- Homecare service
Atman Care
Report from 10 May 2024 assessment
Contents
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
Safe
People’s risks assessments were not detailed enough to give staff information about how to support people safely, particularly around medication and complex health needs. However, the registered manager took immediate action and reviewed and updated people's risk assessments to ensure staff knew how to meet their needs safely. Recruitment records needed to be improved. However, staff were very knowledgeable about the people they were supporting. There were enough staff deployed to meet peoples needs and there was good care continuity.
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.
Learning culture
There were mixed views in relation to staff being trained to meet their needs. Comments from people included, “I think that they do. I am growing in confidence because of the way they support me” and, “They are not trained at all, certainly not as much as they need to be.” One person told us how they had raised concerns in relation to a member of staff not knowing how to use the oven, they said this had been raised with the management team.
Staff told us they knew how to report any accidents or incidents. Managers told us and staff confirmed that any adverse occurrences were discussed with staff teams at regular meetings.
The provider logged all incidents, accidents, complaints and safeguarding concerns electronically and these records included outcomes of investigations and lessons learned. There were several group chat functions for sharing information with the staff team.
Safe systems, pathways and transitions
People told us and relatives confirmed they had been involved in the development and review of their care plan and risk assessments. However, one relative told us that their loved one’s care plan was not always followed by the care staff, and this had been reported to the management team during a review however, no formal action had been taken and the persons care plan continued not to be followed. Because of this people were not always confident that their views and concerns would be acted on to ensure positive changes were made. People told us they usually had the same care staff who arrived on time and stayed for the entire length of their care call.
The provider supported people to transition to more independent living, for example, one person was being supported to move into their own single occupancy accommodation. Managers worked closely with housing providers and social workers to ensure the accommodation was suitably adapted to meet the individual’s needs and to ensure the transition was seamless.
A health care professional who had previously worked with the agency said, ‘I found them to be very helpful and pleasant on the phone or via email’ and, that when the packages of care were set up the management team would always try to deal with queries and rectify them.
The provider had processes in place to ensure they provided regular feedback to social workers in relation to people’s progress and achievement of goals and objectives.
Safeguarding
There were mixed views regarding the safety of people using the service. Some people felt safe with the staff and commented, “I am very happy with them, they are very nice people” whereas other people and their relatives did not feel safe with the care staff and said they were actively looking for another care provider. One person said, “The carers are not professional, they are not trained to even a basic level and they are putting me at risk.”
Staff told us and records confirmed they had received training in safeguarding and knew how to identify potential signs of abuse and report concerns. Records showed the provider had reported safeguarding concerns to the relevant authorities and cooperated with investigations.
The provider had a safeguarding policy in place and staff knew how to access this. Safeguarding concerns were logged and tracked electronically and were updated with outcomes, closure notices and lessons learned.
Involving people to manage risks
People told us and relatives confirmed they had been involved in the development and review of their care plan and risk assessments. However, one relative told us that their loved one had recently sustained a minor injury whilst being hoisted due to staff being “unprepared and untrained” to support their loved one safely. This had been reported to and investigated by the Local Authority who discounted abuse and took no further action. Another relative told us their loved one’s care plan changed depending on their health and the staff were flexible in supporting these changes. The registered manager responded immediately and reviewed and updated people's care records to ensure staff were able to meet their needs safely.
Risk assessments were developed in partnership with the person and their relatives where appropriate. Staff were very knowledgeable about the people they were supporting and knew how to keep people safe. Staff were able to tell us about the medicines they administered, what they were for and any potential side effects.
People’s care records contained risk assessments, and these were reviewed and updated regularly. However, some risk assessments did not contain sufficient details, nor give enough information to staff to ensure they could support people safely. This was specifically regarding people with complex health needs and medicines. The registered manager responded immediately and reviewed and updated people's care records where necessary to ensure staff were able to meet their needs safely. Environmental risks were considered for each person, including potential risks inside the person’s home.
Safe environments
There were mixed views regarding whether people felt that staff respected their property. One person felt the staff “absolutely” respected their home. Whereas a relative told us that staff have on occasions left their home unlocked leaving people within the house at potential risk.
The provider risk assessed each environment and any equipment that might be required, for example, hoists and slings. Staff told us they had received training in moving and handling people safely.
As this was a small service, moving and handling training was delivered via an online course and practical training was provided on a bespoke basis in the person’s home. One of the senior managers was a moving and handling trainer and provided this training to staff as required.
Safe and effective staffing
People told us they usually had the same care staff who arrived on time and stayed for the entire length of their care call. One relative told us how they had requested a consistent staff team for their loved one and the management team had tried to fulfil this request.
There were enough staff deployed to provide safe care for people and absences were covered from within the team. Most care calls (79%) were delivered on time with around 6% being delivered up to 45 minutes late. The registered manager spoke with staff at a following staff meeting to discuss the importance of using the electronic system to log their care call time. Staff told us they had received mandatory training when they first joined and some staff had received additional training relevant to the person they were supporting, for example, training in epilepsy management and rescue medicines. Staff told us they had supervision sessions regularly.
Recruitment records were maintained to show that checks had been made on the person’s identity, references and Disclosure and Barring Service (DBS) records. The DBS helps employers make safe recruitment decisions and helps prevent unsuitable people working with people who use care and support services. However, some records we reviewed did not demonstrate a full employment history and this had not been explored by the provider at interview stage. The provider used electronic call monitoring so they could monitor call times and durations. The managers told us they had systems in place to manage staff who continually failed to log in electronically, however, records showed that there were 56 calls that had not been logged and 45 of these were for one individual person. Training and supervision records were maintained on a spreadsheet with trackers to ensure these records remained up to date.
Infection prevention and control
People did not raise any concerns in relation to infection control and staff wearing personal protective equipment (PPE) such as gloves and aprons. We observed staff accessing PPE during our on-site visit and staff had access to ample supplies.
Managers ensured each location had enough supplies of personal protective equipment, such as gloves, aprons, overshoes and hand sanitiser. Staff told us they had training in infection control.
The provider had an infection control policy which staff could access through an electronic application. Each location where services were provided had a cleaning schedule in place which was checked regularly by managers.
Medicines optimisation
There were mixed views regarding the management of people’s medication. Some people stated they received their medications as prescribed and commented, “They give me my medicines, they are good people” whereas another person told us, “They’ve (staff) made a host of meds errors.” A relative commented, “The carers have no experience of supporting a person with insulin.”
Staff had received training in medicine administration and their competences had been assessed by the registered manager. Staff knew what medicines people took and why they took them as well as any potential side effects. Medicine administration records were completed.
The provider had introduced a weekly medicine audit and these had been completed as planned. These had been introduced following an investigation into a medicines error.