Warrington Borough Council Intermediate Care at Home

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 72 (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.

Staff knew how to raise concerns about safety within the service and during care being delivered to people. They were familiar with the systems in place to alert and report concerns within the organisation.

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 service is one of a number of services supporting people at home following their discharge from a stay in hospital or to prevent a person being admitted to hospital. As people transfer between services, information is shared and assessments carried out to understand what support people require as they return to their home address. Staff told us that recent changes to when and how people’s needs were assessed have improved the amount of information and interaction they have with individuals prior to their care package commencing.

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.

Procedures were in place for people using the service to report any concerns they had, they told us they felt safe using the service. Staff received safeguarding training and knew what action to take to protect people from potential abuse. Internal reporting systems were in place for staff to record and escalate any concerns.

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 and their family members were involved in the planning of their care and support. Where risks had been identified, wherever possible these had been mitigated.

People were involved in the management of risk. This included people being part of their risk management and care planning process. Staff told us that recent changes within the service and the introduction of the ‘In-reach’ model (where staff visit people in hospital to plan their care after their discharge) of working had given the opportunity for staff to get to know people and understand their needs and risk in more detail. One staff member told us, “Assessments are now done by speaking to people over a few days (prior to leaving hospital) and we get to know people.”

We identified that risk management records were not always fully complete or failed to be considered in planning individuals’ care and support. This was recognised by the service and immediate action was taken to make improvements.

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

Risks to individuals using the service and family members were considered within the care planning process. Staff had a clear understanding of what actions they needed to take to keep people safe within their home.

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. However, we identified that a number of staff had not received up to date training in a specific area. This was acknowledged and actions were being taken to ensure that the training was delivered.

Records showed that staff were safely recruited with appropriate checks being carried out at the time of recruitment. Newly recruited staff completed an induction into their role and staff received on-going training for their role. Staff told us that they received regular training. However, a number of staff told us that they had not always received regular supervision for their role, but with recent changes this had improved.

Different ways of managing staff rotas were currently being trialled. This involved staff working in a specific geographical area with changes to their rota. Feedback from staff who were part of the pilot was positive with staff telling us travelling time had lessened and more time was available to spend with people.

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. Procedures were in place and staff received training on infection prevention and control.

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. Policies and procedures were in place for the safe effective management of people’s medicines and staff received training in the administration of medicines.

Systems were in place for the monitoring of people’s medicines which included regular checks taking place. People told us that their medicines were managed well. Their comments included, “Pretty hot on tablets and checking the amounts.” Another person told us the service had worked to ensure that prescribed dressing was available following their discharge from hospital.