Highland Care UK Limited

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.

At our last assessment we rated this key question good. At this assessment the rating has remained 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. Lessons were learnt to continually identify and embed good practice. The provider had systems in place for accidents, incidents and complaints to be recorded. Leaders encouraged staff to raise concerns when things went wrong. People and relatives confirmed they knew how to raise concerns and were confident these would be dealt with appropriately.

A staff member told us, “Every meeting we have, we discuss what went wrong, what went right and what we should do differently to improve.” Managers gave examples of lessons learnt which were shared with staff. For example, they described a person who used to refuse personal care and hit out at staff, so they tried different ways to encourage the person. The nominated individual told us, “We realised once the staff step out of the room and give [person] space, come back again with a different offer, ‘Do you want a drink?’ then they accept personal 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 nominated individual explained they usually received referrals from the local authority by email and once they confirmed they had capacity they would receive the relevant documents including a risk assessment. They told us the care package usually needed to start by the following day so the service worked with the referring authority’s documents until they could carry out their own assessment and risk assessment within 1 or 2 days. The nominated individual gave an example of when the hospital discharged a person to their care to free a bed, but the service sent the person back to hospital because they were not well enough for discharge. This meant the provider took steps to ensure people received safe 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 relatives told us they felt safe with the staff. Staff were knowledgeable about how and when to raise a safeguarding concern should the need arise. A staff member told us, “If I suspected abuse, I would report it immediately to my manager or safeguarding team, following the policy. I would ensure the person is safe and document the facts clearly. Whistleblowing means raising concerns about poor practice without fear of punishment, and I understand how to report concerns externally if needed.”

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 had risk assessments with clear management plans to guide staff in providing care in the safest way. These included mobility and falls, skin integrity, dysphagia, medication and specific health conditions. Staff understood the importance of risk assessments and told us they report any changes to a person’s needs so the care plan and risk assessments can be reviewed and updated. Team meeting records showed risk management was discussed with staff as a learning topic.

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

People had an environmental risk assessment carried out of their home which included who to contact in the event of equipment failure. Staff received training in health and safety so they could ensure people’s homes were safe and report any concerns. The service carried out a fire safety assessment which included the ability of person evacuating, smoke alarms and electrical safety.

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.

People and relatives confirmed the provider had never missed visit but sometimes, staff may arrive late if there was a lot of traffic on the day. They confirmed they were allocated the same staff most of the time so were confident staff understood their needs and preferences. Overall, people and relatives felt staff had the skills needed to provide good care.

The provider followed a safe recruitment process including checking people’s employment history and carrying out criminal record checks. The registered manager told us a group of staff was allocated to each person so that staff absences could be covered by staff who knew the person.

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 and relatives told us staff wore appropriate PPE (Personal Protective Equipment) such as gloves, aprons and shoe covers as needed. Staff received training in infection prevention and control. A staff member told us, “I follow infection control procedures by using gloves, aprons, and masks where required. I wash or sanitise my hands before and after each visit and follow care plans and training guidance to reduce the risk of infection.” The provider had a policy and procedure in place to guide staff in managing the risks of infection. Managers confirmed staff either collected supplies of PPE from the office or field supervisors could take supplies to staff if needed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

People and relatives confirmed staff administered their medicines and they were happy with the support they were given. A staff member told us, “When administering medication, I always follow protocol by checking the name, dosage, time, route and expiry date of all medication.” Records showed medicines were given safely and as prescribed. People had a medicine risk assessment which indicated when they wished to manage their own medicines.

The nominated individual told us, “If a medication is not given in a day, you can actually tell, it’s on [electronic reporting system]. It will flag to say medication has not been given for [person]. So once we pick that up, we are able to contact staff to find out what’s going on.”