Home Instead Senior 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. 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 84 (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.

There were clear systems for reporting incidents, accidents and complaints. Managers reviewed information to identify themes and shared learning with staff. Actions were taken to reduce the risk of re-occurrence and to improve practice. Lessons were always learnt to continually identify and embed good practice.Staff felt confident to raise concerns and understood how learning was used to improve safety and embed good practice. One staff member told us, “When incidents occur, we discuss them. They [leaders] go an extra mile to ensure clients are all safe and their needs are met in the comfort of their homes.” The service used incidents, feedback, and emerging risks to identify learning and drive improvements in care delivery. Learning was embedded within the service and led to strengthened processes, improved staff competence, and safer outcomes for people.

This was evidenced following a medication-related incident involving a couple, where changes in one person’s cognitive ability contributed to confusion regarding the administration of medicines. In response, the service undertook a thorough review involving relevant healthcare professionals and family members. Lessons learned were used to inform wider practice and reduce the risk of similar incidents occurring in the future.

This demonstrated a positive learning culture, where opportunities for improvement were identified, shared, and used to enhance the quality and safety of care provided to people.

Theprovideralways 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 provider demonstrated a proactive approach to supporting people through periods of deterioration and transition. Evidence showed changing needs were identified early, risks were managed effectively and support was coordinated with relevant professionals to promote recovery and independence.For example, following hospital admission and a significant decline in health and independence, a couple received responsive support through a live-in care package and structured reablement programme. This promoted recovery, maximised independence and enabled care to be safely reduced as outcomes improved.

As a result, both individuals remained living safely in their own home, avoided admission to residential care and achieved greater independence. This evidenced effective care planning, continuity of care, risk management and partnership working, resulting in positive outcomes and improved quality of life.

People were protected from abuse and avoidable harm. The provider had safeguarding policies in line with current guidance. Staff received safeguarding training and understood how to recognise and report concerns. They described clear reporting processes and knew how to escalate concerns appropriately. Safeguarding issues were acted on promptly to help keep people safe. Staff spoke positively about feeling able to raise concerns and described a culture where safety was prioritised.

One person told us “Yes, I feel safe, definitely. [staff member] will go and get the district nurse to see me, follow up.They treat me like a friend.”

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. Care plans showed how risks were discussed and agreed with people and, where appropriate, their relatives. This supported people to make informed choices while maintaining their safety and independence. People consistently told us that staff knew them exceptionally well. They were regularly involved in reviews of their care and had confidence in staff’s skills to support them safely.

Staff understood their responsibilities to keep people safe and told us how they involved people in their care. Staff received clear, up to date information about people’s risks and any safeguarding needs. A positive risk-taking approach was adopted at the service, which supported people in the development of skills and independence. People were supported by staff to consider any potential risks and how these could be mitigated. For example, a person was at risk of falls, a manager came out to do a risk assessment and provide further support and guidance to the person to minimise the risk of falls. The person told us “I am a bit at risk from falls. One of the managers came out to check my walking and told me not to get up the way I was doing, she guided me and got the health professional to come out to give me some aids to support me.”

People were supported to regain independence through reablement, this demonstrated how the service managed risks to have a positive impact on people’s lives, such as promoting a person’s independence following a period of increased frailty. Through a reablement-focused approach, people regained confidence and skills in daily living activities, enabling a reduction in support and helping them remain safely in their own home. For people using this service, this resulted in increased independence, improved wellbeing, and reduced reliance on care services.

The provider assessed and managed environmental risks to support people’s safety. Environmental risks and fire risk assessments were considered as part of care planning.They included vital information such as where to shut off gas, electric or water in the event of an emergency. Systems were in place to identify hazards and reduce risks within people’s homes. Staff monitored environmental risks and reported any concerns. People were supported to keep their environment safe.

The provider had safe recruitment processes and completed required pre‑employment checks. Staff did not work alone until they were assessed as competent. Staffing levels were planned to meet people’s needs and visits were scheduled appropriately. Staff received supervision and support, which helped ensure care was delivered safely and consistently.

The provider used an electronic scheduling system to plan and monitor care visits. This enabled real time oversight of when staff arrived and left people’s homes and supported effective rota management. Regular and familiar staff attended calls wherever possible and mapping tools were utilised to ensure realistic travel times, helping ensure calls were not rushed and care was delivered safely.

Staff completed a comprehensive induction, which included knowledge checks, direct observations and competency assessments. This helped ensure they were prepared for their roles and understood the provider’s expectations around safe practice.One staff member told us,“The induction was good it was thorough and I feel I have the right skills to be able to do my job.”

Training was delivered face to face and online, covering key areas relevant to people’s needs. Staff told us this approach supported their learning and helped them feel confident in applying the skills they had developed. Competency assessments were refreshed when needed to ensure staff continued to work safely. Staff were recruited to work with individual people. Staff files contained all the necessary evidence including full employment histories including DBS check (Disclosure and Barring Service).Leaders had identified that staff supervisions had been inconsistent and had put actions in place to address this, including regular spot checks and an open‑door policy to ensure staff felt supported.

The provider had systems to manage infection risks. Staff received training in infection prevention and control and followed guidance when delivering care. Regular audits were completed to monitor practice and identify any shortfalls. Actions were taken where needed to reduce the risk of infection and protect people and staff. Infection control checks supported safe care environments and helped ensure staff followed safe working practices.

Infection prevention and control practices were proactive and focused on achieving positive outcomes for people. Safeguarding records showed the service identified and responded promptly to environmental and infection control risks. For example, following concerns about poor hygiene and a flea infestation, the service took immediate action by arranging pest control treatment, increasing monitoring, and ensuring appropriate cleaning measures were implemented. This reduced risks to the person and staff and helped prevent further deterioration in the person's living environment. People told us that staff were respectful of their homes and surroundings and consistently supported them to maintain clean and hygienic environments. One person told us, “They wear aprons and gloves. A year ago, I got new carpets. The carers wore shoe covers. They help me to maintain good personal hygiene.”

The provider had arrangements in place to support safe medicines management. Staff received training and competency checks before supporting people with medicines. Records were maintained and audits were completed to monitor practice. Medicines incidents were reviewed and learning was shared to help improve safety and reduce future risks.

The service participated in the Technology for Better Care Project, working in partnership with NHS Bristol, North Somerset and South Gloucestershire ICB, technology providers, and community services. Through this initiative, people who required support with managing their medicines were provided with technology to promote safe and independent medication administration. This reduced the risk of errors, improved outcomes and helped prevent avoidable deterioration This demonstrated the service's commitment to innovation, partnership working, medicines optimisation and promoting people's independence through preventative approaches to care.

There were effective systems to ensure that any changes to people’s prescribed medicines were communicated, documented, and implemented without delay. Staff worked closely with healthcare professionals to maintain safe and accurate medicines support. The provider used nationally recognised resources to benchmark policies and practice against sector guidance. The leadership team reviewed all policies annually as standard, and more frequently if incidents or updated regulatory information required earlier review.

People were supported and encouraged to manage some or all aspects of their medicines where they had chosen to do, which included the ordering of prescriptions and taking their medicines independently.