Hand of Hope Homecare Services 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 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.

The service was in breach of legal regulation in relation to safe care and treatment which included risk management and learning from events to prevent further harm to people.

This service scored 56 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. The recording of the accidents and incidents did not support learning and embed good practice. The recording did not clarify where the injuries on the body had specifically occurred. There was limited guidance to enable staff to support people safely. For example, the guidance provided to staff was to ‘ensure regular skin checks.’ were completed. However, these records did not detail how staff should action this. These records did not always detail if care plans and risk assessments were kept updated.Information was duplicated and the recording was generic, not specific to individual people and therefore not person-centred. Therefore, opportunities for learning were missed.

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 manager told us people did not have hospital passports, however, people had folders in their homes with information on people’s health readily available for staff to share with emergency services. Professionals told us the service contacted them to report concerns and informed us, “The service does contact our Brokerage and Social care teams to report concerns”.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. They did not always concentrate on improving people’s lives or protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns quickly and appropriately. The registered manager told us if they received a safeguarding concern, they would, “follow up with the investigation”. However, we were not assured from the feedback we received from the registered manager and staff, that they knew how to identify and protect people from abuse. It was not clear from the feedback received from staff, whether they had been appropriately trained to understand the signs of abuse and how they would report these.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Care records did not always contain sufficient guidance for staff on how to support people with their mobility or specific health needs. We also identified from people’s care records there was no information recorded regarding emollient cream being a fire risk, and risk assessments had not been completed for this, putting people at risk of harm.

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 had guidance in people’s care records to ensure the environment was clear of hazards to avoid the risk of falls.

The provider did not make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not work together well to provide safe care that met people’s individual needs. Supervision records did not always detail how follow up actions would be monitored nor assessed to ensure staff were competent. The provider did not have up-to date evidence to show they were competent to assess and train their staff in moving and handling and medicines. Therefore, we were not assured staff had received adequate training to support safe care to people. As a result of the inspection identifying this concern, the provider submitted an update of the training they have since undertaken. Records relating to recruitment did not evidence the provider had ensured all the correct documentation and checks had been completed to confirm staff were able to work within people’s homes in line with legal requirements. The provider did not demonstrate a robust process to keep people safe in line with their recruitment policy.

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 told us they had access to Personal Protective Equipment (PPE). People and relatives told us staff wore gloves and aprons.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning. Staff competencies regarding administering medicines were not safely conducted.

We identified for one person who was supported with their prescribed medicines there was information recorded regarding their eyesight and hearing. Whilst the care records for this person recorded they did not have any vision or hearing impairment, these care records also stated the person had poor eyesight and had a limited understanding of what was said to them. The guidance for staff was to, ‘Administer [their] medication with a glass of water.’ This did not show the communication needs of the person were considered nor how staff would support the person to make informed choices about their medicines.

People’s care records did not include information on where creams were to be specifically applied on the body. Therefore, staff did not always have the information required to provide safe care. Another person’s ‘when required PRN (pro re nata)’ records that were specifically for their emollient cream referred to tablets and therefore the information was inconsistent and not kept up to date.

For another person, we identified their care records included information about applying an emollient cream but there were no records of this on their medication administration records (MARs). Therefore, we could not be assured the person received their medicines safely,