Kate's Home Nursing

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

At our last comprehensive 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.

We scored the service as 3. The evidence showed a good standard. The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff knew what incidents to report and how to report them. Staff had discussions with managers to learn from incidents and described improvement actions which had been taken to reduce risk of similar incidents recurring. Suction equipment had been purchased to support staff in providing care safely for patients in response to an incident.

We scored the service as 3. The evidence showed a good standard. The service 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 service’s referral processes ensured that all essential information about the patient was received to determine if the patient’s needs could safely be met. Staff worked closely with other healthcare professionals to ensure patients had continuity of safe care when they needed it. Patient records audits were part of the annual audit plan.

We scored the service as 3. The evidence showed a good standard. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

Staff were trained in safeguarding, knew how to raise a safeguarding concern and did so when needed. Staff gave examples of how they had protected patients from harassment and discrimination. Staff worked in partnership with other agencies to protect adults and children and identified actions which supported families in avoiding risk of abuse.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staff provided safe care that catered to the individual needs of each patient. Specific standard risk assessment tools were completed during the initial patient assessment. This included moving and handling and falls risk assessments. Individualised risk assessments were reviewed regularly and care was planned to reduce risks. Staff used scoring systems to recognise and manage when patients’ conditions deteriorated during a care visit.

Staff constantly assessed patient safety and emerging risks which included the patient and family. For example, during a support telephone call staff identified a patient deterioration and arranged a visit in response to the need.

Staff shared care plans and risks associated with the last days of life, such as pain assessments, when handing over care to others.

We scored the service as 3. The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff took precautions to protect themselves and patients during home visits. Staff performed dynamic and responsive risks assessments to protect the safety of themselves and patients. This included home risk assessments and what adjustments would help staff to accommodate patient’s needs, management of equipment or pets in the home. Information was shared using a central electronic system for staff to access and be aware of risks before visiting a patient at home. Staff had electronic lone worker devices and telephone access to senior staff 24 hours a day.

Staff were trained in using equipment and checked it was safe to use, including when it was supplied by other services such as the local NHS community nursing teams.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staffing was provided for patients according to their needs. A nurse lead was supported by 5 nurse coordinators who allocated staff to patients when referred to the service. Most nursing staff who provided care were employed on a zero hours contract which gave them flexibility of working hours. Staff turnover was very low with only one person leaving the service in the last 7 months. Nurse coordinators were also able to cover shifts as needed. Managers were undertaking a review of staffing numbers and skill mix. This was to ensure staff had relevant skills to provide care for patients and provided in a cost effective way.

Staff were up to date with mandatory training which was tailored to the needs of the patient group using the service. Supervision provided by managers supported qualified nursing staff to revalidate their registration.

We scored the service as 3. The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Kate’s Home Nursing staff generally used equipment which was provided by local NHS community nursing services and was placed in patients’ homes. Managers had recently purchased additional equipment and followed processes to train staff in its use, maintenance and cleaning between patients.

Managers monitored hand hygiene in practice and fed back any concerns to staff.

Staff followed policies and used equipment to protect themselves and patients from infection control risks including when providing care after death.

We scored the service as 3. The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs and preferences. They involved people in planning, including when changes were made.

Staff followed good practice in medicines management. Medicines were prescribed by staff in other services such as GPs and remained the property of the patient. Staff maintained records of medicines administered and remaining stock in line with national guidance. Staff were trained in the administration of medicines including use of syringe pumps used for symptom control. Any discrepancies found were reported as an incident, with learning identified and shared with partner agencies.