Guild Care Domiciliary Care

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 since they reregistered. 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.

Safety was a priority for those working at the service.

The provider ensured lessons were learnt to continually identify and embed safe practice. There was a clear and embedded approach to incident and accident reporting, supported by defined processes for staff. Incidents were tracked to ensure timely responses and shared with the health and safety team, who provided a monthly analysis. There was evidence of learning being applied in practice. For example, following a fall, action was taken to review potential contributing factors such as medication use, demonstrating a proactive approach to risk reduction. Incident records showed debriefs and follow-up support for staff, including in situations involving staff wellbeing.

Health and safety was a standing agenda item at team meetings, and staff were actively encouraged to report incidents, reflecting a culture that recognised the importance of transparency and learning. One relative said, “They always communicate with me to say that something has happened.”

Feedback was positive on the transparency and openness of staff. One relative said, “They are very aware of health and safety.” Another relative said, “A long while ago the night bag was not attached and they came over straight away and were very apologetic, that’s the only time anything went wrong, and they fixed it straight away.”

There were systems in place to facilitate safe pathways and transfers for people.

Assessments of need and risk assessments were completed during the initial assessment of care to ensure safe, effective support. Care plans captured people's health conditions and medical needs. These provided the staff with the guidance they needed to seek additional professional health support and when to make appropriate referrals to partners.

The service worked collaboratively with a range of partners to ensure continuity and safety across people’s care journeys. Care records and communication logs demonstrated coordinated working with health and social care professionals, including Speech and Language Therapy (SALT), occupational therapists and community teams. Timely referrals were made when risks were identified, such as for swallowing difficulties, and care plans were updated accordingly. This ensured that staff had clear and current guidance to follow, which reduced risks and improved outcomes for people.

The service also worked closely with specialist teams, such as the dementia crisis team and palliative care services, to prevent avoidable hospital admissions and ensure people remained safely at home where appropriate. These examples showed a proactive and responsive approach to managing transitions.

People were protected from the risk of abuse.

Systems and processes supported the identification and management of safeguarding concerns. Incident reporting included prompts to consider safeguarding escalation and whether notifications to the CQC were required, ensuring that potential concerns were not overlooked. Records showed that incidents were reviewed with consideration of safeguarding thresholds, indicating that staff and leaders understood the importance of appropriate escalation.

There was a culture that promoted openness and reporting, supported by regular discussion of health and safety at team meetings and induction processes that included responsibilities around incident reporting. Staff had completed safeguarding training and demonstrated a good understanding of the signs of abuse and how to escalate concerns.

Feedback from people and relatives was very positive about the culture of safety. One person said, “Yes, they treat me very well, they are all very careful. I feel safe enough.” One relative said, “They treat her very well indeed. The main thing is the excellent communication skill they have to make her feel safe.”

Staff and management worked within the principles of the Mental Capacity Act 2005 (MCA). People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. People were protected when issues around capacity had been identified. Mental capacity assessments were conducted and recorded to determine whether they had the capacity to make specific decisions about their care.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Positive risk taking was promoted with the people being supported.

Risks to people had been identified and assessed. These risks were individual to people and ensured that care plans had the information staff needed to manage these risks safely. Risk assessments considered a range of risks, including environmental and clinical factors, and provided the basis for staff to deliver safe care. For example, one person lived with health issues related to hand dexterity and sensory impairment. Risk assessments guided staff to ensure tasks that required the person to use their hands were supported, while ensuring that their environment remained free of obstacles.

The provider detected and mitigated potential risks in the care environment. They made sure equipment, and areas where care was delivered, supported the delivery of safe care.

The provider completed environmental risk assessments within people’s homes, which supported the safe delivery of care. These assessments formed part of the overall care planning process and helped ensure that equipment and environments were appropriate for people’s needs. Equipment used to deliver care and treatment was suitable and used properly. One relative told us, “There are two hoists one in the bedroom one in the lounge. Also, a wheelchair. Yes, she feels safe in the hoist, and they know what they are doing.”

Staff had completed relevant training to support them maintain safe working environments, including health and safety, fire safety and food hygiene.

The provider made sure there were enough qualified, skilled, and experienced staff. Staff worked well together to deliver safe care that met people's individual needs. People were supported by consistent staff who had developed positive and trusting relationships with them.

New staff completed a full induction and probationary period. One staff member said, “They supported me with every step throughout the shadowing shifts and all the mandatory training. This has helped me to feel more confident to gain knowledge, skills and understanding of day-to-day requirements in my role.”

Training had been identified and provided to staff according to the needs of the people receiving support. These included safeguarding, Mental Capacity Act (MCA) and medication. When required, more specialist support and training was provided to meet specific needs. Competency checks and observations were completed to ensure that good practice and safe care continued. One person said, “Staff are well trained compared to some carers we have had from other companies.” One staff member said, “The training provided by GC is very good and relevant and it's good to refresh our memories about why policies and procedures have been put in place.”

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Systems and processes were in place to protect people and to prevent and control the risks of infection. The provider took appropriate action to identify and control the spread of infection and shared any concerns promptly with relevant agencies when required.

The provider had a proactive approach to infection prevention and control (IPC). Policies were regularly reviewed, and staff received training, covering key areas such as hand hygiene, use of PPE and outbreak management. Staff competence was monitored through observations and assessments, ensuring that IPC practices were consistently applied in people’s homes. One staff member said, “Infection control is an important part of our work in the community and the hand-washing example, when we use the UV gel to show if our hands are clean is a great piece of training.”

Risk assessments and care plans included information about people’s vulnerabilities and any infections, enabling staff to tailor their approach accordingly. The service worked closely with healthcare professionals to manage infections promptly and safely, including coordinating medication and treatment. Lessons had been learned from previous complaints related to cleaning standards, which led to improved documentation and clearer expectations.

Systems and processes were in place to ensure that people’s medicines were administered safely.

Staff had received training in administration of medicine and competency assessments to ensure safe practices. Detailed medicine care plans and risk assessments were completed to support this. These contained information on medicines management, safe storage and administration. PRN protocols were used into care documentation, providing staff with clear guidance on when and how as-and-when medicines should be administered.

Leaders had good oversight of the medicines they managed. Quality assurance audits and checks helped them to ensure safe practices. Medicines administration records were audited daily, with a more detailed monthly analysis undertaken, which supported oversight and the identification of potential errors.

The registered manager and also received electronic alerts to prompt them to address any issues and maintain consistency with staffs’ administration. There was effective partnership working with specialists, through referrals and reviews to ensure that people received medication that safely supported their mental and physical wellbeing. One person said, “My blister packs come weekly and staff administer and record. No issues.”