Home Instead North Norfolk

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 outstanding.

This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 88 (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 exceptionally open, positive, and supportive culture the provider had nurtured meant staff had no fear in reporting safety concerns no matter how small or apparently insignificant. We saw that the provider had a proactive and person-centred approach to the safety of people and shared concerns with other professionals as required to ensure a holistic approach that helped keep people safe. For example, for one person living with dementia who had placed themselves at risk, the provider worked collaboratively with other professionals, the staff that knew the person well and their family to find solutions that meant they could remain safely living in their own home, meeting their wishes and those of their family. We saw the provider strongly advocated on the person’s behalf and that of their family. This demonstrated the provider’s robust commitment to learning from safety incidents and overcoming barriers to meet people’s wishes and preferences.

Feedback from the people who used the service and their relatives’ confirmed staff were adept at supporting people to keep safe including adapting to people’s changing needs. One person who used the service said, “All the staff are very caring and careful but one in particular regularly goes above and beyond what you would reasonably expect. They make me feel very safe.” One relative told us, “[Staff member] is very attuned to my [family member’s] needs and what they may be able to manage as it varies from day to day.”

Staff told us, and records confirmed, the provider had an excellent learning culture in place. Staff told us they were encouraged to report safety incidents, no matter how small, and that there was a ‘no blame’ culture in place. They told us they received support following safety incidents including welfare checks and reflective practice as required to learn from the incident and help prevent reoccurrence. This highly supportive and positive safety culture ensured staff felt comfortable in raising concerns and, through discussions, consistently demonstrated a positive attitude to safety and learning from incidents. One staff member explained how a safety incident had been managed and used to make improvements; they said, “I learnt from it and understood the reasoning behind it when it was explained to me. It’s never done with a negative slant, always done supportively.”

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.

To mitigate the risk of care packages failing, the provider had a robust procedure in place when people first approached the service for support. This ensured people received consistent and person-centred care from a small group of staff who had been carefully matched to them whilst considering their values, expectations, personalities, and interests. This approach also helped people to establish trusting and meaningful relationships with staff.

Consultation meetings took place in people’s own homes to establish their needs, values, outcomes, and expectations of the service, and, in some cases as appropriate, with family members and people important to them. This enabled the service to appropriately match staff with people considering important aspects, all with the aim of meeting people’s outcomes and expectations. Staff told us great care was taken in doing this. One staff member said, “I feel the people who use the service are exceptionally well cared for. Home Instead North Norfolk ensure they match their staff to people with similar interest and values. With excellent training provided all staff know how to care well and provide exceptional care using their knowledge.”

People, and staff, told us care never commenced without introductory visits so people could get to know one another and ensure they were comfortable with the staff member they had been matched with. Once care commenced, the provider ensured regular reviews took place so any amendments could be made. This included completing a 24-hour courtesy call after the first visit to see if the person who used the service was happy with the care and support delivered. A person who used the service said, “New staff always come with experienced ones to be introduced and learn what I need.”

We also saw examples of where the service had worked collaboratively with other partners to ensure safe continuity of care for the people they supported. This included, for one person, working with an occupational therapist to support a person with moving and handling requirements.

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.

The provider had systems in place to help protect people from abuse and improper treatment. This included a policy, staff training, and monitoring systems. Staff were able to demonstrate they had knowledge in safeguarding including in relation to types of abuse, potential symptoms and how to report concerns both inside, and outside, Home Instead North Norfolk. From the records we viewed, we saw that staff had appropriately recognised and reported potential harm, abuse and/or improper treatment and that appropriate and prompt actions had been taken by the service including referrals to the local authority safeguarding team as required.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive, and enabled people to do the things that mattered to them.

The provider had cultivated a positive risk-taking culture within the service that meant risk was not seen as a barrier. We saw that they worked collaboratively with people and other partners to overcome any safety issues, meaning people’s independence was maintained and their wishes met. Risks had been identified, assessed, thoroughly recorded, mitigated, and regularly reviewed to help keep people safe.

The people who used the service, and their relatives, told us they felt the service provided safe care as staff had exceptional skills to meet people’s needs. They told us trusting relationships were built as they saw the same dedicated group of staff who instilled in them confidence and assurance. One relative said, “The staff have the skills to manage risks and take the necessary appropriate action.” A person who used the service told us about receiving care. They said, “There are no issues, I am always safe.”

We saw examples where the provider had worked closely, and over time, with other partners to overcome safety situations to support people’s independence and wishes. For one person, who required moving and handling equipment to mobilise and who very clearly stated they wished to remain as independent as possible for as long as possible, we saw the staff had worked with a health professional to ensure all avenues had been explored to meet this person’s wish. We saw techniques were tried and adapted to suit the person’s needs and preferences until solutions were found that enabled them to remain independent but safe and supported their autonomy. The health professional told us, “Home Instead North Norfolk enable risk rather than avoiding it.” They told us the person felt completely assured by the approach and the professional expressed how refreshing it was to come across a service that works in such a way.

