Harborough Home Care Limited T/A Bridgewater Home Care - Harborough Also known as Bridgewater Home Care - Harborough

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 newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 81 (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.

Systems and processes were in place to learn from incidents to prevent reoccurrence and promote safety. An analysis was undertaken of any incident or concern and the outcome used to bring about any changes required. For example, staff induction had been reviewed with a stronger emphasis being placed on the importance of infection control when dealing with people’s laundry when soiled.

Staff were aware of the services reporting processes regarding accidents, incidents and concerns. The registered manager reviewed records detailing accidents or incidents, and any necessary changes were made to staff practice or the care and support provided to mitigate against repeated incidents.

The provider and registered manager fully supported an open an honest culture. Their role and responsibilities meant they reported safety concerns, which included notifying the Care Quality Commission as part of their regulatory responsibilities.

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.

People’s relatives told us they had contacted Bridgewater Home Care about providing a service based on recommendations from professionals, neighbours and friends. A relative told us, “I asked around friends and these were recommended, and I can see why.”

People were supported by a core team of staff, and when new staff were introduced, they worked alongside existing members of staff, getting to know the person, their preferences and routines. A relative told us, “We have four regular carers, and they introduce us if there is going to be a new one.” This supported a safe transition and promoted consistency of care.

Staff informed us they were always introduced to a new client before the package of care commenced, which included an initial shadow session before they worked by themselves. Staff told us the person’s care plan and records enabled them to work with people safely and meet their needs.

In response to an enquiry from a person or their relative to Bridgewater Home Care, the registered manager organised a visit to meet the person at their home for an initial consultation. The purpose of the consultation was to provide information as to the services offered, fees, the vision and values of the service, and provide literature about the service. The initial consultation was followed up with a further visit, where a full assessment of the person’s needs was undertaken, including gathering information as to their expectations and anticipated outcomes. The registered manager visited the person and their family within the first month to ensure the package of care was working well, and to identify if any changes not already identified, were required.

The registered manager spoke of the importance of communication to support a smooth pathway when people transfer to another service. They told us, “We work with the individual or the family members to ensure we finalise the last day of the service required to ensure a smooth transition to their next place of care. We want to ensure that transferring from our care service to another is without stress and with support in mind.”

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.

People’s relatives spoke of their family members feeling safe with staff, and why. A relative told us, “I know by her body language and by her expressions and her eyes that she is safe and happy with them.”

In the event a safeguarding concern was identified the registered manager met with the person, their family member and social worker to discuss the concerns and provide information about safeguarding, and the referral process. Information relating to safeguarding concerns and referrals were shared with staff to enhance their understanding in support of good outcomes for people.

All staff were clear in being able to recognise and respond to signs of abuse. Staff said they would raise any concerns with the office and records facts, such as injuries or behaviour. All staff said they had received safeguarding training as part of their induction.

Safe and effective systems, processes and practices were in place and implemented to protect people from abuse and neglect. Safeguarding concerns had been raised with the appropriate local authority safeguarding team to promote people’s well-being and protect them from abuse. Statutory notifications submitted to the Care Quality Commission reported concerns about abuse, including where people’s actions placed them at risk, demonstrated the provider’s commitment to promoting people’s safety and wellbeing. This included taking action by sharing information with key partner agencies.

The registered manager fully understood the importance of safeguarding, which from a staff perspective began during the interview process. Staff undertook training in safeguarding and were provided with information as to how to raise and report concerns, underpinned by the provider’s safeguarding policy and procedure.

People’s records included information relating to people’s capacity to make informed decisions.

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.

People’s relatives told us they and their family member were fully involved in decisions about potential risks and the action taken to mitigate them. They emphasised the importance of staff taking their time when supporting people. A relative told us, “Staff never rush him and they use a rotunda transfer aid, and he feels safe with staff.” Another relative said, “We have 2 carers at a time as she has a hoist, and staff know how to use it safely. They don’t rush her; they give her extra time.”

Assessments of people’s needs recognised the importance of promoting people’s independence, using equipment where required to support both independence and safety. A relative told us, “Staff walk beside him and hold his arm.”

The registered manager referred to the importance of empowering people to live a fulfilling life, and the role of the service in enabling people to achieve their goals and aspirations, whilst recognising a person’s choices and wishes may not always be safe. As part of the initial assessment, the person, and where appropriate a family member, were involved in risk management planning, and working with them to make small adjustments to build confidence and maintain safety. To facilitate this, a referral was made to a health care professional, who visited the person at home and identified any equipment to promote safety. For example, the installation of grab rails in a shower cubicle, so a person could shower safely.

When equipment to support the safe handling of people, such as a rotunda was introduced into a person’s home, the registered manager and the external professional involved in the assessment, met with the person and their relatives to demonstrate its safe use; and to emphasise the importance of using equipment safely to mitigate risk.

Where people’s cognitive decline meant they were unable to take the necessary action in the event of an emergency, for example a fire at their home, the registered manager made a referral to other services. For example, requesting the installation of a fire detector, by the fire service, connected to the fire service, who would be able to respond, in the event the alarm was activated.

In circumstances where people’s actions, or those of their relatives placed them at risk the registered manager worked with them and made referrals to other services, including assistive technology to promote people’s safety. In addition, the registered manager updated people’s care records to include specific tasks for staff, such as increased monitoring and observation. A relative told us, “The registered manager and [staff name] are all very good, helpful and suggest things, such as using a tracker in the event [family member] wanders outside again.”

Staff fully understood potential risks and the importance of promoting people’s safety when they engaged in activities that were important to them. A member of staff told us how they reminded a person who went out in the community by themselves to take their walking aid with them.

