Healthvision UK Ltd - North Kensington

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• 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

The service followed robust recruitment procedures and enough staff were employed. Care staff and coordinators completed appropriate training and their competency was regularly checked. Care supervisors and office staff had not always completed appropriate or relevant training. Staff received support and supervision and annual appraisals. The correct numbers of staff were allocated to support people. There were safe medicines processes and regular audits of medicines were completed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

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.

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

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 provider followed robust recruitment procedures. The service obtained and verified references and police checks were carried out before prospective staff started work. There was a probationary period of 3 months, with reviews, and new staff were introduced to people using the service before supporting them on their own. Staff files recorded that the recruitment process had been followed and the probationary period, training and induction were completed. Care staff and coordinators completed appropriate training and their competency was regularly checked. However, the training requirements for care supervisors and office staff needed to be reviewed, to ensure it was completed appropriately and kept up to date. We identified some anomalies with the electronic call monitoring system. For example, there were occasions where it was recorded that the same member of staff had been logged into 2 separate places at the same time. The provider confirmed they would fully investigate this situation to establish the cause and take appropriate action as needed. The correct numbers of staff were allocated to support people and we were assured that calls that required two members of staff were not being completed by single members of staff.

Staff told us there were enough staff employed and they had time to complete their care visits as required. A few staff said they were not entirely happy with their rotas and told us there was little or no travel time between visits, which made it difficult to ensure good timekeeping. The provider and management team told us that they were always willing to review and discuss people’s rotas. They said they had been working hard to make sure there were no back-to-back visits and ensure that appropriate travel time was factored in. They also explained how staff teams worked on patches for ease of travel and to help ensure calls were delivered on time. The provider said they also offered a cycle to work scheme, as reliance on public transport could sometimes be an issue. The provider told us they had paused employing people via the overseas sponsorship scheme, because there had been a marked increase in local job candidates. Staff told us they had support, supervision, spot-checks and appraisals. Care staff confirmed they completed relevant training and kept this up to date. Staff also told us that they completed additional and person specific training when required, including training for people with a learning disability and autistic people. One person told us, "I have had the training and worked with this before but none of my clients that I see at the moment have this."

People told us they felt safe and there were enough staff to support them. Nobody we spoke with had experienced any missed visits. People said that care staff usually arrived on time and stayed for the length of time required, although transport strikes did have an impact on the carers’ punctuality. Most people said they had regular care staff whom they knew well. One person said, “I get the same carer from Monday to Friday and different ones at the weekend, but they are all good.” A few people commented that their visit times were not always regular and one person said that the carers were all strangers. People felt that care staff were well trained and told us, “Yes I think they are well trained and they are good at their job.” and “The staff are trained to do their job and I also believe they enjoy their job”.

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

Care staff supported people with their medicines when it was agreed as part of their care package. People told us they were happy with the way care staff managed their medication. One person told us, “I live on my own and I am diabetic and taking medicines. The carer gives me medicine and food. There is never any issue with the medication.” Another person said, “They always give me medicines and they are very good about that.” People’s relatives told us, “They are okay regarding administering medication.” and “They just come once a day and do [name]’s lunch, they also check the dosette box and make sure [name] has had their medication.”

Staff told us they completed training to manage and administer people’s medication and confirmed that their competency was assessed at regular intervals. The registered manager explained the medication procedures and confirmed that a robust process was followed. The service had appointed a dedicated medicines compliance manager. The registered manager, training officer and a care worker all spoke very highly of the support provided by the medicines compliance manager, as well as the systems in place around medicines. The training officer was well informed and explained the medicines training for staff, which was face to face. The trainer was also aware of supporting people in relation to STOMP (Stopping over-medication of people with a learning disability, autism or both) and was looking into this to take forward.

There were appropriate systems in place to help make sure medicines were managed in a safe way. The provider complied with relevant legislation and guidance in respect of managing people’s medicines. We saw that audits were completed monthly and any issues were dealt with promptly. We were assured that lessons were learned and shared with the staff team following any medication error or incident. We saw the electronic care planning system helped minimise the risk of medication omissions. For example, if a care worker left a visit without administering a person’s medicines, as required, the system would send an alert to the office staff. Office staff would promptly call the care worker to ensure they returned to the person’s home to complete the task. The registered manager told us that this happened on very few occasions. We saw that people’s care plans contained clear details about the medicines they took, as well as when and how they required them.