Thames Homecare Service 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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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. Accidents and incidents were monitored, with action taken to learn lessons from these and mitigate risks posed to people. For example, a person had a deterioration in their mental health, and this was referred to the community mental health team and GP, and a medication review was undertaken.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always make sure there was continuity of care, including when people moved between different services. People had their needs assessed prior to receiving support from the service. However, some care records contained conflicting information and did not always contain enough information about people's needs. This meant we could not be assured information shared between services was up to date or correct. Although, partners told us the service worked well with them and records evidenced input from external professionals was sought for people. For example, where a person had fallen, emergency services were contacted.

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.

The provider had safeguarding policies and procedures in place and staff were trained in relation to safeguarding vulnerable adults. At the time of our assessment no safeguarding concerns had been raised. The management team monitored incidents and understood their responsibilities to report to external agencies where required. People told us they felt safe receiving support from staff. One relative said, “[Name] is so comfortable now. 100% safe, I can go on holiday and not worry. The carers treat [name] like their own parent.”

The provider did not always work well with people to understand and manage risks. Improvements were required to care records and risk assessments, to ensure staff were provided with robust guidance about how to carry out people's care and keep them safe. Whilst we found no harm to people, we found several instances of conflicting and missing information in care plans. For example, 1 person required repositioning to manage pressure care risks, and there was no specific skin integrity risk assessment or care plan in place. Another person required the use of a hoist for transfers. There was not a robust risk assessment, and their care plan did not contain enough detailed instruction for staff to follow. There was also a lack of guidance relating to their hoist sling and how staff should use this safely. This was a recording concern, people and relatives told us staff knew them well and supported them in line with their needs. Following our assessment, the provider assured us they would ensure records were updated and changed their care planning systems, to include more robust assessments and information.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People were supported in their own homes, assessments were undertaken of people's properties, to ensure risks posed to people and staff were managed effectively. People told us staff supported them safely. Equipment was in place to help keep people safe, such as lifting equipment, and mobility equipment.

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 were supported by enough staff. A person told us, “I am happy, I have my usual carer. Staff come within a few minutes of each other, they are usually on time, but if they are running late the carer will call me directly.” Records evidenced staff supported people for their allocated times and most people told us staff arrived on time and stayed for the duration of the call. Staff were recruited safely; all pre-employment checks were in place and staff received inductions upon commencement of employment. Staff felt supported in their roles. Staff had undertaken training in a variety of subjects, to enable them to carry out their roles effectively, this included diabetes management, pressure care, supporting people with learning disabilities, and effective communication.

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 were trained in relation to infection, prevention and control (IPC) and people told us staff wore personal protective equipment (PPE) and kept their homes clean and tidy. The leadership team monitored staff's practice, to ensure safe IPC practices were undertaken in day-to-day practice. A relative said, “Staff have plenty of PPE and bring it with them, I am most pleased with their cleanliness and organisational skills.”

Medicines were mostly managed safely. Staff were trained and had their competency assessed prior to administering medicines to people. People and relatives told us they received their medicines as prescribed, a relative said, “We are very happy with the medication support.” Medicine administration records (MAR) were completed by staff and medicines audits were completed regularly by the management team. However, we found some areas for improvement. For example, where people were prescribed as required medicines, such as creams, there was a lack of protocols in place. And we found a handwritten MAR chart which was not signed by the staff member who had formulated this. Following our assessment the provider assured us they would review all medicines records and protocols.