Radfield Home Care Chippenham & North Wiltshire

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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

We reviewed 8 quality statements for this key question.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives did not share any concerns about this quality statement. Where there had been any incidents people were pleased with action taken by the service. One person told us in response to an incident, “I had an email from the service that further training for staff was recommended about 18 months ago. I believe they [management] do take everything we say seriously. That is why I am pretty pleased with them.”

Staff told us they were aware of the process for reporting any incidents and accidents. Staff told us they had discussions during meetings to learn from what had gone wrong. One member of staff told us, “Meetings happen, we talk about what happens. It is never pointing the finger to blame someone. It gives me the confidence to know my job, there is always room to learn. Everyone is involved and it is made educational for us all, the conversations are a learning point for all the team which is nice we are all in this together.”

We found some incident forms did not record action taken in response to incidents and accidents to prevent recurrence. Management told us they had identified improvement was needed with regards to how incidents were recorded and taken action to improve their recording of incidents and accidents. Although the registered manager was able to tell us of actions taken in response to incidents this information was not recorded. The improvements started by management prior to this assessment needed time to embed into day-to-day practice.

People did not share any concerns about this quality statement.

The registered manager told us they made sure if people had planned appointments that a member of staff was available to go with the person. Management assessed people’s needs and the impact the appointment would have on the person. Following the appointment, where appropriate, staff liaised with family members to update them on discussions. The registered manager told us that family members appreciated being kept updated on people’s health conditions.

Professionals we contacted did not share any concerns about this quality statement. One professional said, “They [management] have been very flexible in their approach to care, making sure they work with the patient and family.”

Systems were effective to make sure people were safe if staff were involved in supporting them to attend appointments. People’s care records demonstrated staff had communicated with relevant healthcare professionals to make sure people had the care needed.

People and relatives told us they felt safe. One relative told us, “Absolutely feels safe. No issues there. I just think it’s the way they [staff] conduct themselves. They [staff] are very professional and very caring. They do everything really, really well and carefully. I’m more than happy with the service they provide.”

Staff were aware of the different types of abuse and how to report any concerns. All the staff we spoke with had confidence that management would take appropriate action in response to concerns raised. One member of staff said, “We need to be transparent all the time, they [management] always remind us to do the right thing.”

Safeguarding concerns had been shared with the local authority safeguarding team. However, we did find 1 incident that had not been shared. The registered manager took action to share this concern during our assessment. Investigations into concerns raised had been completed where appropriate and action was taken to make sure people were safe.

People and relatives did not have any concerns about how the service managed risks and told us staff were mindful of safety concerns. For example, one person told us about the extra care staff took when supporting them with transportation. They told us, “They [staff] are very careful about getting me into the car and out of the car.”

Staff told us they understood the importance of assessing risks and had access on the electronic care plan system to people’s risk assessments. Staff said one of the most common risks for people they supported was falling. Staff talked to us about how they helped manage this risk. One member of staff said, “We make sure people have their [walking] frame, we make sure the floor is clear of objects, and we make sure the floor is dry, not wet.”

Risks to people’s safety had been identified but we found some risk management plans needed more specific information. For example, 1 person was at risk of choking which was recorded in a choking risk assessment. However, the person’s eating and drinking plan did not reference the choking risk. Another person had a health condition which increased their risk of falls. We found risk management plans did not record this person had the health condition. We raised these shortfalls with management who took action during the assessment to review the records.

People and relatives had no concerns about staff working safely.

The registered manager told us staff informed the office of any concerns regarding the environment or risk. They said they regularly liaised with the relevant professionals to make sure any equipment needed was obtained. The registered manager said, “In our area things move quite quickly, any equipment arrives within 24 or 48 hours. [Named company] deliver and service any equipment and we risk assess using the equipment. We also have a backup plan in case of equipment failure.”

Staff completed an environmental risk assessment which identified any hazards in people’s homes. If people needed equipment this was recorded in their risk management plans with details of who was responsible for servicing.

People and relatives had no concerns about the staff skills and timekeeping. Nobody had any issues with missed visits. One relative told us, “If they [staff] ever can’t do the things we require, we always get a phone call or a text. We have never had a missed visit, not in all the time we have been with them.” People and relatives told us management were regularly carrying out spot checks on staff. One relative said, “They [registered manager] come out regularly to see [relative] as well as spot checks. That is done quite regularly by [management] and the carers don’t seem to know they are turning up.”

Staff told us they had received an induction which helped to prepare them for their work. One member of staff said, “I did go to the office for induction. We went through company policies; we did some training like moving and handling and medicines. I also did shadow shifts until I was confident.” Another member of staff told us, “I had a good induction. It was good to know company policies as it was important to know how this company works.” Staff had no concerns with staffing numbers.

Staff had been recruited safely. All staff had the required pre-employment checks carried out before starting work. New staff had an induction which included completion of the Care Certificate. Staff had regular supervision where they could discuss any concerns or training needs. There were sufficient numbers of staff available to cover all care packages.

People told us staff wore personal protective equipment (PPE) whilst delivering care. Comments about staff included, “They [staff] wear rubber gloves and aprons, and they have a uniform on as well”, and “They [staff] always have that (PPE) on and they use their hand gel all the time.”

Staff told us they had access to PPE and were able to replenish their stock easily. One member of staff said, “We have PPE, and it is also made available. I can ring up the office and get some more, they [management] go out of their way to make sure you get it. I ran out of gloves the other week, I rang the office, they asked me where I was going to be on my next visit and brought out some gloves for me.” Staff told us they had received training on infection prevention and control guidelines.

Staff received infection prevention and control (IPC) training as part of their induction. This included assessments of hand washing and tests of knowledge for IPC good practice. Staff had access to the providers IPC policy and had guidance on working safely to minimise risks of infection.

When required staff supported people with administration and management of medicines. We were told “[Relative] has all tablets in a box. They [staff] administer from the packs and follow it all written down [on the records]. If they are getting low [medicines stock], they write me a note to tell me”, and “They [staff] are all very well qualified on what they’re supposed to be doing.”

Staff said they felt confident helping people to manage their medicines. However, we found some medicines processes were not being followed by staff. For example, we found gaps in recording on people’s medicines records which meant staff were not following procedures. Staff confirmed they had been provided with training for administering medicines. One member of staff said, “Medicines training was good, they [senior staff] also came and assessed me, they observed me.”

There were recording gaps in people’s medicines records. It was not clear if people always had their medicines as prescribed. We found action had been taken to follow up on recording gaps when management had completed medicines audits. However, audits took place days after the recording gaps which prevented timely action being taken to make sure people had their medicines. The medicines system did not alert senior staff to a missed dose of medicine at the time of the omission. The registered manager told us they would review the electronic medicines system. Staff received medicines training and were assessed for competence.