Surrey Hills Home Help Services Limited

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 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. A staff member told us, “I learned from accidents by talking with my team and my superiors and following any new rules to stop it happening again.”

Information about accidents and incidents that had occurred was centrally recorded. This included information on what had happened, the action taken, and if any injuries were sustained. For example, one person had experienced a plumbing leak in their home. Staff had taken the person to the provider’s day centre while an emergency plumber and electrician were called to ensure the property was made safe.

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 registered manager felt strongly about ensuring people, especially those living with dementia, received smooth transitions between care services. They told us, “It’s a concern to me when [service users] go into hospital. I’ve been known to go into hospital to write up a dementia care plan about their triggers and needs as its different environment for them. I feel it’s so important for care management to go in and speak to hospital teams to make sure they are being supported appropriately. We always reassess before they are discharged. If there’s been a change of need, we always ask if an occupational therapist has visited their home. Admission and discharge are equally important.”

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 kept detailed records of safeguarding concerns which had occurred. This included information on the concern and which external professionals were contacted to seek support. The provider shared concerns quickly and appropriately and was responsive to any further information requested from them during safeguarding investigations.

People and their relatives confirmed staff wore ID badges during care visits. This ensured people were able to confirm the staff entering their homes were employed by the service. Staff were fully aware of their responsibility to safeguard people from harm and abuse. One staff member told us, “I ensure safeguarding is always at the forefront of my mind and that any concerns are raised immediately to the relevant people.”

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.

Staff knew people well and the risks they faced in their day to day lives. Risk assessments detailed the support people required in tasks such as getting dressed and taking their medication. However, we did identify shortfalls in the documentation around the risks known to people, which has been detailed later in this report. For example, 1 person’s care plan had contradicting information about their mobility needs. Their moving and handling risk assessment also did not include detailed information around this. However, this had not caused any impact on the person due to the staff knowing them well.

We fed this back to the registered manager, who provided us with an updated and clearer risk assessment following our assessment.

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 assessed the person’s environment in which care would be delivered prior to starting a care package. When any issues arose or changes were identified through reviews, these were reported back to the appropriate services such as local authority and occupational therapists. This included when a change in people’s needs required additional mobility equipment.

The provider did not always make sure staff were fully qualified, skilled, and experienced. They did not always make sure staff received effective support, supervision, and development. They did not always work together well to provide safe care that met people’s individual needs

The provider’s arrangements for staffing and workforce development were not fully embedded to ensure consistent oversight and assurance. While people generally received their care as planned, weaknesses in training oversight, recruitment governance, and rota planning were identified which required strengthening. Some staff had not completed training that was important to their role. When reviewing appraisal records, we saw staff had identified a need for moving and handling training to support them in their work. One staff member reported they had not received this training despite working at the service for three years. The registered manager provided completion certificates for an online moving and handling course for 4 out of 14 staff members. However, this training was not recorded on the provider’s training matrix, and there was no evidence available to demonstrate that all staff had completed this training. Moving and handling training is important to ensure staff have the knowledge and skills to support people safely with their mobility and transfers.

We also identified gaps in the provider’s recruitment records which indicated weaknesses in governance oversight. We reviewed eight recruitment files and found that three staff did not have personal or professional references on file. One staff member did not have an application form or health questionnaire available. Although other recruitment files contained the required documentation, these gaps meant the provider did not have a complete oversight of safe recruitment checks at the time of inspection.

People told us there were generally enough staff to support them and that staff usually arrived on time. One person told us, “They stay for the full time which is reassuring; it means they don’t simply come to get the tasks done.” Another person said, “They are sometimes late, but still come.” However, when reviewing staff rotas from January to March 2026, we found that more than half of care visits had no planned travel time between calls. Staff had also raised concerns in their 2025 appraisals that “the rotas don’t work.” While a staff member told us there were plans to improve the rota system to allow sufficient travel time between visits, these arrangements were not yet fully embedded at the time of inspection.

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.

Staff were aware of their responsibility to follow safe infection prevention and control policies. A staff member said, “I follow infection control. I am always washing my hands, wearing the correct PPE (personal protective equipment), using the correct cleaning equipment and following all hygiene rules to keep my clients safe.” The registered manager told us, “We always check PPE on spot checks. We make sure staff have everything - foot covers, hand gels, 3 sets of uniforms. We’ve got 1 client requesting we wear masks at the moment which is fine with us.” PPE was available to all staff and frequently restocked to ensure they did not run out.

The provider did not always make sure that medicines and treatments were safe.

Topical cream medication administration records (TMARs) were not used to guide staff on where prescribed medical creams should be applied on people’s bodies. This meant there was a risk of prescribed medicines being applied to incorrect areas of the body that did not require them. We informed the registered manager of this, who told us they would implement TMARs as soon as possible.

The registered manager informed us medicine administration records (MARs) were routinely audited to ensure medicines were being administered correctly and safely. However, during the inspection process, little documentary evidence was available to demonstrate that these audits had been consistently undertaken or that any actions identified had been monitored and addressed. For example, we identified examples where details between medication care plans and MAR charts were contradictory or did not match. As audits were not always documented to identify these shortfalls, we were unable to verify the effectiveness of the provider’s governance arrangements in relation to medication management.

These risks were partially mitigated by the electronic medicines system in place, which supported staff to administer medicines safely. One staff member told us, “The medication system used helps me give medicines safely by clearly showing what to give, when to give it and how much. It also lets me record everything, so nothing is missed or is given incorrectly.” We identified instances where the system had not allowed staff to log in and record medicines had been given. However, staff had recorded the administration information within the person’s daily care notes.

Protocols were in place for ‘as and when’ medication (PRN). These detailed when the medication should be given and the maximum dosage within a 24 hour period.