Home Instead Warrington & Lymm

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 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 75 (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. The provider demonstrated a learning culture where safety incidents were used to drive improvement. Medication errors were identified promptly through daily auditing systems, with clear evidence of action being taken. This included immediate safeguarding referrals where appropriate, 1 to 1 supervision with staff involved, and additional training to reduce recurrence. The registered manager had implemented a medication errors standard operating procedure which was shared with staff to ensure consistency across the service.

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.

This included liaising with GPs, district nurses and urgent care teams, sharing relevant information to prevent deterioration of conditions. Where concerns were identified, we saw evidence the provider escalated to the relevant bodies and followed through until outcomes were achieved.

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 with family and healthcare professionals quickly and appropriately. The provider demonstrated strong safeguarding knowledge and practice, with multiple examples of identifying and escalating concerns appropriately. For example, where a person had not been reassessed following a hospital admission, the provider identified an increased risk, took immediate action by referring to the urgent response team, and raised a safeguarding concern. Staff understood safeguarding processes and reported confidence in escalating concerns.

The provider worked with people to understand and manage risks.Staff provided care to meet people’s needs that was safe,supportiveand enabled people to do the things that mattered to them.Risk assessments were personalised and regularly reviewed to reflectpeople'schanging needs and preferences. We saw evidence of the provider working with people,familiesand healthcare professionals toidentifyand manage risks in a way that promoted independence and choice. Examples included supporting people to remain safely at home, responding to changes in mobility, and implementing measures such as assistive technology and environmental adaptations to reduce risk whilstmaintainingpeople's autonomy.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We saw evidence environmental risks within people's homes were considered as part of the assessment and review process, and risk assessments were updated when people's needs changed. Staff demonstrated an awareness of environmental risks and knew how to report concerns so action could be taken promptly.

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. The provider demonstrated strong staffing arrangements, including having no missed visits in the previous three years. Rotas were planned four weeks in advance and incorporated dedicated travel time between visits to help ensure staff arrived on time and were not rushed. The provider had effective contingency arrangements in place, including dedicated responder staff who provided cover during periods of sickness or unexpected absence, helping to maintain continuity of care. People told us they usually received support from familiar staff and valued the consistency this provided. We saw evidence all new staff were introduced to people before delivering care independently, helping to build trust. Staff told us they had sufficient time to provide care safely and effectively, and people consistently described the service as reliable and responsive. One person said, “I feel safe when the staff support me. I know what it’s like to not feel safe. In my last agency, I was frightened, very fearful, now I feel the opposite, I feel safe, secure, the staff are more skilled, more mature, I’m so much happier.”

The provider assessed and managed the risk of infection. We saw evidence staff received training in infection prevention and control and the provider maintained oversight of staff training compliance. Staff demonstrated an understanding of their responsibilities in relation to reducing the risk of infection and supporting people safely within their own homes. Staff competence was monitored through spot checks, competency assessments and supervision, helping to ensure safe working practices were maintained.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. People received safe and well-managed support with their medicines. The provider had robust systems in place to monitor medicines management and identify concerns at an early stage. We saw evidence of auditing arrangements, including daily audits for people receiving high-risk medicines and monthly audits for other medicines support. Medication errors were identified promptly, investigated and used as opportunities for learning and improvement. The registered manager had implemented standard operating procedures for medication administration and medication recording errors to improve consistency and safety across the service. Where trends were identified, staff received refresher training and additional support.