Holistic Homecare 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 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. All incidents were reviewed by the registered manager, and lessons were learned to mitigate risks to people. For example, where a person had an incident of distress, this was explored to enable staff to reduce this person's anxieties and try different coping methods and de-escalation strategies.

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 had pre-assessments in place, prior to receiving support from the service, which included details of their diagnosis, history and what was important to them. At the time of our assessment the provider was introducing a digitalised system, which meant information could be shared with external professionals easily, where required.

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 understood their responsibilities to keep people safe, and staff told us they felt comfortable to raise concerns with the management team, and action would be taken. A staff member said, “I don’t have any concerns, but if I did I would report them to my manager. The manager is approachable and fair. I would feel comfortable for a family member to receive care from this service because the staff provide safe, respectful, and supportive care.” People and relatives told us they felt safe using the service. A person said, “I like everything about the service. I like the carers, the manager. They do everything for me. I feel safe and comfortable with them.”

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In homecare services, this is done through the court of protection. The service was working within the principles of the MCA, staff were trained in relation to the MCA. People's care records contained details about people's future decisions and wishes.

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 risks were appropriately assessed and mitigated. People had risk assessments and associated care plans in place. This included where people had specialised diets, health concerns, were at risk of falls, mental health concerns and incidents of distress. People had positive behavioural support plans in place, which detailed how people's health conditions presented, how staff recognised and responded to this, and individualised techniques which worked well for each person.

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. Prior to receiving support from staff environmental risk assessments were in place, to ensure this was suitable for people to receive safe care and support. Regular spot checks were undertaken of people's care, which included a safety and security check of people's premises.

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. Care calls were monitored by the management team, to ensure people received staff support on time, and for their allocated time. People and relatives told us staff arrived on time and they had no missed care calls. A relative said, “[Name] has had the carers for a long time. They are experienced.” Staff were recruited safely, and all appropriate pre-employment checks were in place. New staff received an induction, and all staff received regular supervisions. Staff were trained in a wide range of subjects, to enable them to carry out their roles effectively.

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 and relatives told us staff kept their homes clean and tidy and wore personal protective equipment. Staff understood their roles and told us how they protected people from the risk of infection. The management team undertook regular spot checks of staff practice, to ensure they were adhering to the services policies and procedures. A relative told us, “Staff keep it very clean and tidy (my house). They strip the bed. Put the washing in and put it on the right temperature. They keep the bathroom nice and tidy.”

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. Where people received 'as required' medicines, protocols were in place to guide staff about how and when these should be administered. Staff received medicines training and underwent competency assessments prior to administering medicines to people. Regular medicines audits were undertaken, to ensure staff completed records accurately and people were receiving their medicines as prescribed. A person said, “I take a lot of medication. They (staff) give me medicine. They help me to have it on time.”