain these improvements. At our last inspection the provider was found to be applying unlawful restrictions to deprive people of their liberties. At this assessment we found the service had improved. We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

Relatives told us people’s risks were well managed. One relative told us, “Recording of seizures has gone online which makes things simpler.” All care plans and subsequently the risk management plans demonstrated people, relatives and representatives were involved in managing people’s individual risks.

Without exception the registered manager and staff had in depth knowledge of people’s individual risks and the action they needed to take to mitigate the risk of harm associated with people’s care.

At our last inspection we found the provider was failing to mitigate the risks associated with peoples care needs. At this assessment we found the service had improved. Risk assessments relating to the health, safety and welfare of people were kept under regular review. People living health conditions such epilepsy and swallowing difficulties had their specific risks assessed. Peoples care plans guided staff on how to keep people safe and when to seek medical advice. Staff we spoke with were aware and followed this guidance. The registered manager regularly assessed and reviewed risks associated with people's care and wellbeing and took appropriate action to ensure these risks were managed and that people were safe.

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

Observations from 2 home visits confirmed sufficient and safe staffing levels were in place. Where people had 1-1 support, these staffing levels were being maintained. Where the service needed to use agency, it used the same company and agency staff that were familiar with peoples care needs.

At our last inspection we found the provider failed to ensure staff competencies were reviewed and captured to ensure they continued to hold the skills necessary to carry out their roles effectively. At this assessment we found the service had improved. However, whilst we saw evidence that the registered manager had taken action to ensure staff competencies were under review, we also noted that the new system they had established needed time to be embedded and sustained. The registered manager was able to describe the new processes they had implemented to ensure how new staff were fully inducted into their role and how existing staff had their competencies checked, to ensure they delivered good quality care. They told us, “The aim is to have senior staff overseeing inductions. I am just in the process of implementing a new policy and ensuring it is in line with what we need as a service” and “The ongoing plan is we started a brand-new system for spot checks and the intention is spot checks will go into individual online folders. We have been doing them ad-hoc and to make sure that everyone has had them and then the intention will be monthly, but they will also be done as we require them and competencies 6 monthly or dependent on staff training whichever needs to be done”. Staff told us there was enough staff to meet people’s needs and that they had received adequate training and support. One staff member told us, “We can request training any time” another staff member said, “I feel well supported”.

At the last inspection the provider failed to provide adequate support and training to staff. They further failed to ensure systems were in place to monitor and identify shortfalls in staff training and knowledge. At this assessment we found the service had improved. The provider had carried out an audit of staff training needs, this audit was used to develop a service training plan which focused on different training needs across the staff team. Records confirmed staff received adequate training to support them in their roles. People were protected against the employment of unsuitable staff because the provider followed safe recruitment practices. We observed, and staffing rotas confirmed, there were sufficient staff to meet people's needs.

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.

One person was able to inform us through their personal communication style that they received their medicines as prescribed. This was further confirmed through our observations and a review of the persons medicine administration records.

The registered manager and operations manager described how medicines incidents and/ or errors were reported and investigated. They described how staff were trained in safe medicines handling and how competencies were checked regularly and in line with best practice. Staff told us they received medicines training and had their competencies checked regularly by the provider. One staff member told us, “I am up to date with medication training and our house manager comes in once a month to do competency checks”.

At our last inspection we found the provider had failed to ensure the proper and safe management of medicines and failed to ensure risk assessments were regularly reviewed. They further failed to ensure they captured and recorded staff competencies, in relation to the administration of medicines. At this assessment we found the service had improved. Medicines were ordered, checked and available when people needed them. Medicines were stored, administered, recorded and disposed of safely. Seniors and staff were trained and assessed as competent to administer medicines. They were regularly supervised to make sure they were following best practice. Staff knew how people liked to take their medicines and supported safe administration in a caring manner. Additional information was available to support staff make consistent decisions about when to give a when required medicine or where to administer emergency medicines. These records were accurate and fully completed.