GoodOaks Homecare - Epsom and Reigate

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 78 (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.

Processes were in place to support people, relatives and staff to raise concerns about safety, so care could be improved. Staff were encouraged and supported to raise concerns about risks to safety, and people told us when they had raised concerns, action was taken immediately.

One member of staff told us, “First thing is focus on the client and ring 999 and then inform the office to let them know the incident has happened. We have incident forms that we need to fill in and what record what actions we have taken.”

Safety incidents were recorded and investigated. The registered manager told us safety incidents were used as an opportunity for learning, and staff confirmed this. They said, “With falls, it’s making sure staff tell us. We make sure that all the other carers know, we check for bruising and then update the care plans. When the care plan is updated, we contact staff to make them aware of the changes.”

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

People spoke positively of the referral process which showed how the collaborative approach between hospital-based staff and the service worked in practice. Comments from relatives included, “(Registered manager) met me at mum’s and we went through everything. The transition from hospital to home was great”, “It (the transition) was all very smooth for him” and “They gathered all the info they needed to know what Dad’s needs were.”

The collaborative approach, supported by effective systems and processes of communication between health and social care partners facilitated the safe transfer of people between services. The registered manager told us, “We always make the transition as smooth as possible.” Hospital staff had access to records via the service’s own electronic capacity tracker which had information on the availability of the care packages at the service. A healthcare professional told us, “They (leaders) demonstrated flexibility and responsiveness that exceeded many other providers, often working constructively with the discharge team to facilitate care packages at short notice where safe to do so. This played a key role in preventing discharge delays and supporting patient flow, which is critical in an acute hospital environment.”

Collaborative working between agencies ensured the appropriate equipment was sent with the person to their home. A schedule of calls was planned, based on the person’s needs as identified within their referral assessment. Assurance was sought that the person could access their home, and arrangements included the involvement of family members if appropriate, to be at the person’s home for their return from hospital if required. The registered manager told us of 1 person, “We started just an hour in the morning for personal care. He was using a frame at the start of the package, then very quickly a Sara Stedy and then full body hoist. Each time we changed things very quickly.” A professional told us, “Where there were any changes, risks, or considerations affecting care provision, these were communicated promptly, allowing appropriate planning and ensuring patient safety was never compromised.”

People were supported in a way which worked best for them. Care plans showed the support a person may need, for example to make a healthcare appointment. One member of staff told us, “When we go to a new client, we get all the information on the care plans to focus on, but we also ask if they want anything else to be done so we can cover every aspect.” The registered manager told us, “We go out and do a consultation. We talk through what they can do, what they can’t do, their likes and dislikes, what do they need. If all goes well, we do an assessment.”

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 and relatives said they felt safe with staff and knew how to escalate concerns about their safety. Comments included, “Mum would say if she felt uncomfortable with any of the staff. It is a real relief for me to have GoodOaks. I feel really comfortable with all the staff” and “If there’s a problem or they think he’s not well they let us know. It gives us peace of mind.”

Staff understood safeguarding adult procedures and what to do if they suspected any type of abuse. One member of staff told us, “I check the care plans and if I see any signs of bruises or notice any changes in behaviour, which can be physical, emotional or financial, this could mean something is going on. I raise my concerns to the management who will support the client.” There was a safeguarding adult’s policy that staff were able to access, and staff had received training in safeguarding people. The registered manager had systems and processes for the management and escalation of safeguarding concerns.

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 and their family members felt fully involved in the assessment of risk. One relative fed back, “The carer has been amazing with my husband and makes life so much easier for us all. He has enabled him to do things we would have stopped him doing but it is done safely.” Another told us, “(Family member’s) mobility isn’t great. He has a walker, but staff seem confident in using it with him.”

People’s care records provided staff with the information they needed to support people safely. The registered manager reviewed people’s care records to ensure information about people’s historical risks and health needs were documented. This would assist staff in identifying emerging risks and symptoms. Staff knew people well and were confident in the management of people’s risks. They had access to an on-call system if support was required out of hours. One member of staff told us, “There is a lot of information (in the care plans) about people risks including falls, you need to be aware of certain things. For example, making sure they are using their walking frame correctly.”

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

Risks to people were assessed and measures to enable people to live safely in their homes were recorded. Risk assessments included the risks associated with people's homes and risks to the person using the service. For example, one person was at risk of falls. Information in the risk assessment required staff to ensure that the floors were clear of obstacles and that they supported the person to mobilise. A plan to manage the risk was in place and was understood by staff. All staff had training in moving and handling. The registered manager told us, “We do the environmental risk assessment, we ask if they are using a frame, do they have rugs, suggest maybe moving it, giving them the choice and explaining the risk. (We make) them aware and we can’t force them but explain we have a duty of care.”

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 sufficient numbers of staff to meet their needs in a relaxed and unhurried manner. Comments from relatives included, “They (staff) turn up on time and always stay the time expected” and “They arrive and stay as long as they should. They’ve never been really late.” People said that if carers were going to be late then they would always get a call which gave them reassurance. The registered manager told us that staffing levels were always met and if a member of staff called in sick or was on leave, they would be able to cover the care for people. One member of staff told us, “There are enough staff, I haven’t had any people complaining about staff being late or not attending the call. We have enough time to spend with people. I get enough time to travel.”

People were supported by staff that had undergone a thorough induction programme which gave them the skills to care for people effectively. Staff told us they were not asked to work alone until they had received all required training, and they felt confident in their role. A member of staff said, “I had 2 days in here (the office) just going through policies and procedures. We had videos and face to face manual handling and some online training. [Registered manager] then came out with me to do 3-4 calls to make sure I was comfortable.” We saw that staff's competencies were assessed regularly and recorded. Spot checks by the registered manager were undertaken on staff at people's homes. This was to ensure that care was being delivered appropriately. Staff also confirmed that they had one-to-one meetings with their managers. Things discussed included any additional training needs and feedback on how staff were performing.

Risks of abuse to people were minimised because the provider made sure all new staff were thoroughly checked to ensure they were suitable to work for the service. These checks included seeking references from previous employers and carrying out checks with the Disclosure and Barring Service (DBS.) The DBS checks people's criminal history and their suitability to work with vulnerable people.

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 family members confirmed staff followed infection control procedures by wearing personal protective equipment (PPE), which included gloves and aprons. A relative told us, “I always see the staff wearing PPE. They are very good at helping her too with putting out the bins and things like that.”

Staff completed training in infection prevention and control, and observations of staff competency included assurance staff adhered to the provider’s infection prevention and control policy. One member of staff told us, “It’s important for us to wear PPE and for the clients as well, to protect them from the risks of infection. To prevent any chance of transmitting diseases.”

The registered manager told us, “All staff have infection control training on e-learning and face to face training reminding them when they need to wear PPE and when to change. We will give them as much they need.”

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.

People were supported with taking their medicine if the assessment had identified this was an area of need. Staff maintained a record of people's medicines which included the amount received and when medicines should be taken. A relative told us, “All has been good with medicines. Dad has trouble with swallowing now, so they now give it on a spoon with some water which is a good idea. They adapted to do this when his swallow started going.”

All staff had received training in the safe management and administration of medicines. One member of staff told us, “We write on the MAR (medicine administration record) that we have seen the person taking the medication.” The registered manager told us, “There is the NICE guidance that we follow, I have NICE alerts come through on my emails. (NICE guidelines are evidence-based, independent recommendations developed by the National Institute for Health and Care Excellence). We do a support visit with new staff members and observe medicine administration and then when we go out and double check that they are ok. We also do medicine audits.”

We saw that medicine administration records were monitored as part of the provider’s quality monitoring process.