Trinity Homecare (Worcester Park)

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 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.

Clear information was included in people’s care records to record and track all incidents and accidents that occurred, so any patterns relating to the individual could be identified. This included tracking falls information. We saw 1 person had experienced a cluster of falls and an increase in headaches. Staff were supporting this person to seek medical attention to further explore the concerns.

Incident analysis was undertaken regularly to look at incidents and accidents that occurred, and to establish if there were any patterns or trends. This information was compared across time periods to look for any changes. Staff were liaising with healthcare professionals to explore strategies to support people and try and reduce falls.

Root cause analysis was undertaken and shared across the provider’s other services on any serious incidents that occurred to support learning. This educated staff to be more proactive in identifying when people’s needs changed, be more vigilant to non-verbal communication and take a role in coordinating care and liaising with healthcare professionals.

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.

Clear systems and processes were in place to support transitions. Staff met with people prior to providing care to gather detailed information about the person, what was important to them and how they wished to be supported. Staff also liaised with other health and social care professionals involved in people’s care to gather information about their health and wellbeing and support continuity of care.

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.

Care workers prioritised people’s safety. They had completed training in safeguarding vulnerable adults and were aware of their responsibilities. A care worker told us, “We have a legal duty for the safety and well-being of the people we support, to recognise, report and record any safeguarding concerns we have.” Another care worker told us they, “take proactive steps to prevent potential risks” and ensure the safety of people they were supporting. Safeguarding adults’ policies and procedures were in place, which clearly identified the reporting procedures to ensure any concerns raised were shared with the local authority. People felt safe receiving care. Comments from people’s relatives included, “[The person] is very safe in their hands,” and “[The person] is safe with the care workers. I have complete trust in the care workers.”

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s safety had been identified and assessed. Clear risk assessments and management plans were available in people’s care records. Care workers told us people’s care records provided them with detailed information about how to support people safely. Risks were regularly reviewed and management plans were adjusted as and when required.

Staff respected people’s choices around risk management. One person had been identified as at risk of falling, and trips hazards had been identified within the home environment. However, the person was emotionally attached to the rugs in their house and wanted these to remain down. Care staff respected this decision and ensured the rugs were always straight and laid flat to reduce the risk of tripping.

Staff worked with people and families to support people’s safety. This included putting plans in place to support people who had dementia who liked to go out in the community on their own. The staff ensured a 1 page proforma was available to describe the person should they not return when expected, and we saw for 1 person they had a Bluetooth device on their keys so their family and staff could easily identify where they were.

Staff were aware that falls were the biggest cause of injury for older people in their homes. With people’s consent, the provider had introduced an application for people receiving live in care. This app was set up on people’s TVs and used AI technology to map people’s body and assess their mobility. It was able to map how they were getting in and out of the chair and offer guidance about how to readjust themselves to ensure they were mobilising safely and maintaining their balance. This was part of the provider’s vision to upskill their staff to be able to provide basic physiotherapy to people in their own homes to support people’s mobility and maintain movement. The provider was also trialling another initiative using technology to support movement and exercise. They were using augmented reality headsets which used simple games that mimicked daily movement used around the home. For example, people may shoot a basketball into a net, but the action was the same as reaching for something from a high shelf. Or stamping on mole hills, which was supporting the person to lift their feet.

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

Staff ensured people lived in a safe and suitable environment. Environmental risk assessments were undertaken and action was taken to address any concerns identified. For example, we saw 1 person was not safe to be left alone with access to their gas cooker, so the care workers, together with the person’s family, had organised for the gas supply to be disconnected in the kitchen to reduce the risk to the person.

Staff ensured people had access to the equipment they required and this equipment was kept in good working order. Staff advocated on people’s behalf to arrange equipment to be installed at people’s home to support their recovery and independence. Staff received bespoke training to ensure they had the knowledge and skills to use equipment safely. A care worker told us, “We get the occupational therapists involved to establish what equipment is required and liaise with them.” People and their relatives felt staff received the training to support people with equipment safely. One relative said, “[The care workers] are well trained and if there is any new equipment then they have training and guidance is in place for everything.”

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

Safe recruitment practices were in place to ensure suitable staff were employed. This included checking people’s identity, their eligibility to work in the UK, criminal records checks, obtaining references from previous employers and undertaking a values and competency-based interview process.

Staff were happy with their rotas and felt these were planned well to ensure they had sufficient time to meet people’s needs and undertake their duties. They told us there was good team working, specifically when attending to double up calls to ensure people were supported safely by the right number of staff.

Staff told us they had good access to training, and this was confirmed by training records. Care workers told us, “I am easily able to access the training portal and choose extra training on top of the mandatory training”, “We receive regular training, and we're welcome to visit the office at any time for a refresher,” and “If we need additional support in areas like hoisting, we are able to arrange individual support from managers.” Competency assessments were undertaken in the classroom and out in the field to assess staff’s understanding and retainment of their training. People and their relatives felt staff were well trained and had the skills and knowledge to undertake their duties and shared their learning with families to support them. Relatives told us, “The care workers are very skilled with dementia and they offer us lots of suggestions and prompts, lots of little things that help us.” Another relative said, “[The care workers] come with basic training and then [a member of the management team] trains them on the job. She is an excellent trainer – very person centred.”

Trinity homecare had created a personal development app which staff could access. They were required to complete annual appraisals and set objectives mapped to the company’s values and which supported staff development. Staff confirmed they were also supported to progress in their careers and obtain additional qualifications. A care worker said, “I have also taken advantage of the opportunity to gain my level 3 NVQ which I’m currently completing.”

Staff received regular supervision and felt well supported by their managers. One care worker said. “Support is always available.”

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.

Staff had received training on infection prevention and control and understood their responsibilities. Staff confirmed they had access to personal protective equipment (PPE) to reduce the risk and spread of infection. People’s care records reiterated the importance of following good infection control procedures and appropriate policies were in place. People and their relatives confirmed that staff adhered to good infection control procedures. A person said, “The care workers wear gloves but more importantly as soon as they come in, they wash their hands. Hand washing is a big part of their routine. They always look very smart and are very clean 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.

Care staff understood their responsibilities to ensure people received safe medicines management support. They ensured people received their medicines as prescribed. This was confirmed by people receiving care. They told us, “The visits are timed around the medication,” and “[My care worker] does all my medication. They sort it out from the packets and give it to me when it’s time.” Staff had received training in safe medicines management and competency assessments had been carried out to ensure staff understood their duties.

People’s care records outlined the level of support people required with their medicines. We saw medicine administration records (MARs) were completed correctly indicating people received their medicines as prescribed. Regular audits were undertaken to ensure safe medicines management was adhered to.