Homecare For You Solihull

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 63 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

The management team had previously recognised that care staff were not consistently documenting or escalating incidents. They provided targeted support and guidance to ensure staff understood the correct processes, which led to a clear improvement in practice. The management were then able to effectively analyse incidents and find ways to improve practice and reduce safety risks such as providing targeted training to staff members. Information was also shared with staff through push notifications sent to their work mobile phone and monthly team meetings.

Staff confirmed they understood the provider’s procedures for reporting concerns and told us they followed them.

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.

Profile sheets were available which contained key information about the person in the case of an emergency admission to hospital. Processes were also in place in case of problems with their digital systems to ensure care could still be continued, for example, the registered manager explained each person had a hard copy of their care plan within their homes that care staff could refer to if needed.

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 felt safe with their care staff and relatives agreed. Comments included, “I feel very safe when the carer is here,” and “Yes she is very safe, and I know she feels safe too.”

Staff understood their responsibility to keep people safe. One staff member told us, “I have completedsafeguardingtraining. If there were bruises on a person, for example, I would complete an incident form and inform the office.” Staff were also aware of the whistleblowing procedure.

Staff were given a safeguarding flow chart they could refer to which detailed the actions they must take if they had any concerns about a person.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Whilst risks associated with people’s care needs were assessed, improvements were needed as some records did not consistently contain sufficient information to ensure people received safe care.These included risks associated with people’s mobility, eating and drinking and the administration of some medicines.

Some risk assessments were generic and not person-centred. For example, some people’s risk assessments for their health conditions were not specific to their individual circumstances and needs. This can lead staff to miss important risks that are unique to each person, meaning important preventative measures may not be put in place such as monitoring for changes in the person’s usual symptoms that may indicate their condition is worsening.

The management team had already recognised this issue and had begun work to improve the quality of risk assessments. This was evidenced in several risk assessments we reviewed, which we found to be comprehensive.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Environmental risk assessments were in place and identified the hazards within people’s homes. However, further improvements were needed to ensure they contained enough detail to ensure staff fully understood the control measures required to keep people safe in their home environment. For example, risk assessments needed more information to guide staff on how risks in the environment could be minimised.

Staff confirmed they had received training and were confident in using equipment safely. They were encouraged to seek further support if needed.

Relatives confirmed staff used safe practices whilst using equipment.

The provider had processes in place for the safe recruitment of staff, but these were not always followed, which posed potential risks of staff not being recruited safely.

On inspection we found references obtained that were not listed on the staff members application form, and references not obtained from previous employers despite prior employment being recorded. Some application forms also contained unexplained breaks in employment. As a result, the provider could not be completely assured that staff are suitable to work in a position of trust. The management had already been strengthening recruitment practices and shared a commitment to addressing any remaining areas for improvement.

However, most people and relatives described the staff as ‘well trained.’ Staff completed a comprehensive training programme, which included a wide range of sessions covering all essential areas of care required for their role. One staff member told us, “They gave me good training. I'm confident.”

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 completed infection prevention and control (IPC) training and demonstrated an understanding of how to reduce the risks of infection. One staff member said, “We always wear the correct PPE. Gloves, aprons, masks and we always wash hands before care and dispose of PPE in outside bins, never in the client's house."

Relatives confirmed they witnessed care staff wash their hands and change their gloves.

Catheter risk assessments contained detailed guidance for staff on how to maintain strict infection control protocols to minimise the risk of infection.

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

Medicine administration record (MAR) charts were mostly able to demonstrate people received their medicines as prescribed. However, information about the administration of medicines, as outlined by NICE guidance, was not always included. The administration records were also not able to demonstrate time specific medicines were being administered appropriately.

People and relatives had no concerns about how their medication was managed. One relative told us, “When they give [person] their meds it is recorded on an app on their phones.”

Further work was needed to ensure risks associated with people’s medicines were managed. For example, medicines that increased the risk of excessive bleeding.

Staff had been trained in the safe handling of medicines and their competency was assessed. Staff spoken to could clearly explain correct processes such as the safe administration of medication.