Private Home Care UK Limited (Leicester)

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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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.

Systems and processes were in place to learn from incidents to prevent re-occurrence and promote safety. Incidents were recorded digitally via the electronic care management system and reviewed within 24 hours by a member of the management team. An analysis was undertaken of each incident and where required an action plan developed. Staff were informed of any lessons learnt through meetings and newsletters, which enabled them to make any changes to their working practices to mitigate and reduce similar events or incidents occurring. For example, a footwear risk assessment was introduced following an incident where a person slipped due to wearing poor footwear.

Staff were clear about accident and incident reporting and escalation and spoke of shared learning following any incidents. A member of staff told us, “The manager tells us about incidents that have happened so we can all learn, so they don’t happen again.”

Partner agencies told us the provider informed social work teams of any incidents affecting an individual, where the person’s care was funded by the local authority.

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.

People’s views, and where applicable the views of family members were sought as part of the inspection. A person told us about their experience when they were referred to the service. They told us, “It was all arranged by the social worker. Private Home Care came to discuss what care was needed. They told us what they do and listened to what we needed.”

Referrals came from local authorities, health care professionals or directly from the person or their representative. Referrals from statutory agencies were accompanied by an assessment of the person’s needs, which included any known safety concerns and measures required to promote safety. Assessments of people’s needs were undertaken by a member of the management team to ensure the needs of the person could be met, with consideration to safety.

The registered manager shared information as to people’s needs. For example, their care plan, medication records and risk assessments in the event a person moved from their home to hospital or a care home. A senior member of staff-maintained contact with relevant agencies, the person or family member to support a smooth transition and promote continuity and emotional support.

The providers’ systems and processes supported a collaborative approach between health and social care partners, people and their family members, this facilitated the delivery of safe care and was kept under review through ongoing monitoring.

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.

Safe and effective systems, processes and practices were in place and implemented to protect people from abuse and neglect. Safeguarding alerts and concerns were recorded and monitored. These were incorporated in the providers lessons learnt culture. For example, following a safeguarding investigation, it was found staff had not fully adhered to the providers’ falls policy, when a person was found to have fallen at home. In response, the provider held a staff meeting where the incident was shared and discussed as part of the lessons learnt culture. This emphasised the importance of following the providers’ falls policy.

Staff knew how to respond to an accident/incident, which included contacting emergency services, informing relatives where applicable and reporting the event to office-based staff. This demonstrated staff had learnt from a previous incident and understood their role and responsibilities. Staff told us they stayed with a person following an incident or accident to ensure they were safe and comfortable, and waited until a relative or health care professional arrived, if needed.

Staff had undertaken training in safeguarding as part of their induction and updated annually. Staff were clear about their responsibilities, including the reporting of suspected abuse. A member of staff told us, “Abuse is a very serious matter, and it must be reported even if the person asks you not to.” Staff said they were confident that any allegations would be taken seriously by the management team and acted upon.

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.

The registered manager was committed to the promotion of positive risk taking, enabling independence and dignity through supported risk. For example, a person who wanted to continue cooking independently was unaware of the potential risks of using a cooker. A safe cooking plan was put into place, which included the use of cooking equipment with automatic shut off options.

Risks associated with people’s individual care and treatment needs had been assessed and were regularly reviewed. Risk management included guidance for staff on how to manage and mitigate risks in relation to people’s physical health conditions, mental health and emotional needs.

Staff had undertaken training to promote people’s safety, in several key safety areas. These included, moving and handling people, health and safety, and first aid. Staff told us they took moving and handling practices seriously, ensuring hoists were used properly. Where there was risk of pressure ulcers developing, repositioning of a person was carried out. Staff spoke of looking for redness on people’s skin and recording any changes in daily notes and on a body map. Any concerns were reported to the office-based staff and the person’s family member, if appropriate. Family members confirmed staff’s approach to providing care which promoted good skin integrity. A family member told us, “Staff reposition him through the day and night as he is cared for in bed. He’s got no bedsores.”

Family members told us their relatives felt safe when receiving care and support. Family members were aware of how staff promoted the safety of their relatives, which in some instances included the use of equipment. A family member told us, “They [staff] use a hoist.” Staff told us their competency was regularly checked by senior staff to ensure they were providing the care as detailed within the person’s care plan, including actions required to reduce and mitigate risk.

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

Potential risks related to people’s home environment were assessed to promote both the safety of people and staff. Assessments focused on potential trip hazards such as rugs or uneven floor services and considered the tasks to be undertaken by staff in the delivery of people’s care. A family member told us, “As part of the assessment process a lady from the company came, they looked at the house, at things like fire alarms.”

Important information about people’s homes was documented to enable staff to take appropriate action in the event of an emergency. For example, the location of utility services and how these could be isolated in an emergency.

Potential risks to staff when working alone were assessed. For example, occupants of the home, including any pets. The provider had a lone working policy and an out of office procedure which staff could use to contact for support or advise.

