Prof-Care Limited

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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

Staff knew people well and understood their responsibilities on how to keep people safe. All staff we spoke with were satisfied leaders acted on concerns. During our assessment of this key question, we found concerns around the management and oversight of risk. Care records were not clear or robust in identifying support needs or mitigating risk, and monitoring systems did not provide adequate oversight of the service. This meant some aspects of the service were not always safe and there was an increased risk that people could be harmed. In addition to action taken at the time of assessment we received reassurance from the provider that the new electronic record system would address concerns identified. You can find more details of our concerns in the evidence category findings below.

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.

Staff knew people well and understood their responsibilities to keep people safe. Staff told us they received safeguarding awareness training and demonstrated knowledge of whistleblowing procedures. All staff we spoke with were satisfied leaders acted on concerns. A staff member advised, “I have to report to the management immediately, if the office does not take any action, I have to report to the Police, Social services and to the CQC.”

People told us they felt safe with the support they received and felt they could raise concerns if they needed to. People’s relatives were mostly satisfied their family members received safe care. One relative said, "[Person] is 100% safe with the care and we are more than happy with them." Another commented, “I wouldn’t say [person] is not safe but I would say some of the carers need more training.”

Staff had completed safeguarding training and the provider’s safeguarding policy guided staff about different types of abuse and how to raise a concern to ensure people were protected. Records showed safeguarding concerns were reported promptly to the local authority, but notifications were not always submitted to CQC. Effective systems to provide oversight of accidents and incidents were not in place. People’s care records did not accurately reflect their needs or detail how the service was working within the principles of the mental capacity act.

Risk assessments were not always in place or did not contain enough detail, which meant mitigation measures to keep people safe were not always available to guide staff. Where people had been identified as being at risk e.g. people who show behaviours of distress, there was no full assessment to explore this further to support people and staff to reduce these risks. Action was taken at the time of assessment by the provider and we also received reassurance that the new electronic record system would address concerns identified. Checks on equipment were completed but where issues had been noted there was no record of follow up completed. This was rectified during the assessment. A restraint policy was in place and staff were clear about their role in difficult or challenging situations and only to use restraint if trained to do so. However, staff had not received training in positive behavioural support which would provide more detailed knowledge and guidance of how to support someone who may show behaviours of distress.

People told us they were involved in making decisions about their care and support. Relatives were mainly positive about their involvement in the care planning process. One relative said, “I do like to keep on top of any changes that are made in the care and they are more than happy to run things past me first.”

Staff were knowledgeable about people's needs and preferences and how to manage people's risks. One staff commented, “Make sure environment is safe. For example at bedtime, try and leave in bed and adjust heating, glass of water, night alarm and switch off everything including the kettle at the wall.”

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 management systems were neither robust nor effective. Records provided showed evidence of supervision taking place and observations to help them develop within their role. However, the matrix in place was not fully complete or up to date and only detailed low levels of supervisions taking place. This was also reflected in the training matrix for staff. Training certificates evidenced staff attending relevant training to support them in their roles, but the training matrix was not up to date or accurate. The provider advised that the new electronic recording and management system would address these issues and provide better oversight going forwards. Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. However, it was noted that some areas of the process needed closer scrutiny. For example, to ensure there were no gaps in a staff member's work history. We shared this information with the registered manager who took immediate action. The rota provided showed that some calls overlapped or had limited or no time for travel time between calls. One person also had close spacing between calls which meant a long gap between the last and first call of the following day. This was raised with the management team and reassurance given that this would be addressed immediately.

Staff told us they were well supported by the management team and felt confident to raise any concerns. They told us there were enough staff to meet people’s needs. They told us they received appropriate training and supervision. One staff member said, “Staff morale is good. We are happy and we are supported when we have issues.”

People were positive about the support they received from staff. One person commented, “I feel very well supported and looked after by well trained and intelligent carers.” Relatives were mostly positive about the support received by their relative. One relative said, “[Person] gets on very well with them and we have a good solid team of carers to help.” Another relative commented, “We have plenty of staff and carers to come and help thank you, but I would say that they do chop and change quite a bit which can be quite distressing for [person].”

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.