Archived: Faith IN ME Home 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

During our assessment of this key question, we identified four breaches of the regulations. There were not enough skilled and experienced staff to meet people’s needs. Recruitment processes had not always been completed before new staff started work. Systems in place did not help ensure people were protected from abuse and improper treatment. People did not consistently receive care in line with their preferences. Management and oversight of the service was ineffective, systems in place did not identify risk or drive improvements. Staff had access to Personal Protective Equipment (PPE) and there was an infection control policy in place, however some people told us that staff did not always wear PPE.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Systems to enable managers to learn from untoward events were not robust. Accidents were recorded in people’s notes but there was no system to give an overview of accidents which might support learning and help identify patterns and trends.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Some staff were aware of how to raise any concerns to managers and were confident these would be dealt with. One commented: “I think things would be followed through.” However, other staff told us their concerns were not listened to. Some staff told us they would not know how to report safeguarding concerns outside of the organisation.

There was a safeguarding policy in place, which included local contact details. Safeguarding information was available in the office. Not all staff had received up to date training on safeguarding. When people were able to consent to care they had signed forms to indicate they were in agreement. Some people had Power of Attorney arrangements in place and this was recorded although it did not consistently detail in what areas they held Power of Attorney.

Visit times were unpredictable and this could impact on how safe people felt. Comments included; “Sometimes I’m so tired I want to go to bed, but I can’t until they come” and “[Staff name] is always in a rush .” Relatives described occasions when they felt their family members well being had been negatively impacted due to poorly timed visits. For example, one relative told us routine was very important to their family member due to specific health needs. They commented; “If they don’t get here on time [Name] goes to bed hungry.” People and relatives told us they felt they/their family members were safe when personal care was being provided. One commented; “I generally feel safe with staff on the whole.” Systems to protect people from the risk of financial abuse were not robust. We were told of one person who was paying fees directly to the owner and no receipts had been provided . The owner/provider told us they had set up a business account in the month before the site visit and all monies were now going through this account. However, this meant there had been a significant period of time when finances had not been well managed.

Risks were not consistently clearly identified or managed. There were not always risk assessments in place relating to people’s specific health conditions, for example catheter care. One person had been identified as at risk of becoming ill if they consumed too much sugar. The risk assessment stated; “Staff are to be aware of [Name’s] intake of food and drink and to ensure we are not making high sugar content (sic).” Daily notes did not include information about what the person had eaten referring to ‘snacks.’ At the previous inspection we found environmental risk assessments were not being developed to highlight any risks in people’s homes to staff. These were now being completed. However, staff were not always aware of them.

Most people were aware of their care plan and what information it contained. They told us risks were known to the staff providing care and well managed. Comments included; “They are good at mobilising me around safely” and ““My relative has a care plan in place and I’ve had involvement with it and it meets my relative’s needs.” The inconsistent visit times could impact on how risks were managed. One relative told us their family member could be left in bed for long periods without personal care because of the gaps between visits which put their skin integrity at risk.

Staff told us they did not always have the information and knowledge they needed to support people who were new to the service. They said that they received brief notes and general information but full care plans would not be available in the first instance. One commented; “We don’t always know what is expected of us .”

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

There were some vacancies on the staff team. Staff told us they were frequently asked to work additional hours to cover gaps. While some staff did not mind this, others felt pressurised at times to work more than they wanted to. Some staff told us they were sometimes put on the rota outside of their agreed working hours without being asked or informed beforehand. At the time of the first visit to the office staff told us they had face to face supervisions and spot checks were completed. Following the departure of a key member of staff we were told these were no longer being carried out. Staff did not always feel well supported at work. There were gaps in training records and not all staff had completed an induction before starting work. There was no evidence the Care Certificate was being completed. Medicine competency checks had not been completed for all staff . One member of staff told us when they had told managers they did not know how to use a particular piece of equipment they were told to look it up on YouTube.

Managers told us they allowed an hour either side of a planned visit time before they would regard it as a late visit. This was not clearly laid out in the organisations policy which stated; “Faith In Me Home Care will outline the timeframe of what constitutes a missed visit in their Service User's Contract (usually a visit running over 15-30 minutes late), and ensure that this is discussed with the Service User at the pre-service stage.” No-one we spoke with was aware of the hour leeway. People, relatives and staff told us visit times were inconsistent and unpredictable. New staff had visited people they had not been introduced to before they had uniforms or any identification cards. Recruitment checks were not consistently completed before new staff started work. For example, one member of staff had started working on their own before their DBS had been received. Another member of staff had worked at the agency previously and had recently returned. Recruitment checks had not been carried out following their return. This meant the provider could not be assured of their conduct during this period . Staff new to the service completed shadow shifts. However, these sometimes included them acting as the second carer on a shift where 2 carers were needed to provide support to a person. This meant people were at risk of being supported by staff who were inexperienced and had not completed the relevant training. The owner had, until recently, been delivering training as part of the induction process. They did not a hold a train the trainer qualification and so was trying to identify an external trainer to fulfil this requirement until they could complete their own training. This meant new staff would not have access to appropriate support before starting their new role

People told us their visit times varied widely. Comments included; “The times can be up to two hours difference”, "My real issue is bad timings”, “You just don’t know what time they are coming” and “The staff are all ok but the hours are all to pot .”

The provider had an infection control policy in place, which was accessible for staff.

Staff had access to Personal Protective Equipment (PPE). One person commented; “I think they cover all the guidance in regards to hygiene standards” and “I’ve never had any issues with staff on bad hygiene.” However some people told us that staff did not always wear PPE.

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