Bliss Care And Training Ltd - Barnet

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

Some people faced risks which were not identified, effectively assessed and planned for. This meant managers and staff were not always able to monitor and manage these risks and promote these peoples safety. Management did not have an understanding about the key risks which people faced day to day. This included people who were very vulnerable, which meant their emergency planning for the service was not effective. There were issues with the plans and systems made by managers to ensure some people received their medicines safely. These issues placed people at potential risk of harm. There was no evidence anyone had come to harm as a result of these shortfalls, but this was a risk. This was a breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider told us they would address these issues. Staff were knowledgeable about what potential abuse could look like and how they needed to report any concerns to a manager quickly. Managers reported any concerns to the local authority also in a timely way. People and their relatives felt safe and comfortable with the staff who supported them. For example, one person’s relative said, “[Name of relative] has the same 2 regular carers and [name of relative] has formed a relationship with them. They are very nice people kind and understanding and mum feels safe in their care.” One person told us, ’I am very happy with the carers who are nice and friendly. I know them really well. They are always on time and stay the full care time.” There were sufficient staff to meet people’s needs in a timely and planned for way. Recruitment checks were in place when new staff were appointed. However, there were shortfalls in the checks completed. Such as gaps in employment histories and references not being verified.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were happy with the care they received and told us when they raised issues these were resolved quickly.

Staff were unable to describe any occasions when managers had shared lessons learnt from mistakes in an effort to improve practice in the future. Managers were not able to evidence to us when known mistakes had happened and how they had informed and supported staff to learn from these lessons.

Processes had not been created to effectively promote lessons to be learnt when mistakes happened.

People felt confident they were safe.

Staff spoke confidently about the processes to report concerns and raise issues about people’s safety. They were also confident, their concerns would be listened to and acted upon by the office staff and managers.

The local authority confirmed they had received safeguarding alert referrals, and the managers responded quickly to requests for information from social workers.

There were processes for staff and managers to respond to concerns about a person’s safety, welfare and their health.

People felt safe with the staff who cared for them.

Staff and managers were clear about what potential harm and abuse could look like.

Safeguarding processes were in place.

People felt safe with how their care was arranged and delivered.

Staff were informed about people’s needs and the assessed risks they faced before they started visiting people. Managers felt confident they were effectively risk assessing and monitoring risks. However, we identified this was not the case during this assessment.

Processes had not been developed to assess and audit risk management, to assure managers and partners individual risks were being well managed and if improvements were needed.

People had environmental risk assessments in place. However, these did not always explore all the environmental risks some people faced. These assessments also lacked details about the risk of equipment used in some people’s homes.

Staff understood what some environmental risks may look like. Staff could not tell us if they had been briefed about some environmental risks relevant to some people.

There was a process in place to assess people’s environments. However, further work was needed to make this effective each time it was applied. This was not being effectively audited and checked by the provider and managers.

People saw the same staff regularly and visits were usually completed at the agreed time. When delays did occur, this was explained to people and staff arrived at a reasonable time thereafter.

Staff did not feel rushed and felt they had enough time with people. If they needed to stay longer this was understood by the office staff and managers. Staff told us they had enough time to travel between care visits. Managers promoted a culture of staff staying with people if they needed more support and if something had gone wrong such as the person being unwell.

The management team were monitoring closely the deployment of staff and staffing numbers. However, staff recruitment checks were not always completed fully and evidenced to show partners such as the CQC and local authority and assure themselves, safe recruitment checks had been completed.

People were satisfied with staff’s infection prevention and control (IPC) practices. Some had asked staff to wear more personal protective equipment (PPE) which the management team had acted upon.

Staff had plenty of PPE and new deliveries took place frequently.

Staff had the appropriate equipment. Actions were taken if there were any issues with the use of PPE.

People were satisfied with the support they received with their medicines.

Staff felt confident when prompting people their medicines. The management team had assessed staff’s competency to administer medicines, and they carried out regular auditing of medicine records. However, we found risk assessments and care plans did not explain what prompting medicines looked like for individuals.

Processes were not all in place to monitor the prompting of people’s medicines was taking place, and in a safe way. Auditing people’s medicines was not always effective, especially in relation to ‘as required’ (PRN) medicines. Specifically, protocols and medicine records were not always in place, nor were records completed in full, with safe PRN practices adhered to, when some people had their PRN medicines and staff completed these records.