Love Life Care

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• 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 told us they felt safe with care staff and had confidence that any issues that may arise would be promptly addressed by the management team. Where safeguarding concerns were identified, the management team promptly alerted the relevant agencies. People’s relatives told us their loved ones were safe and staff kept them informed about changes in health or incidents, where appropriate. A relative recalled an incident and told us, “My [relative] was unwell. The two care staff who were there were fantastic they were very calm and called the ambulance. If they weren’t there, I dont know what would have happened. The care staff followed the ambulance in their car and went to the hospital to check if further help was needed. Staff were brilliant and called us instantly. They had everything under control.” Staff took action to seek medical support when required, and the provider made appropriate adjustments to mitigate risks to people. We saw multiple examples where the registered manager had sought advice in relation to a complex feeding regime from external professionals, to ensure the person received safe care. People received care in line with their risk assessments and care plans. However, some improvements were needed to ensure risks were robustly assessed by the use of standardised assessment tools. Further improvements were needed in relation to formalised competency checks and staff training in various areas such as moving and handling, pressure area care and behaviours that may challenge staff. The registered manager had already taken steps to address this in response to our feedback. People told us that care staff in the main were on time for their visits, but sometimes they were a little later than expected. The registered manager was looking into extending travel time, due to speed restrictions in the local area, which was impacting on staff travel time. One person told us, “9 times out of 10 they are on time."

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.

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

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.

People told us they felt safe with the staff team that visited them. Comments included, "They are kind and caring and I feel safe, of course", and, "They are absolutely fantastic". Relatives also commented that they felt their loved ones were cared for safely. One relative told us, "They care for us as a family. We have had a number of emergencies, but they are so helpful for example coming to the hospital late at night and offering to help. They really know us and listen to what we need."

The manager followed their processes to escalate any concerns to relevant professionals and partner agencies.

There was a safeguarding policy to guide staff and the registered manager in the event of a safeguarding concern. All staff had completed safeguarding training, some were overdue refresher training, but the registered manager was planning to address this. Staff were able to identify the different types of abuse and circumstances that amount to a safeguarding. Staff told us they knew what to do if they were concerned about abuse. One staff member told us, "I'm very confident [registered manager] would take action, they did previously when I had concerns about a person."

Processes were in place to ensure staff were competent and this included spot checks. However, competency checks needed to be formalised so they were documented and signed off by a competent individual. When we discussed this with the management team they took immediate steps to begin shadowing staff and formalising observations. Risks to people were assessed, however, the use of standardised assessment tools which identify risks such as the development of pressure ulcers, or malnutrition, were not in place. This would support the service to identify any concerns earlier and guide staff to take the correct actions. When we brought this to the attention of the management team, they immediately began implementing assessment tools where appropriate. Risks to people with specific health conditions, such as diabetes, also required further detail to ensure staff knew the warning signs of people becoming unwell. The management team implemented guidance promptly.

Staff understood the risks to people well and were kept up to date when there were any changes to people’s needs, this included an instant messaging system. One staff member said, "The use of [instant messages] for individual clients means that staff can easily share information with each other, so even if there is a gap between us seeing clients, we are aware of changes and feel prepared when we next visit them. This has been a great way of communicating and getting support." The management team had robust oversight of risks affecting people, and would update care documents and guidance in response to people's changing needs.

Risks to people were assessed and collaboratively managed with people, their relatives, the staff team and other professionals. Care plans and risk assessments were in place, and in some cases where complex procedures needed to be followed, additional step by step guidance was in people's homes. There were risk assessments in place for various aspects of people’s care such as the risk of choking, risk of falls, and environmental hazards. One person told us, "Last week I was [unwell] and an ambulance was called and the carer sat with me and waited hours. I was so grateful" A relative told us, "The care has been fantastic, those [carers] have really prolonged my [relative's] life – they have gone way beyond what they have been asked to do."

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

The registered manager told us there were enough staff to support people effectively and any new care packages were always assessed in line with capacity. Staff said they received regular on-line training, which enabled them to do their job effectively. However, we were concerned that certain types of training, such as moving and handling, should be provided in a face to face environment to ensure staff had hands on experience with certain types of equipment used to move people safely. We also noted that other relevant training, such as pressure area care was not listed as mandatory, and therefore we could not be assured that staff were competent to identify potential changes in people's skin condition. Following discussions with the registered manager, they immediately took steps to rectify any gaps in training, including seeking face to face training and making multiple training types mandatory for staff. This included diabetes, behaviours that challenge staff, equality and diversity and sexual safety. The provider used a thorough recruitment procedure to ensure that only suitable staff were employed. Required checks, such a criminal record check, references and personal identity had been completed before they were allowed to start work.

People told us they were supported by a consistent staff team who knew them well. They said staff knew what support they needed, and they were never rushed. People told us staff generally stayed for the whole duration of their visit and would do extra jobs if needed. Some people described how staff would go 'above and beyond' during their visits to help with other tasks. People said staff were usually on time although traffic sometimes impacted on timeliness. The registered manager was reviewing travel time as local speed reductions were having an impact on staff travel. People and relatives were very satisfied with the care they received.

People told us they knew who the management team were as they had regular communication, and had met both the registered manager and care manager who would carry out visits periodically. The registered manager ensured that staff who visited people had always met the person first during shadow shifts. Staff told us they knew the people they visited, and had clear guidance to understand their needs. Staff told us that communication with the management team was very good, and that they received supervision, not always on a face to face basis, but all of the staff we spoke with told us they felt supported. One staff member said, "The management team have been so friendly, approachable, supportive and relatable and it’s nice to work with them on some of the double up calls. I have felt so supported from day one, and this is down to management and other carers. They all made me feel so welcome, I was given information, training, policies, procedures and I never felt like I was just thrown in at the deep end." Another told us, "The management team are wonderful, and they take into account my family life, and make my shifts flexible. That means a lot."

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.

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