Bhandal Homecare

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 service. This key question has been rated 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.

The provider logged accidents and incidents, as well as near misses, and we saw the registered manager reviewed these to identify any themes and trends. Any areas of concern, or good practice, were highlighted and shared with the wider staff team to promote improved ways of working.

Learning was used proactively to drive improvement. Staff reflected on incidents, feedback and good practice, and learning was shared across the team. For example, issues identified through quality monitoring led to targeted support for staff and strengthened practice, helping to maintain safe care.

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.

The provider completed a thorough assessment of people’s needs, preferences and wishes with people prior to care commencing, they also included relatives and external professionals where appropriate to ensure they had a clear understanding of people’s needs.

The registered manager explained the process, including how the person, their family, and other professionals would be involved where appropriate. People and their relatives told us the provider worked with them and respected their preferences and choices. One relative explained that their family member's needs and preferences were discussed in detail during the initial assessment, and the service had consistently respected their request for specific carers. This demonstrated people were actively involved in planning their care and that their wishes were listened to and acted upon.

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. For example, the service acted promptly when concerns were raised about a person's safety. They made a safeguarding referral, provided advice to the family, and worked with other agencies to help ensure the person remained safe, including during planning for their discharge from hospital.

The Mental Capacity Act 2005 is a legal framework which enables people to make their own decisions where possible. If a person lacks capacity to make a specific decision, any decisions made on their behalf must be in their best interests and respect their rights and freedoms. Mental capacity assessments had consistently been completed with people, capacity was fully considered including fluctuating capacity, and the appropriate documentation was in place. This was supported by the provider's policy and procedure.

People and relatives we spoke with felt they and loved ones were supported by a dedicated staff team, including the management team, who worked in a way that always prioritised people’s safety. Relatives expressed consistent feedback that the same staff regularly visited people so there was rapport, trust and understanding. This gave all concerned peace of mind.

Staff were trained and knowledgeable on safeguarding processes including reporting issues to external teams for example, the local authority and CQC.

The combination of these ways of working meant people were consistently supported to remain, and feel, safe.

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 relatives told us they were fully involved in the management of risk and that staff had a good understanding of measures to ensure people’s safety. The registered manager was able to give us clear examples of how people were supported with risk issues without impacting their autonomy. One example demonstrated how staff effectively supported a person's dietary needs following a speech and language therapy (SaLT) referral, implementing recommended guidance to promote safe eating and drinking, while maintaining the person's wellbeing and independence. We saw risks were assessed and mitigation was in place which kept people safe.

This approach meant people were supported to remain safe but still enjoy foods they liked.

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

Before beginning care the provider completed an environmental risk assessment with people at their home, this included consideration of all aspects of any internal and external risks to people and staff, including external lighting, whether there were any trip hazards, appliance safety and fire risks.

Where risks had been identified we saw risk assessments and risk reduction measures were implemented and this was clearly documented in people’s care plans. For example, staff told us how a service user had been supported to access the community safely by adjusting care visits to ensure they weren’t rushing to return home.

This ensured people and the staff supporting them were safe.

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.

Staff were recruited safely using robust recruitment process and completing the relevant checks. They received a full induction, shadowing with experienced staff, comprehensive training which included bespoke training from external professionals engaged by the provider and regular competency assessments.

The registered manager spoke about securing the right people for the staff team and upskilling them to provide the best possible care and raise standards in the sector. “Our plan is to get the right people in and support them as much as we can. Hopefully that helps them stay, but if they move on, they take what they’ve learned here with them and help raise standards somewhere else. For us, it’s never been about hoarding knowledge, it’s about sharing it and helping improve care wherever we can.”

People and relatives supported that staff were skilled and well trained. One person said, “The expertise and quality of the carers and their training illustrates how seriously they regard their role.”

When assessing new people, the registered manager ensured staff had the skills and training needed to meet their individual needs. Where specialist support was required, additional training was arranged, including working with healthcare professionals such as stoma nurses to ensure staff could provide safe and effective care.

Ensuring they recruited the right people and provided staff with a full induction, training and ongoing support and guidance meant people received safe care from competent staff that met their specific needs. Feedback from everyone agreed that the staff were trained and competent in all aspects of care.

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.

The provider ensured staff had access to appropriate training, personal protective equipment (PPE), and clear guidance to promote effective infection prevention and control. Staff followed good hand hygiene practices, used task-specific PPE, and ensured equipment and clinical items were cleaned and stored safely.

People's care plans detailed the support they needed with personal care, clothing and maintaining a clean home environment. As a result, people were protected from the risk of infection, supported to remain healthy and well, and received care in a safe environment that promoted their comfort and wellbeing.

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.

Medicines were managed safely, and people received the support they needed to maintain their health and wellbeing.

Systems for the administration, ordering and oversight of medicines were well managed, including support with emergency treatment prescriptions where required. People and their relatives told us they were confident medicines were managed safely. They told us that staff organised and collected medicines where required. Relatives also told us they were able to use the provider's electronic app to monitor the support being provided, including checking when medicines had been administered. This helped promote transparency, provided reassurance, and enabled relatives to remain involved in overseeing their family member's care.

Staff received training in medicines management, and their competency was regularly assessed through observations, spot checks and ongoing supervision. This helped ensure people received safe and effective support with their medicines and promoted positive outcomes for their health and wellbeing.