Staff had undertaken training to promote people’s safety, in several key safety areas, which included, moving and handling people, fire safety, health and safety, and basic life support. Staff had their competency regularly assessed to promote people’s safety.

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

Potential risk related to people’s home environment were assessed to promote both the safety of people and staff. Assessments focused on potential trip hazards such as rugs or uneven floor services and considered the tasks to be undertaken by staff in the delivery of people’s care. The registered manager ensured the person or their family had any equipment used by staff in the support of people’s care, such as a hoist was serviced in line with the manufacturer’s guidance.

Staff received personalised and tailored training in the use of equipment, enabling them to meet the individual needs of the person within their own home environment. Staff’s competency was assessed and regularly reviewed.

Consideration was given as part of the home assessment to fire alarms and carbon monoxide alarms. If these were not present, then permission from the homeowner was sought for a referral to be made to the local fire service. Important information about people’s homes was documented, to enable staff to take appropriate action in the event of an emergency. For example, fire escape routes were identified.

Potential risks to staff when working alone were assessed. For example, parking and external lighting, occupants of the home, including any pets. The provider had a lone working policy and an out of office procedure which staff could use to contact for support or advice.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People's relatives had overwhelming praise for the reliability of the service and the continuity of care provided by a core team of staff. A relative told us, “We get 3 regular carers and we know each other. I know that I can trust them implicitly, we don’t get a strange face coming in.” Another relative said, “They’re crack on time and if late, (which has only happened twice,) the office rang me, as there had been a delay at the previous client. They never rush him and I’ve known them to stay half an hour over time if they’ve been talking”

The provider used an electronic scheduling system to plan and monitor care visits. This allowed the provider to see in real time when staff arrived and left the person’s home. Relatives told us they knew which of their core staff member was attending. A relative said, “We are told who is coming, a bit like a rota.”

People’s relatives consistently told us the staff were highly experienced and dedicated. A relative said, “The carers are very proficient and knowledgeable.” Another relative said, “Staff have been in the industry of care for a long time so are well versed and well trained and know what they are doing.”

The managing director and registered manager ensured staff had the skills and knowledge to enable them to provide good quality care, through the provision of an induction programme, training, supervision and assessments of competence.

Personalised development plans for staff were implemented upon their commencement of their employment, providing a comprehensive induction, which included being introduced to those they would be supporting. The period of the induction was flexible with consideration given to staff’s experience in care. Staff induction included working alongside experienced staff, getting to know people, their needs and preferences as to how they wished their care to be provided. Staffs’ competency was assessed throughout their induction in collaboration with them. A member of staff told us, “I was given an overview of the clients I would be working with; I got to read the care plan and then shadow a senior carer before I was left to work on my own. I felt very confident that I knew the person’s needs.”

Records showed staff undertook training in a range of topics related to health, safety and welfare. Staff had also undertaken training specific to people’s needs which included improving skills and understanding the needs of people with a learning disability. Staff completed The Care Certificate (set of 16 mandatory standards for health and social care workers, ensuring they have the fundamental skills, knowledge and behaviours to support quality and compassionate care). A member of staff told us, “We have a learning cloud which records all our completed training and prompts any refresher or new training sessions.”

The managing director and registered manager provided opportunities for staff to develop their knowledge and skills, by encouraging and facilitating them to undertake vocational qualifications in care and leadership. Staff who had additional responsibilities spoke of being supported to undertake vocational qualification to support their personal development.

Systems were in place to monitor and respond to poor staff performance, with an emphasis on supporting staff to develop through be-spoke mentoring underpinned by an action plan.

Staff were recruited in a safe way. Appropriate checks were carried out prior to people commencing work, to enable the provider to be confident that suitable staff with the right skills and experienced were employed.

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.

People’s relatives confirmed staff wore Personal Protective Equipment (PPE), such as gloves, aprons and in some instances, masks. A relative told us, “Staff wear, gloves, aprons and a mask sometimes if we or they have a cold. They put the dirty things in the bin.”

People’s initial assessments considered any concerns relating to IPC, which included identifying whether a person had any underlying health conditions which meant they were susceptible or at from risk from infections. Staff spoke of one person they supported being particularly vulnerable to infection, so they always wore full PPE at all times.

Checks were undertaken to ensure staff adhered to IPC policies and training. Staff records confirmed they completed IPC and food safety training.

The provider had a policy for infection prevention and control (IPC), which all staff were required to read and sign. Potential risks related to infection were assessed, and any concerns were shared with the appropriate agency.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Most people’s relatives told us they supported their family member with their medicines. Where people did require support from staff, their relatives confirmed they had no concerns. A relative told us, “Staff give her 2 tablets, they never miss.” Another relative said, “Staff stay with him until he has used his inhaler and taken his medicine.”

People’s care records included information about their prescribed medicines and the role of staff in providing support. A relative told us, “Staff collect medication from the chemist for him.” Where staff supported people with their medicines, they signed an electronic record to confirm the person’s medicine had been administered or applied.

Staff received training, which was updated annually, and underpinned by a competency assessment which was reviewed regularly throughout the year.

Staff were knowledgeable in the safe administration of medicines, and confirmed they didn’t administer medicines for some, often their role being to prompt or remind people to take their them. Staff were aware of the importance of medicines being taken on time, particular for people with specific health conditions such as Parkinson’s Disease. They confirmed they had their competency checked in medicine management.

Systems and processes were in place, underpinned by the provider’s policies to ensure people’s medicine was managed safely. The registered manager, as part of the oversight of the service, regularly audited electronic medicine administration records so as any anomalies or concerns were identified and any required action taken.