Luv To Care Home Care Ltd

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

We assessed 5 quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was requires improvement. Based on the outcome of this assessment the combined scoring for this key question has improved and the safe key question has been rated good overall. People were safeguarded from the risk of abuse and avoidable harm. Risks about people’s safety were assessed to ensure they were supported to remain as safe as possible. People received support from staff who received a range of training suitable to their role and staff were keen to enhance their knowledge and understanding. We reviewed records which identified there were enough staff to meet people's needs, however feedback from some people indicated staff sometimes arrived later than expected for their call or newer staff were not as confident which impacted their experience of the care provided. There were sufficient practices in place to protect people from the risk of infection and staff had access to plentiful supplies of personal protective equipment. People were supported to manage their medicines and care records included information for staff on how to meet people's needs.

This service scored 66 (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.

Overall, we received positive feedback from people that they felt they received safe care. Most people told us they felt able to raise any concerns and knew who to contact. Comments we received included, "Yes I do feel very safe with the carers because I get on with them. They are very attentive and the office phones me every 2 months to check on me."; "The staff are all very nice, so I do feel safe. If I didn't I have the agencies telephone number to call.", and, "I do feel safe because all the carers have been fantastic and if I didn't I would contact the manager."

Staff we spoke with were confident in their role and responsibilities to keep people safe. All staff we spoke with knew how to escalate any concerns and what action to take to protect people from the risk of harm. Comments included, "If I have any issues I always report them straight to the office and speak to our seniors and management and I have always found that any issues I have had has always been dealt with effectively.", "My first call would be to the office. If the time was out of office hours it would be the on call number and discuss with who ever is on call. I would then follow this up with an email to the company/management and also include details in my notes for that [person]", and, "If I had any concerns about anything I would go to my manager, she would listen and then act on my concerns. I could also speak to one of my seniors who I get on very well with and I am listened to by them. The on call phone is always on, the office number also connects to the on call phone when no one is in the office, we have an email address for management we can email. I feel at ease talking to management and know there are a few ways to do this if I need to."

The provider had effective systems and processes in place to protect people from the risk of abuse. This included digital record keeping of all accidents and incidents and supporting documents such as body maps where appropriate. The registered manager maintained oversight of all concerns raised and relevant information was shared with safeguarding teams and commissioners as appropriate. There were appropriate policies in place for staff to access and follow. Where we noted the policy could be more robust to include all relevant commissioners for people supported by the service, we shared this feedback with the registered manager who acted on our feedback to update the information before the assessment concluded.

Most people told us they felt confident that familiar staff who knew them and their needs well, supported them to manage risks associated with their care. For example, people who required support to maintain their skin integrity told us staff helped them with daily tasks to manage this. Some people told us they felt involved in managing their risks and discussed their needs with staff, and another person said, “I have a care plan detailing any risks to my care and support and how [staff] should manage them.”

Staff we spoke with were aware of the risks to people and where they could find information in people's care records about any mitigations. Staff told us people's care plans included all of the information they needed to manage people’s risks and keep them safe. Staff were clear on procedures to follow in emergencies if people needed urgent medical attention and how to escalate any concerns.

The provider operated digital records and monitoring systems of people's care calls and tasks which supported them to have up to date oversight of the care people were provided with and respond to any concerns timely. The provider ensured people and staff could access advice and guidance in and out of office opening hours. The provider ensured there were appropriate contingencies in place for people in the event of emergencies or server weather, considering people who would be most at risk and what response they would provide to keep them 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.

We received feedback from some people that they felt some staff were not always confident meeting their needs, or they did not feel confident with there support for moving and handling tasks. For example, one person said, “I always get concerned with new carers who I have never seen before when they are trying to help me use my Rotunda and often its obvious these carers do not know how to use them or support me safely. I like to be sure that these carers have been trained to use equipment safely.” We also noted where people required 2:1 support, they provided poorer feedback in the experiences of the care provided. Feedback included some people feeling rushed or staff not arriving together where this was required which impacted their experience of the care provided. We raised this with the registered manager who told us staff sickness had been a challenge, however they felt this had improved providing better continuity in staff support. We also recommend the provider reviews the staff induction processes in view of the experience of care afforded to people.

Staff we spoke to said there were enough suitably qualified staff to support people. Staff were keen to take further qualifications appropriate to their role and some staff told us they were completing NVQ equivalent qualifications. Some staff raised travel time between care calls as a challenge, especially during busier times on the road. However, staff we spoke with said that they were not aware of any missed care calls. Staff told us they felt supported and they had regular supervisions and spot checks to review their conduct. We received feedback from 2 staff that they felt some newer staff started working too soon and may have needed more shadowing before they were confident, however new starters we spoke with felt they received good support.

The provider supported staff to undertake a range of training opportunities relevant to their role. We reviewed records which demonstrated staff recieved regular opportunities to update and refresh their knowledge and skills. New staff were supported with an induction pathway and part of this enabled them to shadow more experienced staff. The provider had an appropriate recruitment policy in place and completed a range of pre-employment checks to assess new staffs suitability for their role. Where we found a shortfall in some information on staff files the provider addressed this immediately on-site.

We received feedback from people that staff wore appropriate PPE when supporting them to meet their needs. Comments included, "Carers always wear gloves and aprons and masks when needed to.", and, "I have seen carers wear gloves, aprons and masks when and where appropriately."

Staff we spoke with told us they had access to plentiful supply of personal protective equipment (PPE) and these were readily available. Staff also understood the importance of good hand hygiene practices to prevent the spread of infection. One staff commented, "I train new carers, we wash our hands. Use PPE, aprons, gloves and mask [where required]. We change the gloves between tasks. Wash our hands in between and when leaving the person. The most important thing about infection control is [hand washing]."

The provider had appropriate infection prevention and control policies and procedures in place. The provider was in the process of appointing an infection control lead in line with their policy. Staff were provided with relevant training to support them in their role.

Not all people we spoke with required support to manage their medicines. Where they did, we received feedback from a person that they felt impacted by staff lateness. They told us, “Most of the time carers do give me my medication, but if they arrive late, I take them myself, which does happen a lot.” We raised this with the registered manager who told us they would review this. Where a person had additional swallowing needs they told us staff supported them to manage their medicines safely.

Staff we spoke with had a good understanding of how to support people with their medicines. Staff told us they received training and were assessed as competent before they supported people with safe administration of medicines. Staff told us they found the digital medicines records were helpful in ensuring people received the right medicines. For example one staff said, "No I have no concerns about people’s medications or how I administer them. As I am able to access the notes from the previous carer in regards to medications, I am able to check before I give to the client. If I was ever worried about a timing or new medication I am able to refer to the medication group the carers use or call the office."

The provider used digital records to support them to monitor and have oversight of people's medicines tasks. We reviewed peoples medication administration records which staff completed in line with best practice guidance. We noted that where there were shared agreements between the agency and family to undertake shared medicines support, records and delegation could be clearer. The registered manager told us they were aware of this and were working towards creating clearer processes to reduce impact on people's medicines being disrupted. For example, where relatives were responsible for ordering and collection of medicines there was an increased risk of medication being missed as stock depleted which they were addressing. Where medicines had been missed there was appropriate action taken to check if this would cause harm to people