Profad Care Agency Limited

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

At our last inspection we rated safe as requires improvement, this rating remains unchanged. People’s medicine was not always managed safely and properly. Records were not always completed, up to date and accurate. People felt safe receiving support. There were sufficient staff to meet people’s needs. Systems were in place to recruit staff safely. Required pre-employment checks had been completed for staff before they started work. Staff had received relevant training in relation to their roles. Staff knew how to keep people safe from harm and abuse, incidents were reported.

This service scored 62 (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 their relatives had mixed feelings about the services culture of safety. “To be honest it’s not been great, we have struggled to get a response to our concerns”. Another raised a concern and it was resolved in a timely manner.

Staff knew people well and understood how to provide the care they needed. Staff told us they would report any incidents to their manager or the office. They confirmed there are, “Lessons learned sessions to share good practice with all the staff.” The registered manager told us they promote an open and transparent approach, focusing on sharing good practice and learning from when things go wrong. The registered manager told us they involve people in any safety events, ensuring to meet people’s desired outcomes where possible.

Systems were in place to record accidents and incidents. These were reviewed on a monthly basis and outlined actions which had been taken. Where complaints had been received, the provider actioned these and records showed how areas of concern had been addressed with staff concerned.

Staff confirmed assessments were completed for people who received support. One staff member told us “We speak to people directly, family and any health or social care professional who are involved.” The registered manager told us they work in partnership with professionals to ensure a smoot transition to their services. For example, district nurses, physio's, social workers. They told us they “come together to get the best for people, in their best interest”.

Staff worked with partners, for example, district nurses and commissioners, to provide appropriate care to people. One professional said, “ I have had a lot of contact with Profad Care Agency recently and I have always found them to be responsive to my emails and calls. They seem to ensure staff consistency to customers when requested and stick to requested call times when able”.

Processes were in place for taking on new admissions for people using the service. This was usually by a referral through the local authorities. The provider completed an assessment to ensure they could meet the person’s needs appropriately and ensuring a smooth transition to the service. The provider then had a follow up with the person and their representatives to ensure they were happy with the care they were receiving and if there was a need for any adjustments.

People were safe. One relative told us “Yes, it is a safe service. The regular carers are well trained and professional, pay attention to detail and are very tidy workers”.

Staff were clear about how to identify abuse and said they followed the processes to report abuse. The registered manager shared how they promote safeguarding at the service. For example, staff induction and training and discussions in team meetings and supervision. They registered manager told us how people’s safety is their priority, and they support people to make informed decisions.

Processes were in place to monitor safeguarding concerns. This demonstrated where action had been taken. For example, the provider had sought advice from healthcare professionals and arranged retraining for staff. There was a safeguarding policy and procedure in place to protect people from abuse.

We were concerned that people were at risk of not receiving care at times which were appropriate for them. We heard that, ‘They don’t always attend calls for the allocated times and can reduce a 30-minute call to a 10- or 15-minutes” another said the times between their calls were not suitable. Not everyone we spoke with were aware of their care plan or felt the provider had discussed the times of the calls in relation to availability with them. Although, this was not the case for everyone using the service.

Staff followed peoples care plans. However, we were not assured that that this fully met all peoples needs due to the feedback from people and their relatives. If there were any changes needed to the care plan or new risks identified, they would tell the office. The registered manager told us they worked with people to ensure their care is person centred and care is provided to them in a way they prefer. They told us how information is gathered from people and their representatives during assessment and involve them throughout the planning of their care.

Systems and processes were in place to ensure to ensure risks were identified and mitigated. However, we found people’s care plans were not always up to date and reflective of people’s care and support needs. This meant that people were at risk of receiving inconsistent care and that staff did not always have up to date information about people before they visited and supported them.

People and relatives told us they had access to equipment to keep themselves safe. They felt staff had the knowledge and training to support them with this. One person had concerns about their security and had to frequently remind carers to ensure the external doors were closed and locked appropriately.

Staff felt safe accessing people’s properties and had access to all the information needed. The registered manager told us how they complete assessments of people’s homes to consider any environmental risks, before care delivery is commenced. They will identify any risks within the home, and they ensure staff are informed to promote safety. Any equipment used within people’s home is managed by an external provider and staff must check equipment is fit for use prior to supporting a person with the equipment.

Systems were in place to identify and manage foreseeable environment risks within people’s home. The provider had a health and safety policy in place which identified expectations of staff at all levels to maintain safety for themselves and people using the service.

Some people told us they felt there were language barriers affecting good communication. In addition, some people did not receive a call to inform them when staff were going to be late, staff did not arrive on time and did not always stay for the full duration of the scheduled calls. Although on the whole, people reported that staff had the right skills to meet their needs and were generally complimentary.

Most staff felt there were enough staff, “My workload is manageable and I manage to have breaks etc throughout the shifts”. One staff explained even though they had caring experience, “The training offered by Profad, made my understanding better and knowledge much improved”. The registered manager told us of the providers recruitment processes to ensure staff are safely recruited, trained and competent prior to delivering care. They shared the ongoing support and monitoring of staff throughout their employment. For example, through regular team meetings, supervision, spot checks and observations.

We found staff were working long hours and did not always have sufficient breaks. Scheduled calls were not always conducted in line with the preferred times, recorded in people’s care plans. There was insufficient travel time for some staff between care calls, meaning service users were at risk of receiving inconsistent care and reduced calls. Staff received suitable training to carry out their roles. Their competencies were regularly checked to ensure safe practice. The provider had systems in place to ensure safe recruitment of staff.

IPC (Infection prevention and control) measures were in place. Comments included, “They wear gloves. the bedding is kept clean and regularly changed” and “They dispose of rubbish appropriately; always wear gloves and change them after completing personal care tasks”. However, another family advised, “There have been times the bedding has been damp, they don’t always change it, so we have to check and complete this instead”.

Staff demonstrated a good understanding of IPC processes and told us they had received training. They obtained personal protective equipment (PPE) from the provider. The registered manager told us of systems they had in place to monitor infection prevention and control with staff and in supporting people in the community. They shared how they actively promote hand washing and the continued use of PPE.

The provider had an IPC policy and procedure in place. Staff received training in infection prevention and control and how to put this into practice. PPE was readily available for staff at the providers office. There were systems in place to monitor staff conduct. For example, checking staffs’ knowledge in meetings and completing spot checks.

People’s home visits were sometimes delayed which meant they did not always receive their medicines on time. Feedback was inconsistent, with some people happy with their medicines support and others not. For example, “They just put tablets down and do not check to see if they have been taken”, and “We found tablets on the floor which had not been taken”. Another shared, “Some carers take the tablets out of the blister pack and leave them in a cup in the cupboard for the next call, this is not safe”.

The registered manager said systems in place to ensure safe delivery of people’s medicines. They shared the governance systems they had in place to monitor medicines, for example, audits. We found these to not always be effective and did not identify the areas we found during our assessment. For example, one person’s medicine administration records (MAR), showed a medicine was not being given as a regular medicine, but as required. The records failed to identify this, and there were no protocols in place to guide staff on how and when this should be administered. Another person had topical cream medicines prescribed, but there were no body maps in place, to guide staff on where this should be administered. We found that administration records were not always completed, up to date and accurate to demonstrate medicines were safely administered. Staff confirmed they received annual medicines training and competency checks.

Medicines policies were in place; however, staff were not always following the policy, which meant people were not always receiving their medicines safely. Records in relation to people’s medicines were not effectively maintained. For example, medicine records were not always completed, up to date and accurate to ensure people’s medicines were administered safely. Medicine audits completed by the provider were not effective in identifying the issues found during the assessment.