Niche Care Rotherham

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 received safe care. Safeguarding procedures were in place and staff were aware of and had received training in safeguarding adults. Staff were knowledgeable of the risks associated with people’s care and knew how to support them to minimise risks. Care plans detailed risks to people with plans in place to reduce risks. People told us they received safe care from Niche Care Rotherham. People were supported by consistent staff who knew them well. Staff received regular training to ensure their skills and knowledge were up to date. However, staff did not always feel supported by the management team and often didn’t feel listened to. The registered manager informed us they would take action to improve staff morale.

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 their relatives told us the communication with care staff was good. People and their relatives told us if they had any concerns they would speak with the care workers, and they would resolve any issues. One relative said, “You can’t fault them [care workers], they are very flexible.”

Staff told us that when changes were made to systems and processes, they were not supported to understand how to put them into practice. There was a lack of guidance for staff. Leaders were aware of how to respond to accidents and incidents which included how to record and report incidents. However, their knowledge was not always shared with other staff to ensure consistency.

Systems were in place to learn from accidents and incidents. Lessons learnt were completed following accidents, incidents, complaints and safeguarding concerns. The provider had policies in place which were accessible to staff. There were monitoring systems in place to ensure that lessons were learnt from incidents.

Some people shared details of all the different healthcare professionals involved in their care. People and relatives told us care staff had assisted them to contact healthcare professionals when needed. One person told us how staff had supported them to contact the occupational therapist when they required support with equipment.

The provider had policies in place which were accessible to staff. There were monitoring systems in place to ensure that lessons were learnt from incidents. However, staff did not feel involved in these processes.

We received feedback from partners that there had been some substantiated concerns regarding call duration and quality of care. The local authority completed an assessment of the service in March 2023 which identified some areas of improvement.

The provider had processes in place to ensure safe system, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided.

As part of this assessment, we had to make a safeguarding referral due to allegations of poor moving and handling. The provider took appropriate actions to address the concerns. Generally, people felt safe while using the service and told us staff were aware of risks associated with their care and support.

Staff were knowledgeable about protecting people from the risks of abuse and would take action to address any concerns. Staff said the registered manager would take action to address safeguarding but knew who to contact externally if needed.

The provider had systems in place to ensure people were protected from the risks of abuse. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of her responsibilities under the MCA 2005.

People and their relative felt care staff supported them to manage risks associated with their care. For example, 1 relative said, “The carers had suggested equipment which may prove to be helpful, such as having a commode downstairs.” Another relative said, “The carers are good at talking to [relative] as a form of distraction whilst showering and washing [relative].” One person said, “I feel quite safe with the carers. They seem knowledgeable and always wash and dry me properly."

Staff were able to explain how they supported people safely and in line with their current needs. Staff knew people well and were knowledgeable about risks associated with people’s care and support. One care worker said, “I include people, and involve them in all decisions and I know how people like their care to be delivered.”

Support plans showed risks associated with people's care had been identified and managed safely. Risks were identified and managed. Risks were regularly reviewed and updated where there was a change in need. Staff promoted people's safety and independence. People’s care plans were regularly reviewed and in response to any change in needs.

People told us staff gave alternatives to ensure their home was safe. One person said, "Niche recommended certain equipment aids for the house, such as a safety handle in the bathroom and a key safe box outside." People felt appropriate equipment was in place to manage risks associated with their care. One person said, "There is proper equipment in place such as inflatable sheet and hospital bed." This had made the person more comfortable and safer.

Staff were aware of environmental risks and spoke with people about potential hazards in their homes. Staff were aware of risk assessments and explained how they carried out their role safely and in line with people’s preferences.

The provider had several advice documents for people such as the hot water bottle awareness as documented above, Heatwave advice about keeping hydrated and how to spot signs of dehydration. This is also known as 'beat the heat,' document. Environmental risk assessments were also completed in each property.

People felt confident staff were trained and told us the staff were knowledgeable. One relative said, “I have no concerns about training. [Relative] is never at risk.” Another relative said, “I would highly recommend them [Niche], everything is going well.”

Staff informed us they completed training regularly but did not feel supported by the office staff. Staff felt there was a communication problem and staff morale was low. Staff told us spot checks; supervision sessions and appraisals were very adhoc and when they did take place, they were not meaningful development sessions.

Training matrix showed staff had received training and support to carry out their role. There was a safe recruitment process in place.

People told us staff wore PPE and washed their hands.

Staff were aware of infection prevention and control and told us they had access to PPE and washed their hands frequently.

Staff have access to PPE as required and we expect staff to keep masks, gloves and aprons. Hand wash and hand sanitiser is available. Staff are encouraged to wash hands in-between tasks and calls.

People told us they were always asked or prompted by staff to check their medicines had been taken, alternatively people were assisted to take their medicines at the time of the visit.

Staff confirmed they recieved medication training when they first started working for Niche and refresher training on a yearly basis. Staff were asked a series of questions to check out understanding. Although when the new legislation came into force, staff told us they were emailed a copy told to read it as there were changes to sign and send back. Staff told us they were not given any guidance about the changes.

Medicines were managed in a safe way. Although recent audits identified some concerns, these had been identified and actioned.