Baxters 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 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 reported safety events. Management listened to concerns about safety and investigated incidents. Staff told us they were properly debriefed after incidents occurred, and learning was communicated effectively.

People and staff told us they would raise safety concerns with the management team if they were worried about anything. A person told us, “Nothing has ever gone wrong.”

Professionals gave us clear examples where the service worked well with them to highlight safety events and took appropriate action. For example, staff staying with a person in hospital to provide specific care that could not be given to them by healthcare professionals at the time.

A professional told us, “The provider demonstrates strong systems for communication of safety events. Any incidents, concerns, or changes in condition are communicated promptly and in a timely manner via email or telephone. The service is responsive when issues arise and works collaboratively with professionals to investigate and implement appropriate actions.”

This meant people were protected from the risk of repeated safety events.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

The service ensured people had hospital passports, which had clear, concise information regarding people’s health needs and the complex care they required, meaning the person would be safe when moving between services. The registered manager told us staff always accompanied people to hospital to ensure safe transitions between services.

The service worked exceptionally well with health professionals to ensure consistent, joined up care. The service strongly advocated on people’s behalf for video reviews or in-person reviews at their home, to minimise potential risks posed by accessing a communal healthcare environment. This meant people were continuously able to access and move between services in a safe way that minimised disruption to their lives. The service was exceptionally proactive in seeking advice, using clinical knowledge and skills to ensure people were safe and received effective care. A person’s relative told us, “Before I have even thought of it, it is done.”

Professionals told us, “Baxters Homecare demonstrates very good communication and accurate reporting, ensuring that relevant information is consistently shared with professionals, patients, and families… From my observations, the service maintains good 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.

People and their relatives told us they felt safe. We were told, “I am 101% confident that [person] is safe, looked after, [their] needs are met, [their] voice is heard and their dignity is preserved.”

The provider had an up-to-date policy staff could access at any time. Staff received safeguarding training, were confident in raising concerns, and demonstrated a good knowledge of signs of abuse.

The provider raised safeguarding referrals when required and engaged with local authority teams to ensure they had been resolved. The registered manager told us, “We encourage an open culture and ensure staff feel confident to approach us, it is not about things going wrong.”

A professional shared an example of where the service had raised a safeguarding referral for a person and worked alongside health teams to ensure the person was protected from harm.

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. The provider supported people to manage risks by completing thorough risk assessments in partnership with them, their families, and relevant healthcare professionals. The registered manager described situations where individuals were helped to eat safely while still making their own choices about food and arranging for a GP to visit when needed. Staff also enabled a person to continue their preferred nightly routine, such as having their choice of drink before bed alongside their prescribed medication, in a safe and monitored way.

This meant that people were involved in managing risks to themselves.

The provider was aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider collaborated with equipment providers to identify, anticipate and address risks within the design of a person’s home, to support staff to deliver safe care. They worked closely with people and their relatives to ensure potential hazards were recognised early and managed thoroughly.

Staff completed detailed assessments of each person’s home environment and supported individuals to reduce risks such as maintaining clear pathways to promote safe transfers, and mobility.

The provider also collaborated with the fire service to ensure people were able to evacuate safely with extra support tailored to their needs, demonstrating a strong commitment to people’s safety beyond routine care.

Where people required specialist equipment, the provider worked in partnership with families and external suppliers to ensure individuals had the right equipment for safe transfers and daily living, and these were suitable for use within the home. Records evidenced staff checked personal equipment before every use, ensuring it was in good working order, and escalated to managers effectively when something was wrong. For example, staff had escalated a broken item of assistive equipment, which leaders promptly referred to the correct service for exchange.

Risk assessments were also in place for the provider’s main office, ensuring a safe and well‑managed environment for staff to attend team meetings, training and supervision. These measures were effective as they reflected the provider’s wider culture of continued safety in the community.

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

Staff recruitment was managed appropriately, with evidence of interviews and enhanced disclosure and barring checks. People chose a stable, consistent team of staff to provide care to them. People and their relatives named staff members evidencing they were always visited by their preferred carers. The registered manager told us the provider does not use agency staff as a rule, and would rather cover any shortfalls in staffing themselves, to ensure people received high quality, consistent and safe care.

Staff received regular supervision from both the registered manager and an external nursing consultant, to ensure full oversight of staff knowledge, skills and aspirational goals. Staff received regular appraisals.

Staff were given bespoke, face to face training to ensure they could cater for people’s needs, including bowel care, moving and handling, dementia, dysphagia, and diabetes within the provider’s other service. Once staff had demonstrated the skills needed for their role, they began supporting people in the community. This included spending time shadowing visits in people’s homes, allowing them to get to know each person’s routines and preferences. Staff only started working independently when they were confident and assessed as competent to provide safe, person‑centred care and support. The leadership team carried out regular spot checks to ensure safety standards and quality of care was met.

Records evidenced staff worked well together and handed over important information relating to people’s care, ensuring continuity of care. This meant people experienced safe care from staff they knew well.

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, their relatives, and staff told us staff wore appropriate Personal Protective Equipment (PPE) when carrying out care tasks. All staff had completed up-to-date training in infection prevention and control.

This meant people were protected from the risk of becoming unwell.

The registered manager told us staff were issued with a clean uniform in a different colour each day. This system enabled the provider to be fully assured staff consistently wore clean, hygienic clothing, reflecting their commitment to maintaining high standards of infection prevention and control.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

People were always supported to take medicines only when they needed them. The provider worked closely with healthcare professionals to review one person’s medicines and safely discontinued a medicine that was no longer required, so the person could be supported through dietary changes. This prevented the need for invasive procedures and significantly improved the person’s quality of life.

People had thorough medicine care plans in place. These assessed any risks associated with people’s medicines, the administration of their medicines and detailed the support people needed.

Staff recorded medicine stocks at every administration, and provided pictorial evidence on people’s care records, allowing leaders to identify any errors in real-time. We reviewed an example where a medicines error had been identified through the provider’s daily medicines audit. The registered manager told us they were able to call the staff member whilst on their shift to discuss what had happened and discuss lessons learned, and continued to monitor staff practices. This meant the increased risk of harm to the person was prevented and provided clarity for staff to administer medicines safely and effectively.

Staff used Medicine Administration Records (MARs) to record when medicines had been given, as well as consistent recording in daily notes. Leaders encouraged staff to report any errors as soon as they were made, with a focus on learning rather than blame. Records evidenced the service sought prompt advice and communicated learning across the staff team in the event of a medicine error.

People were supported to obtain rescue medication, which could be safely administered by staff to prevent hospital admissions. Staff consistently worked with families and medical professionals to administer this at the right time.

Staff had thorough, step by step administration guidance available to support people with taking their medicines. Staff received face to face medicines administration training assessed by external providers, as well as internal training assessed by “train the trainers.” Staff received annual competency checks. This meant people consistently received safe support with their medicines by trained and competent staff