Care 4 Care Headquarters

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

Based on the findings of this assessment we found the service had improved and addressed the outstanding breach we identified at their last inspection relating to how they coordinated staffs call visits. This meant people now received care and support from staff who were now on time for their scheduled call visits. The provider continued to have a positive culture of learning lessons when things went wrong. Care plans were still based on pre-assessments conducted by the provider and various external health and social care professionals prior to people receiving a service. People were still kept safe and were protected from avoidable harm, and staff understood how to safeguard people. People were cared for and supported by staff who knew how to manage risks they might face. Staff were appropriately trained and supported, and their suitability and fitness to work in adult social care continued to be thoroughly assessed. Medicines systems were still well-organised, and people received their prescribed medicines as and when they should. Staff continued to followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19.

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 the provider learnt lessons when things went wrong and acknowledged when they could and should have done better. An external health care professional told us, “The provider is good at reflecting upon their practices when things go wrong and looking at how they can improve the care they deliver.”

Managers and staff told us any incidents and accidents, safeguarding concerns or complaints involving the people they supported were always logged and analysed. These incidents were routinely reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. Care staff confirmed information about any lessons learnt were always shared with them during individual supervision and group team meetings with their line managers and fellow co-workers. The office-based managers encouraged an open and transparent culture where people received a service, their representatives and staff could all raise concerns without fear.

The provider learnt lessons when things went wrong. The office-based managers continually reviewed incidents and accidents, safeguarding concerns, and complaints, to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons so they could continually improve. This information was shared and discussed with staff during individual and group meetings.

People told us they were invited to participate in an assessment process prior to them receiving a service from this provider. People told us they received the personal care and support that was planned in accordance with their assessed needs and wishes

Managers told us people's personal care needs were assessed before they were offered the opportunity to receive a service from this provider. The registered manager confirmed these initial assessments were used to help staff develop person-centred care plans for everyone they supported.

External health and social care professionals told us the provider always collaborated with them to establish and maintain safe systems of care.

People’s care plans were based on assessments conducted by the provider and various external health and social care professionals. These care plans included detailed information for staff about how to support people with their personal care and support needs. We saw care plans had been developed for everyone currently receiving a service from this provider.

People told us they felt safe with the staff who supported them at home with their personal care. One person said, “The carers are lovely and I feel safe with them.”

Managers supported staff to protect people from abuse. Staff received safeguarding adults training as part of their induction which staff confirmed was routinely refreshed. Staff knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. One member of staff told us, “I would contact the office and inform the managers or the person in-charge straightaway if I saw or heard about anyone we looked after being abused or neglected. We are well-trained and know how to protect people from abuse.” Another member of staff added, “We are trained extensively to recognize the signs of abuse and neglect. If I witness or suspect abuse or neglect has occurred I would immediately inform my line manager.” Staff were routinely reminded about their safeguarding roles and responsibilities at individual or group team meetings with their line managers and fellow co-workers. The office-based managers understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were in place to protect people from the risk of abuse. The provider had clear safeguarding policies and procedures in place which were up to date, in line with relevant legislation and accessible to all. The providers safeguarding policy was included in the staff handbook which could be easily accessed electronically on the handheld devices all staff had been given. The provider also had a staff ‘Speak up/Whistle blowing policy in place which was also accessible to all. Managers worked well with external agencies, such as local authorities, the police and the CQC, and acted in a timely way to ensure people were safeguarded and protected from further risk.

People told us care staff knew how to support them in a safe way that helped prevent and/or minimise the risks they might face.

Care staff were aware of people's daily routines, preferences and needs, and knew what action to take to reduce or safely manage risks people they supported might face. One member of staff told us, “I am well-informed about the risks our clients may face, including how to prevent or manage falls and pressure sores. We receive regular training on risk management, and I am proficient in implementing preventive measures, such as ensuring the environment is safe, using appropriate mobility aids correctly, and performing regular checks to prevent pressure sores. We use risk assessments and care plans tailored to meet the individual needs of everyone we support.”

People's care plans contained up to date risk assessments and management plans that ensured staff had access to all the information and guidance they needed to know about how to prevent or appropriately manage risks people might face. They included risks associated with people’s home environment, infection control, managing medicines, moving and handling and preventing falls, food and nutrition, dementia awareness and pressure sore prevention and management. These risk assessments and management plans were regularly reviewed and updated as people's needs changed.

People told us staff from the office routinely came to visit them at home to check the equipment staff used to support them, such as mobile hoists, remained in good working order and fit for purpose.

Managers were able to assure us that there were effective governance arrangements to monitor the safety of people's homes and equipment staff used to support them.

Health and safety risk assessments and management plans were conducted on the home environments where people using the service lived and the equipment staff used, such as mobile hoists.

