Alina Homecare - Dorchester

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 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 had established a process of learning from events that had either put people and staff at risk of harm or had caused them harm. Openness and transparency about safety was actively encouraged and embedded in the service. Safety concerns were shared amongst the wider staffing group within the organisation to ensure all staff were aware.

Staff understood their responsibility to raise concerns and report incidents and near misses; they were fully supported when they did so. Incident and accident records were completed, reviewed and scrutinised by the management team. When identified, lessons were learned, discussed and communicated to staff at monthly staff meetings, regular supervisions and visits. The registered manager was proactive in sharing lessons learnt and good practice to staff to prevent re-occurrence, promote safety and to further enhance the quality of care provided.

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 service worked with people and those close to them to establish their plan of care and comprehensive individual transition plans, prior to the person moving between services. This helped eliminate any risks of harm and ensured the person received continuity of care. Pre-assessment paperwork was always completed involving people, relatives and partners prior to services commencing and these assessments were shared with staff.

People were supported by staff to attend healthcare appointments and when they needed hospitalisation. We received positive feedback from people and their relatives about maintaining continuity of care and their involvement in creating and reviewing people’s care records. One relative told us, “Staff have called an ambulance twice, and stayed with my [loved one] while the paramedics were there. When my [loved one] had a bad fall, staff member accompanied [them] to the hospital, and stayed for hours by [their] side, offering reassurance. They also take [them] to the dentist and a doctor.”

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 their relatives confirmed they felt the service provided by Alina Homecare - Dorchester was safe. One relative told us, “The staff understand the importance of protecting a person living with dementia.”

The provider had established effective safeguarding systems, policies and procedures and managed safeguarding concerns promptly using local safeguarding procedures whenever necessary. There was a consistent approach to safeguarding and matters were always dealt with in an open, transparent and objective way. Where required, investigations were thorough. As appropriate, people and those important to them were involved in this process and informed about what action would be taken to keep people safe.

All staff had participated in safeguarding training and demonstrated a comprehensive awareness and understanding of their roles and responsibilities. Staff knew how to recognise the signs and symptoms of abuse and who they would report concerns to both internally and externally. They told us they felt confident management would listen and act if they raised concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. People had the necessary assessments in place to ensure their rights had been fully respected. The provider followed principles and requirements of the Mental Capacity Act (MCA) where people were deprived of their liberty under the Deprivation of Liberty (DoL) in the community setting through an order by the Court of Protection. Deprivation of liberty occurs when an individual is not free to leave a community setting due to restrictions placed on them, for their safety and well-being. There was a clear understanding of DoLS, they were used appropriately and only when it was in the best interest of the person.

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 to people’s health, safety and welfare were identified. For example, risks associated with people’s mobility, skin integrity and malnutrition. These risks were assessed before people started to use the service and amended as needed. Risk assessments were created and maintained within the provider’s electronic recording system and updated regularly or when things changed. Relevant health and safety concerns were included in people’s care plans.

Staff told us they were given enough information about people’s risks and how to keep people safe when providing their care. For example, how to support people to reduce the risks they face when outside of their homes or continue hobbies with appropriate risk management measures in place.

People and their relatives felt involved in managing risks, and risk assessments were person-centred, proportionate and reviewed regularly. People and relatives, including legal representatives, confirmed they were, when appropriate, involved in creating and reviewing people’s care plans. One person told us, “I have regular care plan reviews with [manager’s name]. They are extremely helpful and always answer any questions I may have.”

The provider detected and controlled potential risks in the care environment.

The service provided support in people’s own homes, they were not responsible for the upkeep of these premises. However, risk assessments were in place to ensure the environments in people’s homes were safe to protect people and staff from harm. For example, there were effective arrangements in place to manage risks associated with fire or slips, trips and falls. When people used equipment, there was a system in place to make sure that this was serviced, checked and safe for use.

The service made sure staff could always contact them in an emergency. Staff told us, “We have an alert button on our [electronic recording system] which allows us to raise concerns with our office and an option to alert family if needed.”

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.

We received overwhelmingly positive feedback about staff. People and their relatives expressed that they were happy with staff supporting them. One person told us, “It’s been a relief to have them. They have all been very pleasant. When I got home from hospital once they arranged for a carer to be there to turn my lights on for me which was good.”

Staff had the right mix of skills to make sure that practice was safe, and they were able to respond to unforeseen events. Staff told us they felt supported and received appropriate training and supervisions to enable them to fulfil their roles. People and staff told us the provider ensured staff’s skills and experience were carefully matched to the needs and preferences of people they supported. People were supported by a regular staff team, and care was delivered through agreed routines which meant people experienced continuity of care. One person told us, “I have a great relationship with all the staff. My main carer knows exactly what I like and how I like it which I find extremely helpful. [They] never forget.”

Appropriate recruitment checks were carried out as standard practice. Recruitment processes were robust, and staff were recruited safely. The manager told us they had no vacancies and staff retention was very good, so they had not needed to use agency staff to cover absences.

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 were protected as much as possible from the risk of infection because their home environment and equipment were kept clean and hygienic. They were supported to maintain their own personal hygiene in line with their needs and preferences. Staff were provided with and used personal protective equipment (PPE) such as disposable gloves and aprons, which met recommended national guidance and were appropriate for the care they were delivering and the level of infection risk. One person told us, “Staff always put their PPE on and dispose of it. They absolutely do follow infection prevention.”

There were clear roles, responsibilities and procedures around infection prevention and control that met current and relevant national guidance. Staff received appropriate training on infection prevention and control (IPC) and understood their role and responsibilities for maintaining high standards of cleanliness and hygiene in the premises and their own personal hygiene, including hand hygiene.

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.

The service used an electronic medication administration record system (eMAR), which was linked to the tasks staff were required to complete during each visit. If a person refused their medication, the system was updated and the office was automatically notified. PRN protocols were in place to guide staff on how and when to administer medicines prescribed to be given when required.

Staff were regularly observed and had their competency and knowledge assessed when administering medicines, including how to dispose of medicines safely. Staff confirmed they had training, and competency checks to make sure they gave medicines safely. Staff told us they felt supported regarding medicines management. Comments included, “I received adequate training in medicines administration and recently had my refresher training which I found very useful as things can change. If I am ever unsure, my manager is always at hand to help guide me with advice and support.”