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 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 listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Processes were in place to monitor incidents, accidents, and complaints effectively. The registered manager demonstrated how lessons were learned and shared with staff. Staff reported feeling confident to raise concerns and trusted the registered manager would take appropriate action when needed. One member of staff told us “I’m very comfortable raising concerns never had a problem with this” and another staff member told us “you never have to feel on edge or worry about asking them anything or raising anything. They are very proactive.”

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.

Care plans were person-centred, and we saw evidence they were regularly reviewed and whom was involved in those reviews. Staff used an electronic call monitoring system to log in and out of their visits which also flagged delays or missed visits to the management team. We saw evidence that alerts on the system were audited daily. Visit notes and medication was also audited every 2 weeks and the electronic medication forms would notify management if there were any issues.

Feedback from people and reviewing the service’s visit data, confirmed staff arrived on time and stayed for the full duration. People told us they received rotas in good time and were notified of any changes. People also told us they mostly had the same care staff. Staff also confirmed that they visit the same people. One person told us “Punctuality is always very good. You can usually set your watch by them turning up”.

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.

Staff were up to date with safeguarding training and demonstrated a clear understanding of how and whom to raise concerns. The registered manager demonstrated a culture based on openness and learning to continuously improve the service. Relatives told us they felt their family members were safe, with comments such as, “My relative feels very safe with the carers and not subject to any risks whatsoever”.

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.

Risk assessments and care plans were person-centred and tailored to individuals’ needs. The registered manager had established effective systems to ensure risk assessments were regularly reviewed and updated, with active involvement from the people and their relatives.

Staff we spoke with told us that that care plans and risk assessments were always clear and regularly updated. Staff told us “If I found something had changed, I would ring the office and they change or escalate things right away.”

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

Environmental risks were clearly documented within people’s care plans. A lone working policy was in place to ensure staff could safely access people’s homes. Staff had received health and safety training and told us they would always be able to contact management if they had an environmental concern.

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.

Staffing was safe and effective. Staff received regular supervision and spot checks to assess their knowledge. Training was up to date, with a mixture of online training and practical sessions tailored to staff needs. Staff felt supported and valued. New staff members completed an induction when they joined the service to equip them for their role. One relative told us “I think the carers are well equipped in knowledge and well trained”.

The service used an electronic rota system that ensured adequate staffing. Where possible people and staff told us that they had continuity with their visits. Staff took pride in working as a team to ensure there was always cover during times of sickness and absence. If cover was still needed there was a clear system in place of whom would cover calls if staff could not. We saw examples where field care supervisors would cover visits and the registered manager if needed.

Recruitment records showed staff were recruited safely. This included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had received full inductions and multiple references from previous employments had been sought. Where a staff member had remained employed by the service for some time, DBS checks were renewed regularly.

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.

Infection prevention and control measures were robust. People told us staff consistently wore personal protective equipment (PPE) and followed hygiene protocols. Staff received training on how to manage infection risks and pressure care. One person told us, “As I’m aware there have been no complaints around hygiene standards and my relative has told me they [staff] wear PPE. I would give them 10/10 for standards”.

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.

Care plans included detailed information about each person’s medicines, ensuring staff had clear guidance on administration and monitoring. Protocols for medicines prescribed on an as-required (PRN) basis were in place and documented. Regular medicine audits were conducted, which would identify any issues promptly. The services electronic medication system would also notify management if there was anything raised by a staff member at the visit.