Staff had undertaken training to promote people’s safety including in relation to moving and handling and basic life support. We saw that the provider had employed a freelance consultant to train staff in supporting people to take positive risk and that training was specifically designed with individuals who used the service in mind, ensuring training was bespoke. One staff member said of the training they received, “Importantly it has provided me with an understanding of what our clients are living with, enabling me to provide person-centred and high-quality care, something Home Instead North Norfolk prides itself on.” Additionally, staff had their competency to perform safe care assessed on a regular basis to ensure people remained safe.

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

The provider risk assessed people’s homes to promote their safety and that of staff. This included in relation to potential hazards such as uneven floors and the use of stairs as well as identifying utility shut off points in the event of an emergency. Consideration was given to fire management and the use of equipment to help prevent this such as smoke detectors. Additional risk factors such as pets and people smoking were also assessed to help mitigate risk and keep people safe.

The provider 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. The provider had invested heavily in robust staff recruitment, training, induction, support, and development which had contributed to people receiving exemplary care. Staff told us, and records confirmed, the provider undertook robust and extensive recruitment checks to ensure potential staff had the skills, attributes and values that aligned with those of the provider. Staff then received a thorough induction which not only prepared them for their role, but to provide person-centred care to those they would be supporting; staff told us this. One staff member said, “I think the training provided is very good. Alongside eLearning (the delivery of training through digital technologies) and in person training we are also provided with extra training tailored specifically to the service user.” This staff member also told us they were encouraged to complete additional qualifications; they told us, “It gave me a better understanding of dementia and more insight to understand and better support a service user.” The people who received the service, and their relatives, without fail, agreed staff had all the skills, knowledge and experience needed to provide them with a safe, individualised, caring, and dedicated service that exceeded their expectations. One relative said, “Staff are very professional, reliable and deliver what they say they’ll do.”

The provider understood that investing in their staff contributed to an outstanding service that consistently delivered high-quality care that positively impacted on the people it supported. For example, not only had the provider ensured care professionals had received ongoing bespoke training and support, but they had also invested in themselves as leaders by employing freelance consultants to guide them and their business. All partners spoke highly of the provider and the service it delivered however one said, “There is a strong emphasis on doing the right thing for individuals even where this may not always align with the commercial interests of the business. The leadership team demonstrate a clear awareness of the responsibility that comes with providing care and focus on acting in the best interests of those people they support.”

Staff received ongoing and continual support in many forms including formal support visits, competency assessments, supervisions, and appraisals. They told us the processes in place were supportive, collaborative, and helped them develop in their role to be the best they could. However, it was the informal support that staff told us they valued the most and made them feel cared for. We were given examples of how the management team made regular welfare checks when staff were experiencing challenging times, both professionally and personally. One staff member told us, “I feel very supported in my role. I can talk to anyone in the office and they help and advise me. I never feel alone or not listened to. I am always shown respect and kindness. Nothing is ever too much trouble, and they go above and beyond for their staff.”

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.

The provider had systems in place to assess and manage infection prevention and control including a policy, staff training, use of personal protective equipment, and risk assessing people’s needs around infections. The people who used the service, and their relatives, told us staff were respectful of their homes and supported them to keep them clean. One relative told us how the service had supported their family member with domestic tasks and keeping their home hygienic. They said, “The house is absolutely spotless now, which makes a huge change.” A staff member described how they identified a hygienic issue in a person’s home and how this was actioned by all staff going forward. The staff member said, “It was added as a task on the app (electronic care planning system application) for all staff to check. This is very important. It’s not about being better than anyone else, we make a good team and work to our strengths. We serve the person, what they need, we give. You can’t go the extra mile if other staff don’t and they do.”

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. Staff had been trained in medicines management and administration and the provider had systems in place to monitor medicines to ensure people received them as prescribed and in a safe manner. The records we viewed confirmed this. We saw that staff had information to support them in administering medicines and that their competency to do so was regularly assessed. The provider sought advice regarding medicines from appropriate health professionals as required and supported people to seek medicines reviews if any of their needs changed. People were also supported to take their medicines independently, but safely, if this was their wish. The artificial intelligence (a branch of computer science that develops systems capable of performing tasks requiring human-like intelligence) systems the provider had in place to monitor medicines management and administration also meant medicines were audited multiple times a day. This helped to not only prevent medicines mismanagement but identify any shortfalls promptly so they could be quickly rectified helping to protect people from the risk of harm.