People told us staff who supported them never missed their scheduled call visits, were usually on time, and would always let them know if they were running late. People also said staff always stayed and completed all the tasks they were supposed to do in a unrushed manner in line with their care plan. A person using the service told us, “My carers are very good and they usually turn up on time. On the rare occasions they are late, they will let me know,” while a relative remarked, “Staff generally turn up on time.” A community health care professional added, “I have found that staff punctuality has been excellent. Staff members consistently arrive on time, and communication regarding any delays is proactive and clear. The managers are aware that reliability is crucial in maintaining a stable and dependable care routine for our clients.” Furthermore, people told us they received continuity of care from a regular group of care staff who were familiar with their personal care needs, preferences and daily routines. One relative said, “My [family member] has a regular bunch of staff that turn up, which I have no complaints about.” Another relative added, “The agency is really good at making sure my [family member] normally has the same group of carers who look after her.” People were also positive about staffs knowledge and skills and said they were always kind and friendly. A relative told us, “The staff always talk to my [family member] with such kindness and respect.”

Staff told us their call visits were well-managed. One member of staff said, “In general, my calls/visits are well-planned. I have plenty of time to get from one appointment to the next and finish the necessary duties. I can give excellent care without feeling rushed thanks to this.” Another member of staff added, “We’re now encouraged to support clients who live near us which has really helped us cut down on our lateness, which used to be a big problem. I personally feel less rushed during my visits than I did.” Staff also told us they had a dedicated group of people they regularly supported. They also said the staff who coordinated their visits tried to ensure they supported people who lived locally to ease the pressure on travel time between call visits. The training staff received was routinely refreshed to ensure their knowledge and skills remained up to date and relevant to their role. Staff demonstrated good awareness of their working roles and responsibilities. A member of staff told us, “We undertake the Care Certificate training as part of our induction. Our mandatory training is then refreshed annually for all staff both online and in-person.” Another member of staff added, “Our training is regularly updated to ensure we are always equipped with the latest knowledge and best care practices.” Staff had ongoing opportunities to reflect on their working practices and to identify any further training or learning they might need. This included regular supervision, team and overall work performance appraisal meetings with their managers and/or fellow co-workers. One member of staff said, "I receive all the support I need, including regular individual and group supervisions and annual performance appraisals. This helps me stay on track and improve my skills.” Another member of staff added, “The ongoing support we receive from the staff in the office helps us to continuously improve our skills and provides us with ample opportunities to develop our skills.

Since the last inspection, the provider introduced a new electronic call monitoring (ECM) system, which improved coordination and monitoring of call visits. This system logged the exact times staff arrived and left, automatically notifying office-based managers if care staff were running late, left early, or missed a call. The provider routinely analysed ECM data, reflecting the scheduled dates and times of staff call visits. The provider matched people receiving services with staff who lived in the same geographical area. Several staff were named as designated drivers responsible for taking others to their scheduled call visits and ensuring they arrived on time. People received consistently good personal care from a core group of staff familiar with their needs, preferences, and daily routines. Training records showed staff attended relevant courses to support meeting a range of needs. Training was refreshed regularly to keep staff up to date with recognized best practices. New staff underwent a comprehensive induction program mapped to the Care Certificate, which included shadowing more experienced staff. The provider’s recruitment processes were thorough and followed diligently. They conducted thorough pre-employment checks to ensure staff suitability for their roles, including identity verification, previous employment, character references, right to work in the UK, and Disclosure and Barring Service (DBS) checks. These checks provided information on convictions and cautions, helping the provider make safer recruitment decisions.

People told us staff who provided their care and support always wore appropriate personal protective equipment [PPE]. A person using the service said, “My carers wear all the relevant gloves and aprons when they visit me.”

Managers and staff told us they had received up to date infection control and food hygiene training. One member of staff said, “We have always had sufficient personal protective equipment [PPE], and regular COVID-19 testing is in place. If any staff member tests positive, they are required to self-isolate to prevent the spread of the virus. Additionally, we are strongly encouraged to get vaccinated, and many of us have taken up this offer to protect ourselves and our clients.” The registered manager also told us they had ample stocks of PPE which they kept in their offices, which care staff could easily access as and when required.

The provider followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider had an up to date infection prevention and control policy in place.

People who received assistance from staff to help them manage their medicines told us staff always ensured they took their prescribed medicines as and when they should.

Staff were clear about their roles and responsibilities in relation to the safe management of medicines. Staff received medicines training as part of their induction and their competency to continue managing medicines safely was assessed by managers at least annually or more frequently if required.

Medicines systems were well-organised, and people received their medicines as and when they should. People’s care plans included detailed information about their prescribed medicines and how they needed and preferred them to be administered. The provider now operated an electronic medicines system. Electronic medicines administration record [eMAR] sheets helped ensure the office-based managers would be automatically notified about the occurrence of any medicines error in real and could take immediate action to address such an incident. We found no recording errors or omissions on any eMAR sheets we looked at during this assessment. Staff received safe management of medicines training and their competency was routinely assessed and refreshed.