In Home Care Chichester

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.

Lessons were learnt to continually identify and embed good practice. There were opportunities for staff and leaders to learn lessons and improve outcomes for people. People felt able to talk to staff about safety concerns. Accidents and incidents were appropriately reported and acted upon.An electronic system recorded incidents in real time which immediately flagged the incident to the management team. Investigations were undertaken and learning was used to improve people’s care experiences.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. There were clear processes in place to promote continuity of care when people moved between services including transfers to hospital. Emergency packs and hospital passports contained key information about people’s health needs, communication preferences, and support requirements. These were shared appropriately to ensure healthcare professionals had timely access to accurate and relevant information. This helped to promote safe, coordinated, and person-centred care during transitions.

The provider worked closely with people using the service and with healthcare partners to understand what being safe meant to them and how best to achieve this. Staff received appropriate safeguarding training and demonstrated a clear understanding of their responsibility to protect people from avoidable harm. They were aware of how to recognise potential concerns and understood reporting procedures. People told us they felt safe with the staff who supported them.

Staff understood the importance of ensuring any restrictions were lawful, necessary, and proportionate to the level of risk and potential harm. We reviewed people’s care plans and there was no evidence of restrictive practices or people being unlawfully deprived of their liberty. The registered manager demonstrated a clear understanding of the process that would need to be followed should an application to the Court of Protection to deprive a person of their liberty become necessary.

The provider did not always work effectively with people to understand and manage risks. Risk assessments and management plans were in place, however, these did not consistently contain accurate or sufficient information to ensure people received safe care. In some cases, risk assessments did not align with the information recorded in people’s care plans. These included risks associated with people’s mental health, medicines, behaviours, and risks posed to staff. There was no evidence of people experiencing harm, however systems for assessing and managing risk were not sufficiently robust to ensure people and staff were fully protected from the potential risk of harm.

During the inspection, we shared examples of these concerns with the registered manager. They acted to implement improved processes to ensure risk assessments contained more detailed and person-centred information to ensure the safety of both people using the service and staff.

The provider detected and controlled potential risks in people’s homes. They made sure equipment, facilities and technology supported the delivery of safe care. Staff knew how to undertake safety checks in people’s homes. Lone working protocols and safety checks were in place to aid staff safety and well-being.

The provider did not always ensure continuity of staff to meet people’s needs in a consistent and coordinated way. Feedback about staffing arrangements was mixed. People said care calls were rarely missed and the rota confirmed this. However, concerns were also raised about a lack of continuity, with different carers attending visits and some calls perceived as rushed. This meant people had to repeat information and did not always feel their needs were fully understood or met. In contrast, positive feedback was also shared describing reliable support from regular staff members who were familiar with people’s preferences and understood their needs well.

Safe employment processes protected people from the recruitment of unsuitable staff. Staff received a comprehensive training and induction which included mandatory training and observed practice. Staff new to care undertook the Care Certificate which is a set of 16 standards that form the basis of training for health and social care support staff in England.

The service supported people with a learning disability and autistic people. Processes were in place to ensure staff training met the requirements of the Oliver McGowan Code of Practice, which sets out the mandatory training standards for staff supporting people with learning disabilities and autistic 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. The provider had an up-to-date infection prevention and control (IPC) policy. Staff received training to mitigate the risk of infection being transferred when moving between people’s homes. People told us staff wore personal protective equipment (PPE) whilst supporting them in their home and with personal care.

The provider made sure that medicines practices were safe and met people’s needs, capacities, and preferences. Regular medicine checks and audits were undertaken to ensure medicines were administered safely in line with guidance, and people’s preferences.

Medicine administration records (MARs) were completed in line with good practice guidance. There were clear protocols for administering ‘as and when required’ (PRN) medicines. Known risks were appropriately assessed, and safe practice guidance was followed to reduce potential harm.

Staff responsible for administering medicines received appropriate training. This included observed competency assessments to ensure they had the necessary skills and knowledge to administer medicines safely and effectively. People told us they had no concerns about the way their medicines were managed or administered and examples showed medicines were managed in a way that supported independence and safety.