Access 24/7 Healthcare Ltd

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 – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The provider did not ensure all required recruitment checks were completed on staff. The service was in breach of legal regulation in relation to fit and proper persons employed.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. Lessons were learnt to continually identify and embed good practice. The registered manager told us they are always discussing how to move forward and improve the service. The management shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. Information was shared with staff through a WhatsApp group, information leaflets, power point presentations, supervisions and meetings. A member of staff told us, “The manager keeps us up to date with any changes.” However, we found some concerns from the previous assessment had not been addressed.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff told us they read through the care plans to ensure they had all the information they needed to provide support safely. Relatives told us they were happy with the initial assessment process and the way the support package was put into place. A relative told us, “A full risk assessment was completed with the manager when [relative] first started and we talk about changes, these are then put on the care plan so the carers coming know about it.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. The registered manager had become the safeguarding lead within the service and had raised safeguarding concerns appropriately and had worked with the local authority to investigate these to ensure people were being safeguarded.  Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to the Local authority if I needed to.”

The service worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks to people had been assessed and risk assessments had been put in place to help mitigate these. Risks included areas such as supporting people with physical healthcare needs, use of mobility equipment and with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments. Staff told us they always read the care plan and checked the care planning application they used on their phone to see if there had been any changes to the care package. A relative told us, “The carers are all so kind and caring and although [relative] is nonverbal they all understand [relative] well enough to know what he needs.” Another relative told us, “Yes, the nurses are highly trained to do all that [relative] needs, we have a regular team of nurses whom we have really got to know well.”

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

The registered manager had not always ensured staff were safely recruited. Relevant recruitment checks were not always completed before staff started work. We saw gaps in recruitment files, such as some staff did not have completed references and references received had not been verified. The HR manager had completed staff file audits. However, the audits lacked detail, and the information recorded on the audit did not have any dates for actions to be completed and there were no outcomes recorded. Details of who the actions needed to be completed by were also not recorded. The registered manager had not completed the appropriate checks to ensure that staff were recruited safely into the service. This demonstrated a continued breach of Regulation 19 [Fit and proper persons employed] of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the site visit, the registered manager sent a revised staff induction template and an updated staff information form which had been implemented.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. The registered manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen on staff files. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. The clinical leads completed regular audits. There was a robust system in place to identify any shortfalls and to ensure people received their medicines safely.