Saint Andrews Limited Also known as Home Instead Oxford

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 72 (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.

Incidents, accidents and safeguarding concerns were reported, reviewed and used to promote safer care. Records showed incidents were managed appropriately. Staff told us they knew how to report concerns and were knowledgeable about the process for reporting incidents and accidents. Incidents were often discussed with the team of staff who supported the person who was involved in the incident. One staff member told us, “[care manager] does quarterly care professional [staff] meetings, when there is an incident that has happened, we talk through the incident, what has been done, what could have been done differently.”

Accidents and incidents were analysed, and lessons learnt were shared with the team. For example, lessons learnt had been identified when a person developed sepsis, the provider created a sepsis information sheet and shared this with all staff.

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.

Office staff carried out comprehensive assessments of people's care and treatment needs before they commenced receiving support from the service. This helped ensure the provider was able to meet people's needs safely and effectively and enabled appropriate planning for a smooth and well-managed transition into the service.

People were introduced to the team of staff who would be supporting them before care commenced. This meant people had the opportunity to meet staff, become familiar with those providing their care and begin building positive relationships from the outset. This approach helped reduce anxiety, promoted continuity of care and supported people to feel comfortable and confident with the support they received.

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 were protected from the risk of abuse and avoidable harm. All staff received regular safeguarding training. Staff had a clear understanding of their responsibility to report any safeguarding concerns. One staff member told us, “I would phone [safeguarding lead] and tell [them] the details of the concerns, I would then send an email. I would call the office if [safeguarding lead] wasn’t available”. Another told us, “I would report any form of abuse, whether it be physical, emotional or neglect. I would go to my manager, if there were any safeguarding concerns within the [person’s] home I would also report such as a trip hazard.”

People told us they felt safe when receiving care and support. One person told us, “I am very happy with the carers who arrive on time and always stay. In fact, they are excellent in every way. I feel safe in their care.”

The provider had an appointed safeguarding lead, who was responsible for taking the lead on all safeguarding concerns. Staff told us they received safeguarding training. One staff member told us, “I have received safeguarding training when I first began and then safeguarding updates over the year. I have learnt a lot from the training that I have received, including the importance of information storage, how to safeguard people when inside and out of their home. I think the safeguarding training I received was all relevant and important to my role.”

The provider had reported safeguarding concerns to the relevant local authority and had notified the Care Quality Commission (CQC) by submitting the required statutory notification.

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.

Risks were identified through personalised risk assessments and regular reviews. People with specific health risks were supported effectively to reduce the likelihood of avoidable harm. For example, a person with epilepsy had a risk assessment in place, providing staff with guidance on how to support the person if they had a seizure. However, further work was required to strengthen risk assessments to ensure they provided staff with detailed guidance on how to carry out tasks such as transfers which required the use of moving and handling equipment.

The provider supported people to take positive risks safely. The care manager told us risk assessments should not be used as a restriction but as empowerment. This meant people were supported to continue to do things that were important to them.

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

Environmental risk assessments were in place to ensure potential hazards were managed safely. This included areas such as clutter, floor conditions, pathways, handrails, lighting and fire safety, to ensure people were supported in a safe environment. Guidance was available to staff on where shut off valves for water, gas and electricity were located within people’s homes in case of emergency.

The provider had identified the need for strengthening their process for monitoring equipment servicing, an action plan had been completed, and the provider was working on strengthening this process. This demonstrated a proactive approach to maintaining safety and preventing avoidable risks.

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.

Prior to people’s care starting, staff assessed the needs of people and worked to match them to a team of staff to meet their needs. Where necessary, specialist training was provided before staff started supporting people This meant people were supported by staff who had exceptional levels of skill and knowledge to provide safe and highly effective care.

The provider had invested in workforce development through the introduction of its own Care Skills Academy, designed to enhance the quality of training and support staff to develop the knowledge and skills required for their roles. The provider had also established a simulated practice area within the office environment, enabling staff to develop and practice care skills in a safe and supportive setting before undertaking shadow shifts. This demonstrated a proactive approach to staff development and helped promote confidence and competence among new and existing staff.

Staff were required to complete a full induction programme, mandatory training and competency assessments before lone working, to ensure they had the knowledge, skills and competence to carry out their duties safely and effectively. As part of the induction process, new staff shadowed experienced staff members to support them in developing the confidence and practical experience required for their role. To further strengthen this process, the provider had developed its own shadowing prompt guide, which provided staff with a clear framework for learning and observation. This helped ensure shadowing was completed consistently and effectively, enabling new staff to gain a better understanding of people's needs, care delivery expectations and best practice before working more independently. New staff had regular professional development meetings with senior leaders to monitor their progress and address any additional learning requirements.

People and their relatives consistently told us they felt staff were well trained. Comments included, “All the carers are well trained and good at their jobs,” and “Everyone is well trained and experienced.”

Recruitment checks were carried out to ensure staff were safe to work with people. Pre-employment checks included a job application form, an interview, enhanced Disclosure and Barring Service (DBS) check and references. DBS checksprovide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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 received health and safety training, which included infection prevention and control and food safety. This helped ensure staff understood how to work safely and reduce the risk of infection.

The provider had an infection control policy in place to ensure infection prevention and control were managed safely. The provider monitored staff practice through regular spot checks, which included observing hand‑washing techniques and the correct use of personal protective equipment (PPE). These checks provided assurance staff followed safe working practices during care delivery.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

People's care plans did not always contain sufficient information to support staff with the safe administration of "as required" (PRN) medicines. Protocols were not consistently in place to provide staff with clear guidance on when these medicines should be administered. For example, 1 person had prescribed medicine to support the management of their epilepsy; however, there was no documented guidance to direct staff on the circumstances in which this medicine should be given. This increased the risk of inconsistent practice and did not support the safe management of medicines. Following feedback, the provider advised they would review and update PRN protocols to ensure staff had clear guidance on the administration of these medicines.

One person was supported to manage their medicines by a relative. However, staff occasionally administered medicines when the relative was unavailable. There was not a robust system in place to clearly identify when responsibility for administering medicines transferred from the relative to staff. This increased the risk of medicines being mismanaged and did not provide assurance the arrangements for the person's medicines were consistently safe and effective.

Staff had received training in the safe management of medicines, and their competency to administer medicines had been assessed. Staff had also received additional specialist training where required for the administration of specific medicines, helping to ensure they had the knowledge and skills to support people safely.