Healthy Homecare Services Ltd

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 69 (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 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, relatives and staff had clear access to safeguarding information, including what to look out for and how to report concerns, and this was reinforced through meetings, service user guides and ongoing communication. Feedback from relatives reflects confidence in the safety of the service people received, with one relative commenting, “I do feel [loved one] is safe, staff are kind, they don’t rush.”

Staff followed a well established process for reporting safeguarding concerns, and all issues raised were documented, investigated and addressed in a timely way. Appropriate notifications were made to the Local Authority and CQC, and evidence of this had been shared. Multi-agency involvement was sought whenever required to ensure safe and transparent outcomes.

All staff have completed safeguarding and Mental Capacity Act (MCA) training, refreshed regularly, which also incorporates principles from the Equality Act 2010. Mental Capacity Assessments were completed when required, and staff were able to confidently explain how decisions were made in the person’s best interests.

The provider did not always work well with people to understand and manage risks. Staff did not always provide 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 contain detailed information to guide staff in supporting people safely, using strategies that were proportionate and the least restrictive. Where people may make unwise decisions, their choices were respected while still giving appropriate consideration to their safety. Daily records reviewed showed that risks were managed in line with agreed strategies. We found that some risk assessments were not always updated in accordance with the provider’s policy. This was discussed with the registered manager who confirmed after our office visit that these had been reviewed and now all up to date. People and their relatives were involved in discussions about risks through reviews to ensure thatsupport reflects their choices and preferences.

Policies were in place and aligned with best practice guidance, covering key risks relevant to the people who use the service, such as falls, choking and epilepsy. Staff have received appropriate training to understand and support the individual risks of the people in the service. The training matrix reviewed demonstrated that training was up to date in areas such as falls management, choking, epilepsy and other condition specific risks.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 levels were suitable to meet people’s needs, and rotas showed appropriate cover was in place. The required recruitment processes and checks were completed when recruiting new staff.

Staff training records were reviewed and showed that mandatory training was up to date, including learning disability and autism training, and training specific to individual needs where required. Performance management processes and recruitment policies were in place and aligned with current guidance.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicine records showed that people received their medicines as prescribed. However, some entries were recorded late. While this did not affect the safe giving of medicines, it meant the records were not always up to date, so staff visiting later in the day might not always have the latest information.

Medicines that were needed as and when required were logged and given appropriately, and staff understood when these should be given. Medicine audits were in place but not updated as often as required, and the electronic system showed overdue audit actions, demonstrating that oversight needed to be more consistent. Medicine training was up to date, and all staff who administered medication were suitably trained and competent.

Care plans included clear information about each person’s medicines, including the support they required, any associated risks, and any cultural or personalpreferences. Communication with GPs or pharmacists was used when needing to clarify medicines issues.