1 Homecare

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.

The service had an incident recording policy which staff understood and knew how to access. We saw completed incident forms which had been considered by the managers and escalated to other organisations when required. The registered manager monitored incidents to check whether any changes or improvements to care delivery were required.

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 conducted thorough assessments of people’s need when they were first referred to the service to aid an effective transition. Leaders worked alongside relevant health professionals when required to make sure they captured relevant information about people and their needs. Care packages were reviewed after a few weeks to make sure they met people’s needs and the registered manager continued to review support at regular intervals.

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 a safeguarding policy which contained information to guide staff about what constituted a safeguarding concern, and how to raise this appropriately. Staff completed safeguarding training and knew what to do if they were worried. There had been a low number of safeguarding alerts and investigations within the service, although the registered manager had a system to collate and monitor when they did arise.

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.

Leaders undertook a wide range of risk assessments and did so alongside the person and their relatives. Risk assessments were reviewed and updated at regular intervals or when there was a change. Risk assessments considered issues such as the risk of falls, and risk of choking. Information included guidance for staff about how to minimise any risks to the health and safety of people.

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 conducted environmental risk assessments which looked at issues such as trip hazards, pets and smoking risks. Staff completed fire safety training and there were plans to inform staff about how to support people to evacuate their home in the event of a fire. Staff completed training about how to use moving and handling equipment and made sure equipment was in good condition before they used it. Managers checked that equipment was serviced regularly.

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.

Leaders managed rotas so that people received consistent and familiar staff. Staff told us their rotas were managed well, and they had enough time to travel between visits and to stay for the correct length of time. The provider recruited staff using safe processes and made checks such as disclosure and barring service (DBS) checks, right to work, and references. Staff completed relevant training for their role and compliance rates were high.

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.

There were appropriate policies and procedures, and staff understood how to keep people safe from the risk of infection. Staff had access to hand gels and personal protective clothing (PPE) such as aprons and gloves. Managers completed spot checks at people’s homes which included consideration of hand washing and bare below the elbow (this is guidance to make sure staff do not wear clothes or items below their elbows to reduce the risk of infection). People told us they observed staff washing their hands and wearing PPE at the required time such as preparing food or completing personal care tasks. When commissioned to do so, staff supported people to clean and tidy their homes safely.

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.

The provider supported people with complex needs such as use of a PEG (a tube inserted into the stomach to deliver nutrition, fluids, and medicines) and epilepsy. We checked the medicine care plans and found they contained some guidance but would benefit from extra detail. We fed this back to the registered manager who agreed to review with their nurse straight away. Staff were trained by a nurse employed by the provider and their competencies were checked regularly. Staff also completed medicines training as part of their care certificate. There was guidance about medicines and staff accessed important information about people’s prescriptions securely on their mobile telephone; they signed to say when they administered people’s medicines. The provider encouraged people to manage their medicines independently where this was appropriate. Staff checked stock levels and expiry dates to make sure medicine was in date and effective.