The provider made sure there were always enough qualified, skilled and experienced staff, with the appropriate language skills and knowledge, including cultural and diversity awareness, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

The provider had a robust system and process, which ensured people received safe and continuous care, provided by a core team of staff who had been ‘matched’ to meet the person’s individual needs, with consideration to their protected characteristics as defined by the Equality Act.

A person-centred approach to care was embedded across the organisation, which included the scheduling and planning of care visits. People were ‘matched’ with staff with consideration to their age, gender, religion, shared interests, language, specific cultural requests and health care needs. This meant positive outcomes for people using the service. People were able to communicate their needs effectively and their well-being promoted.

People and family members told us they were supported by a consistent team of staff who they had developed positive relationships with. A family member told us, “My [relative] is supported by 2 -3 staff. She is very familiar with them, it gives continuity of care, which is really important to her, as she would struggle with different people all of the time.” A person told us, “I’m Gujarati speaking, staff speak in Gujarati, or in English when I speak in English.”

Staff arrived on time. In the event staff were running late, which people told us was infrequent, they were always informed. A family member told us, “Staff are very punctual for visits. They maybe 10 minutes early. They ring me if they are going to be late by 15 minutes. That’s happened about twice in a year.” A second family member said, “Staff come on time and if delayed sometimes, at a previous call or emergency, then I was informed. It's very occasional.” People and family members told us staff stayed for the full care call time. A family member told us, “Staff never leave early, even by one minute. They sit and chat. They stay exactly 45 minutes and will stay longer if mum wants to talk.”

Staff were recruited in a safe way. Appropriate checks were carried out prior to people commencing work. This enabled the provider to be confident suitable staff with the right skills and experience were employed. Staff received the support they needed to deliver safe care; this included supervisions, appraisals and support to develop and learn. Staff confirmed they had regular supervision. Staff completed the Care Certificate as part of a structured induction and were encouraged to study for vocational qualifications in care.

Records showed staff had undertaken training in a range of topics related to health, safety and welfare. They had also undertaken training specific to people’s needs which included training on improving skills and understanding the needs of people with a learning disability or those living with dementia. Staff who supported people and cared for people with a learning disability were knowledgeable as to how this could impact a person’s ability to learn, understand and respond socially, and what they, as staff might need to consider when supporting them. When required, staff received training from health care professionals to enable them to meet people’s individual health care needs, including any delegated health care tasks, administering medicine in response to a person having a seizure.

People and family members expressed confidence in the ability of staff to meet their needs and spoke of staffs’ knowledge and understanding of the support they required. A family member said, “The staff are trained in dementia.” A person told us, “The carer is really involved. They understand Fibromyalgia and how it affects me.”

Staff said they were introduced to new people and were given time to read their care plans and ask questions. They confirmed they always received training in any specialist health care needs prior to the commencement of a new care package of care. A staff member said. “We are always given any specialist training we might need before a package starts, and there’s shadowing by a senior or experienced carer.” This meant staff had the opportunity to observe care delivered by senior staff, so they felt comfortable and competent before they delivered care.

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.

People and family members confirmed staff wore Personal Protective Equipment (PPE). A person said, “Staff wear gloves and aprons when they wash me. They wear face masks and wash their hands. They put it all in the bin.” A family member said, “Staff do wear PPE, aprons, gloves and masks. If needed, they put on shoe covers. Hygiene practice is spot on. I’ve had no infections.”

Staff received annual training on infection prevention and control (IPC), and had their competency assessed in the use of PPE and cleaning procedures. A member of staff told us, “We all have to do annual refresher training, so it’s always fresh in our minds.”

The provider had a policy for IPC in line with good practice guidance. Potential risks related to infection were assessed, and any concerns were shared with the appropriate agency.

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.

People and family members told us staff supported them with their medicine, where required. In some instances, this meant reminding people to take their medicine. A person told us, “Carers remind me and ask me if I’ve taken my medicines.”

People’s care records included information about their prescribed medicines and the role of staff in providing support. A member of staff told us, “The manager is very strict about medication administration and the completion of MAR (medicine administration records) charts.”

Staff received training, which was regularly updated and included checks to determine staff’s competence. They had, where applicable, undertaking training in delegated health care tasks related to the administration of medication, which included, oxygen therapy and the administration of medication via a nasogastric tube. (A nasogastric tube is used to support when a person cannot eat or swallow safely on their own). Staff who supported a person with complex needs fully understood the procedures and complexity of meeting their needs. A family member told us, “Staff are trained to give medicines through the nasogastric tube as a solution, they are specially trained to do this through a feeding pump machine. The agency modifies any changes in medicines in the care plan after the consultant has discussed with us.”

Staff confirmed they had received training on-line and face to face from the district nurse. A member of staff told us, “The district nurse gave us face to face training; they were brilliant.” People in some instances lived with Parkinson’s Disease, for those people, medicines had been prescribed which were known as ‘time critical.’ Staff were aware of the significance of administering these medicines on time.

Systems and processes were in place, underpinned by the provider’s policies to ensure people’s medicine was managed safely.