Highlands Care 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.

This is the first assessment for this service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

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.

There was a proactive and positive culture of safety, openness and honesty within the service. Staff listened and responded appropriately to concerns about safety and events. Lessons were learnt to continually identify and embed good practice.

People were supported to make informed choices and risks were assessed and managed safely. There were systems in place to ensure accident and incidents were reported, recorded and investigated. The registered manager had oversight of incidents and when things went wrong, ensuring transparency and accountability. Lessons were learnt and communicated effectively to staff to help drive good standards of practice and service improvements. Policies and procedures were in place to ensure people’s safety, such as safeguarding and whistleblowing.

The provider 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.

The registered managers assessed people’s needs and risks and evaluated whether the service could meet them safely. Records showed effective communication and good working partnerships with health and social care professionals when required. The registered manager told us they worked closely with people and their families, GP’s, and community nurses to ensure people received appropriate care and treatment. The registered manager was a nurse by profession and used their knowledge, skills and experience to help people to access healthcare promptly when required.

The provider worked with people and health and social care 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 provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe with the staff who supported them. Comments included, “I absolutely feel safe with the carers who come to me, they are lovely girls. They are marvellous, I couldn't be happier and I can't fault them”, and “I do feel that [loved one] is safe for example, [registered manager] is so proactive and always looking at a way forward and the solutions. If there is a problem, I always feel able to contact her and she's always gets back to me.”

People were supported by staff who understood the provider’s policies and procedures in relation to safeguarding adults and children. Staff had received training in safeguarding adults and children from abuse. Staff we spoke with showed good knowledge of how to recognise the signs of potential abuse and understood the process for reporting concerns and escalating these to external agencies if needed. The registered manager was aware of their responsibilities for reporting safeguarding concerns to the local authority safeguarding team and the CQC and records were monitored and maintained to ensure this.

The provider 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 were identified, assessed and documented. Assessments considered areas of risk to people including mobility, mental and physical health, nutrition and hydration and communication amongst others. Assessments detailed how staff should best provide support to people to minimise and mitigate risks identified in these areas.

People and their relatives told us they felt safe when receiving care. Comments included, “There are 4 main carers and so [loved one] knows them all and they know [loved one] which is invaluable. They use a hoist, and they are all very competent using it. [Loved one] never feels unsafe with them”, and “They [staff] are very diligent at reporting things back to me for example, they phoned me when there was an issue with medicines. It's a real relief to know that I can relax and if I go on holiday, I know that they will deal with everything while I'm away.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff carried out risk assessments of people’s home environments to ensure safety for both individuals and staff delivering care. Assessments considered factors such as, fire, electrical and trip hazards, and any equipment used in providing care.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People’s support was planned according to their needs and people confirmed that they received the support they needed as planned. Comments included, “The 2 carers always arrive together. They are generally on time and if they're going to be a little bit late, they let me know but it's never particularly late. They always stay for the full amount of time and if they have a bit of time to spare, they sit and talk to [loved one]”, and “There are 2 carers who tend to come and they feel like friends to me. They have never missed a visit, and they always arrive around the same time”, and “[Loved one] has a regular carer who they really like and get on with and feel safe with. If they are away, then it’s always another same carer who fills the gap, so there's always a familiarity for [loved one].”

Staff told us and staff rotas showed that people received their care and support at the time they needed it. A staff member said, “We get our working rotas on a monthly basis, so we always know where we have to be. This works well and we get enough time to travel between people. I use the company car to travel which makes it easier.”

Staff records showed that staff completed an induction in line with the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. Staff training matrix showed that staff had completed training in areas such as fire safety, infection control, learning disability and autism, food hygiene, moving and handling, nutrition and hydration, dementia awareness and safeguarding adults and children amongst others. Other areas of training where also completed to meet people’s individual needs such as tissue viability and diabetes. Records showed that staff received formal supervision sessions with the registered manager.

Robust recruitment procedures were in place. Staff recruitment records included proof of identification, application forms with employment histories, employment references and right to work in the UK checks. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had completed infection control training and demonstrated a clear understanding of the procedures required to prevent and minimise the risk of infection. The provider had an infection control policy in place. Staff told us the service provided them with personal protective equipment (PPE) and a uniform.

The provider 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.

Some people looked after their own medicines and some people required support from staff to take their medicines. Where people required support to take their medicines this was recorded in their care records. Care plans outlined the level of support individuals required in managing their medicines and identified who was responsible for providing the support.

Training records showed that staff had received appropriate training, and their competency to administer medicines safely had been assessed. Medicine Administration Records (MAR) were completed appropriately in full with no gaps noted and the registered manager completed weekly medicines audits to ensure continued safe practice.