Homecare Team 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 as good. 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.

We identified a breach of regulation 12 regarding safe care and treatment, due to concerns identified regarding medication.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Records showed accidents and incidents were documented, and staff understood the importance of reporting concerns. Staff told us they felt comfortable raising concerns and were confident these would be addressed by management.

We saw several examples where incidents had occurred. The registered manager had carried out analysis to determine what happened and help prevent any re-occurrences and promote future learning.

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.

Assessments of people’s needs were carried out when they first started using the service. One relative said, “A pre-assessment was done 2 years ago, [person] went from hospital to home with Homecare put in place, very happy now.”

The registered manager told us about one person who had transferred to Homecare Team Ltd after experiencing concerns with their previous care provider. Before care commenced, the service completed a comprehensive assessment, developed a personalised care plan, introduced a consistent staff team, and maintained regular communication with the person and their family throughout the transition.

The transition was completed smoothly with no disruption to care. The person reported feeling safe and reassured, their anxiety reduced, and they quickly developed trusting relationships with the care team.

People who used the service and their relatives said the service was safe. One relative said, “[Person] is very safe with the staff.” Another relative said, [Person] feels absolutely safe. [Person] was on his own for a few days last year as we were all away at the same time and Homecare Team were brilliant and gave him round the clock care, which was excellent.”

The provider 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 provider shared concerns quickly and appropriately.

There was a safeguarding policy and procedure in place which was in date and provided an overview about what people could do if they experienced any abuse.

Staff had completed safeguarding training and understood how to report concerns, although we noted some of this was last completed in 2024 and needed to be updated. A member of staff said, “Safeguarding is about protecting people from any harmful or abusive situations.”

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.

Risk assessments were completed to make sure people could safely receive care in accordance with their wishes. Risk assessments were personalised to each individual and their circumstances.

The feedback we received was that risks were well managed and people said they felt involved if there were ever any problems. One relative said, “[Person] had a pre-assessment 2 years ago. Staff visit in pairs to use the hoist which is what’s needed.”

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

Home environment risk assessments were completed when people first started using the service and were reviewed regularly. This helped to keep people and staff safe from risks associated with slips, trip and falls and fire safety around the home.

Personal emergency evacuation plans were completed and provided an overview of how people needed to evacuate in an emergency.

The provider did not always make sure there were enough qualified, skilled and experiencedstaff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care thatmet people’s individual needs.

Staffing rotas demonstrated how many staff were available to care for people, although these sometimes-showed staff were expected to be in different places at the same time. Exact login and out times were recorded to the second, meaning there was a high likelihood these were being manually inputted on to the call monitoring system. We raised this with the registered manager who told they would review the accuracy of these records.

Despite the inaccuracy of recorded visits, people and relatives said visits were on time. One relative said, “On time 100% as they are on-site so never late, no missed visits ever.” Another relative added, “They are a nice team, all very supportive, we feel very safe, nice people and [person] likes them all. We see familiar faces, they are on time, no problem, no missed visits.”

Staff told us they received enough training to support them in their role. A training matrix was used to show the training staff completed, although this needed to be updated as it showed some outdated courses from 2024 for annual training. The provider told us this would be updated.

Staff responsible for administering medicines using specialised techniques had not undergone competency assessments by the delegated nursing body, which could compromise the safe administration of medicines.

Staff were recruited safely, with appropriate pre-employment checks carried out before staff started working with the service which included Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions. The information helps employers make safer recruitment decisions. Staff had opportunities to learn, and any poor performance was managed appropriately.

Staff supervisions and appraisals took place, giving staff the opportunity to speak about their work in a confidential setting and discuss careers development.

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

Staff managed the risk of infection via the use of appropriate personal protective equipment (PPE) such as gloves and aprons. Staff said there was enough PPE available to carry out their role effectively.

Most staff had received training in infection prevention and control to support their understanding of best practice, although we noted this needed to be updated for a select few, dating back to 2023 for some staff.

Staff infection control practices were monitored during spot checks carried out within people’s homes. One relative said to us, (Person) is kept clean and tidy, as is their home. The staff do an amazing job.”

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were not involved in planning.

The Medicine Administration Records were not always accurate or legible to evidence people using the service were receiving their medicines as prescribed by their GP. Medicines risk assessments were sometimes incomplete, underestimated the risk of some medicines and did not identify those medicines that were time specific.

Supporting information for the administration of medicines lacked clarity regarding responsibilities for ordering, collecting, and storing medicines, and did not specify whether family members were involved in medicine administration.

To maintain a person’s health and wellbeing the provider was administering some medicines without their knowledge, known as covert administration. We reviewed the information and found the provider did not have all the necessary measures in place to ensure these medicines were being administered safely.

People with swallowing difficulties may need medicines administered through a gastric tube to support their health and wellbeing. The care plan lacked guidance on the preparation and safe administration of some medicines via the gastric tube, creating a risk of inconsistent and unsafe practice.

Records were maintained to document the application sites of medicated skin patches and evidenced that patches were rotated between different sites in accordance with the manufacturer’s guidance. However, discrepancies were identified between the patch application dates recorded within these records and those documented on the MAR charts.

Staff were trained and assessed as competent to administer medicines safely. However, staff responsible for administering medicines using specialised techniques had not undergone competency assessments by the delegated nursing body, which could compromise the safe administration of medicines.