Vista Home Care 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

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 encouraged a learning culture to ensure risks were mitigated. People and relatives told us they knew how to raise concerns and felt confident appropriate action would be taken to address them.

The provider operated effective systems and processes to record and review accidents and incidents to ensure risks were reduced and lessons were learned. Due to the low number of people using the service there were a low number of accidents, incidents and complaints. Staff knew how to record and report accidents and incidents and how to escalate safety concerns.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, maintaining continuity of care when people moved between services.

Pre-admission and post hospital admission assessments were completed, and this information was used to develop care plans and risk assessments. Procedures and contingency plans were in place to aide continuity of care. People and relatives told us their care plans were updated when their needs changed and to reflect information from other healthcare professionals.

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.

Staff received training in safeguarding and had individual observations of their practice to ensure they effectively applied this training to their day-to-day work. Staff had a good understanding of how to identify and respond to any concerns about people’s safety and welfare.

Processes were in place to protect people from abuse and poor care. There had been no recent safeguarding concerns, but the registered manager was able to demonstrate a good working knowledge of how they would report and monitor any future concerns if required. Staff and people using the service were confident the registered manager would take appropriate action to ensure people’s welfare and safety.

The provider had systems in place to assess and manage risks and involved people in understanding the best way to mitigate these risks. However, the provider did not always ensure a consistent approach to risk management.

Risk assessments in relation to people's health, safety and welfare were in place and reviewed. Overall, we found this information was comprehensive and reflected the actions staff were taking to keep people safe. We saw some examples where specific risk assessments were not in place or did not contain up to date information. For example, 1 person was at risk of falls and pressure sores but their risk assessments in these areas had not been updated to reflect their current needs. The registered manager explained this was an issue with the electronic care system and took action to address this during our assessment. They assured us they would adapt the electronic system to ensure risk assessments were consistently updated going forward.

People told us staff delivered safe care and helped them to reduce risks effectively. One relative told us staff were, “competent and trained adequately to help manage risks. Staff were aware of [my relative’s] needs and treated [them] well.” Most people and their relatives described how they had reviews of their care plans at least once a year or if their needs changed. We saw evidence of this in the records we reviewed. Our conversations with some people indicated they would have benefitted from a more timely care review. The registered manager told us some care reviews had been delayed due to recent operational changes. They assured us everyone using the service would receive a care review as an immediate priority.

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

People did not always receive good continuity of care. People told us staff timekeeping needed to be improved and the quality of care could be variable depending on the staff member. For example, 1 person told us they, “Felt safe with the staff who came and that they were trained to do the job. [However], staff were often late…and the care had been up and down mainly based on the carer.” Another person described how they had raised similar issues with the registered manager in the past and now things were “ok [and they had] carers they were happy with.” The registered manager said they had identified these issues and were working to address them through their supervision processes. They also arranged care reviews to ensure any individual issues with care quality were identified and addressed.

People received care from regular staff who were familiar to them. Contingency plans were in place to ensure people received the support they needed in the event of an emergency or adverse event. We did not see evidence of any missed care calls and people told us staff usually called ahead if they were going to be late.

Staff spoke positively about the induction, training and support they received. All staff completed mandatory training which was refreshed each year and included key elements such as moving and handling, medicines management and safeguarding. Where people had specific care needs specialised training was sourced. For example,1 person used individualised equipment. A specialised training provider had delivered training to staff. The registered manager confirmed only staff who received this training and been assessed as competent would support this person. They consulted with the training provider and local health care professionals to develop a practical assessment which they used to ensure staff remained competent in using this equipment.

Processes were in place to ensure staff were recruited safely. Checks were completed to ensure new recruits were safe to work with vulnerable people.

The provider assessed and managed the risk of infection effectively.

Staff received regular training in infection prevention and had spot checks of their practices to ensure they understood their role in maintaining high standards of cleanliness and hygiene when caring for people.

Staff told us they had good access to personal protective equipment and demonstrated an awareness of how and when to use this to reduce the risk of infection. People using the service confirmed this.

The provider operated safe systems to ensure people received their medicines as prescribed. Some improvements were needed regarding medicines records to ensure they were consistently detailed.

Staff supported some people to take ‘as required’ medicines. Clear records were kept when ‘as required’ medicines were given, including the time and dosage. However, staff did not always record the reason why these medicines had been given. One person did not have an individualised protocol for their ‘as required’ pain relief medicine. The registered manager addressed this during the assessment and provided assurance that individualised protocols would be in place for all ‘as required’ medicines in the future.

The provider had an effective electronic medication administration system. Staff understood how to administer and record the administration of prescribed medication for people on this system. We saw 1 person’s needs had recently changed and the registered manager was in the process of updating their medicines care plans to reflect these changes.

Staff received training in medicines management and had their competency checked at least annually. People told us staff were competent and provided the required support with their medication.