Avengers Prime Care

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

People were safe with staff as staff had been trained in safeguarding and put this training into practice. Staff had infection control training and used appropriate personal protective equipment when providing personal care. Staff followed good medicines management practices and people received the medicines they were prescribed, although we gave feedback to the registered manager on how they could strengthen their medicine processes. There were sufficient staff to care for people in a way that met their needs.

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 told us they had never experienced an incident or accident whilst receiving care from staff at the agency.

Staff told us if there was an incident or accident, they would, “Complete an incident form and call the manager.” The registered manager said, “We have to share mistakes and learn from them.”

There was a system in place in which to record incidents. The registered manager reviewed incidents and took action in response to them, noting lessons learnt and next steps for staff. For example, a medication error occurred and mandatory medicine competency checks were introduced and a staff team meeting called to discuss the incident.

People told us they were happy with the care they received from staff having been with previous care agencies. They said staff made them feel safe.

Staff said they were given information about people prior to commencing care. This enabled them to understand why a person may need care and it could help explain why they may be resistant to care.

The local authority told us the registered manager was good at sharing outcomes of investigations resulting from accidents, incidents or potential safeguarding concerns.

The registered manager always carried out assessments with person face to face. They told us, “It’s important to meet with someone and then I would recruit the staff we need.”

People felt safe with the care staff. They told us, “I have never felt unsafe or worried with carers.”

Staff were able to describe what they would do if they suspected abuse was taking place. A staff member said, “I would complete a report, fill in a body map and speak to the manager. I would ask the person if they were aware of what had happened.” Despite this, we heard of a potential safeguarding concern which had not been investigated by the registered manager. We raised this with the registered manager who told us, “This is the first time I have heard this. It has definitely not been raised with me before.” They said they would follow these concerns up with the person. Following our assessment, the registered manager sent us an update demonstrating they had done this.

Staff followed a process should they suspect abuse was taking place. The registered manager told us a staff member had whistle-blown and a full investigation had taken place. The registered manager had reported the concerns to the local authority. However, they had failed to report them to CQC as per their requirements of registration. We discussed this with the registered manager who assured us they would inform CQC in future.

People told us they felt safe with staff. One person said, “They know how to reposition me, or hoist me without me feeling at risk.”

Staff told us they followed people’s care plans to help ensure they reduced potential risks for people. A staff member told us, “His biggest risk is pressure sores. We need to make sure we check his skin every time and we reposition him regularly. He is also at risk of choking and we cut his food up very small and feed him slowly.”

Each person had a care plan which included detailed information about their health and care needs. Within the care plan, risks had been identified and guidance was in place for staff. For example, where one person was diabetic, there was information as to what staff should do should their blood sugars go too high or too low. Staff were able to describe to us what action they would take and this was in line with written guidance.

People told us they felt safe in their house and environment. They said they had everything they needed in order to stay safe.

Staff said their priority was to keep people safe. A staff member said, “We need to know what we are doing. We clean and do the laundry; we follow good infection control practice. We are always washing our hands. We clean out the fridge and make sure everything is tidy.”

Guidance was in place in people’s care plans so staff knew what tasks were needed in order to help people maintain their safety. Care plans were reviewed and updated when necessary.

People told us they saw the same staff. One person said, “I have 6 staff who I see consistently.” They added, “However, out of the six that come to me, I only feel confident that 2 know exactly what they are doing (as they have been with me for a number of years). The others need to have additional training and they only had one shadow shift, which I don’t feel is enough.” They added, “There has never been a time when no staff have been here.”

Staff said they were given sufficient time to complete all the care that was required. They said between care they carried out other tasks. One staff member said, “The manager is always rotating us to ensure we have a break as people have very complex needs.” Staff went through and induction period which included e-learning, face to face training and shadowing a more experienced staff member. A staff member said, “The training is on-going. I am learning a lot. I shadowed a senior carer once, but I could have done with another shadow session. But [person’s name] can guide me.” A second staff member told us, “It felt alright to me (the training). However new staff need more shadow shifts. One is not enough.” We addressed this with the registered manager. They told us staff were, ‘signed off’ by her and none of the staff had asked for additional shadow shifts. They said however, they would discuss this further with staff and arrange them if needed.

Staff went through a training programme when commencing work at the agency. They were also expected to complete the Care Certificate which is a set of modules aimed at people working in health and social care. The registered manager was a qualified nurse and as such was able to train other nurses and carers based on their professional qualifications and experience. Other training programmes were being arranged specific to help ensure staff competence. However, until these were arranged some staff said they were not fully confident to complete one aspect of a person’s care. Staff were recruited through a robust recruitment process which included providing evidence or performance in previous roles, evidence of the right to work in the UK and confirmation of their fitness to carry out the role. A staff member told us, “I completed an application form, provided references and had a Disclosure and Barring Service check done.” The registered manager said, “I carry out interviews myself because I know what I am looking for.”

People told us staff followed good infection prevention and control (IPC) practices. One person said, “They (staff) wear their gloves and wash their hands.”

Staff said they knew how to follow good IPC practices. One staff member told us, “We wash and dry our hands and we always wear gloves for any contact and aprons for personal care. We are really protected. There is a bin outside. For bowel movement waste, we double bag it.”

The agency had an IPC policy in place and staff were expected to follow this policy when providing care to people. The registered manager carried out spot checks with staff to help ensure they followed good practices.

People told us they received the medicines they required. They said staff, ”popped” out the medicines for them to take.

Staff told us, “The pharmacy put [person’s name] medicines in a Dossett box (a box labelled for each day's tablets). They are responsible for checking the correct medicines are in the box. We pop the medicines out so he can take them. Some medicines have to be given at a certain time.”

Staff undertook medicines training and had competency assessments to help ensure they followed good practices. People had electronic medicine administration records (eMARs) which recorded a mixture of individual medicines as well as one entry which covered the medicines in the Dossett box. Although staff were not administering medicines, they signed to say they had dispensed them. However, without being able to identify each individual medicine, there was a risk that if the person did not take one tablet, or a tablet was dropped, staff may not know which medicine it was. As the person involved had capacity there was a low risk from this, but we raised this with the registered manager. Following our assessment, the registered manager confirmed with us they had changed the medicines administration practices and staff were now recording each individual medicine on an eMAR.