Helping Hands 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 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 66 (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 did not always have a proactive and positive culture of safety. Staff listened to concerns about safety and reported safety events; however, learning was not always fully embedded to ensure good practice was continually strengthened.

Whilst we saw evidence of learning in some areas, such as falls management, there were other aspects where learning needed to be strengthened. This included the handling of complaints, the use of the electronic monitoring system, and medication processes, which we have outlined further in the Well‑Led section. This meant the provider did not always have effective oversight or assurance that improvements were being consistently embedded across the service.

Relatives told us they had been kept informed when incidents occurred and staff communicated any changes in people’s needs. One relative said staff updated them consistently and acted quickly, including contacting emergency services without delay following a fall. Staff we spoke with confirmed this approach. One staff member described arriving to find a person had fallen; they had contacted the next of kin and informed the office, who followed up when they could not get through. They had also contacted 111 for advice. Their visit overran due to the incident, and the office arranged cover immediately, which they described as the team being “On the ball.”

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 and relatives told us a pre‑assessment had been completed before care began, and staff confirmed new people had care plans in place from the outset to guide safe support. The registered manager explained assessments included people’s cultural, spiritual and language preferences to ensure care was delivered in a way that respected their beliefs. They told us they matched people with staff who spoke their preferred language, such as Polish, Gujarati or Hindi, to support communication and understanding of any religious or cultural needs.

The registered manager also told us staff could share essential information with ambulance crews when a person went to hospital, using the care app to provide details such as medicines, blood thinners or Do Not Resuscitate (DNR) decisions.

We saw initial assessments were completed before care started, including a review of the person’s needs, history and the support required.

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 and their relatives told us they felt safe with the care provided. One person said, “I feel safe and look forward to them coming.” A relative told us the care in place had given their family reassurance that their loved one received the support they needed and was therefore able to remain in their own home.

Staff demonstrated a clear understanding of safeguarding. One staff member said it was about “Making sure there’s no danger to themselves or others,” including reporting any new marks or bruises and ensuring people could not access medicines inappropriately. They told us they reported concerns to the office and added, “Everyone should live a dignified life no matter what is thrown at you.”

Safeguarding policies and procedures were in place, and staff had undertaken safeguarding training. At the time of our inspection, no person required an application made to the Court of Protection for a Community Deprivation of Liberty Safeguard (DoLS). This occurs when a person lacks capacity to consent to their care and treatment. It protects people who can’t protect themselves.

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.

People had been assessed for individual risks associated, such as potential falls. Where risks were identified, control measures had been put in place, including clear guidance for staff on what to do if a fall occurred. Staff confirmed this and described how they supported people who might become distressed. One staff member said, “[Person] can get a little down. I distract them and this works.”

The registered manager explained how they assessed and managed risks, including checking whether equipment was needed, making referrals to occupational therapy, and ensuring people had access to items such as lifeline alarms. They said their approach was about “Managing risk to allow people to continue doing what they have always done, safely.”

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

Environmental risks within people’s homes had been identified as part of the initial assessment process. Assessments included key information about people’s medical conditions, legal arrangements such as Power of Attorney and the Mental Capacity Act, and the level of support required. They also captured important environmental details, such as the location of utilities and any risks within the home. For example, risks relating to the use of a heated blanket and a key safe had been assessed and documented.

The provider had a lone‑working policy and an out‑of‑hours procedure in place, which staff could use to seek support or advice when needed.

The provider did not consistently ensure staffing arrangements were sufficient or effectively organised to meet people’s needs safely. They did make sure staff received supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

People’s experiences of staff arriving on time were mixed. Some people said staff were generally on time, while others described late or early arrivals that caused stress. One relative reported a 45‑minute delay on a day they needed to leave the house. Some relatives said repeated late calls had led them to reduce or amend call times. One relative shared, “It affects their day because it causes anxiety and disrupts working days as a knock on effect to family who get called when things aren't as they should be.” However, other people and relatives said whilst calls were sometimes earlier or later this had no impact on them.

We received mixed feedback from staff about travel time. Comments included: “There isn’t always enough travel time. The other day I had 10 minutes to complete a 25-minute journey.” “We already have busy rotas which then leads to less travel time and racing about and given 10/15 minutes travel for an over 30 minute drive away which has a knock on effect getting to the next calls on time.” We reviewed rotas and found travel time had not always been planned effectively, resulting in some calls being earlier or later than intended.

Whilst staff we spoke with did not raise concerns about their working hours, we found some staff were not consistently supported to work within working time regulations. Some staff had limited breaks between shifts, which has the potential to impact safety and quality.

People and their relatives gave mixed feedback about domestic tasks; some said these were completed, while others reported tasks were left unfinished or staff did not use their initiative.

Staff received training relevant to the needs of the people they supported, completed an induction when they joined the service, and had regular supervision and annual appraisals. Safe recruitment processes were in place, including references and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with 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.

People and their relatives told us that staff wore appropriate Personal Protective Equipment (PPE). Staff were able to describe how they reduced the risk of infection during care delivery and told us PPE was collected from the office and was always readily available.

One staff member said: “The task list within the app tells us what PPE should be worn, with guidelines, and if there are specific requirements for individual people, such as wearing a mask. I change my PPE after each major task or if it becomes dirty.”

Staff had completed infection prevention and control (IPC) training. The provider also carried out observed practice checks to ensure staff used PPE correctly and followed IPC procedures when required.

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.

Some people had ‘as required’ (PRN) medicines; however, the instructions for their use were not always clear. For example, 1 person had been prescribed a PRN laxative, but there were no specific directions for staff on when this should be administered. Some people had PRN paracetamol prescribed as “1 or 2 tablets”, there was no written guidance to support staff in deciding when 1 tablet was appropriate and when 2 should be given. Staff did not consistently record whether 1 or 2 tablets had been administered. This created a potential safety risk, as inaccurate records could affect decisions about further doses or emergency treatment. As a result, staff did not always have the information they needed to administer medicines safely and effectively to support people with pain management.

Some people were prescribed time‑sensitive medicines that needed to be given 30–60 minutes before food. There was no written guidance to support staff with this requirement. Records we reviewed showed occasions where food and medicines were administered at the same time. This meant medicines may not have been absorbed as intended and may not have achieved the desired therapeutic effect.

Most people and their relatives told us they had no concerns about how medicines were managed. However, 1 relative raised ongoing concerns about communication regarding their family member’s medication. They told us they had needed to contact the office repeatedly and that staff frequently phoned them to ask about the person’s medicines, or to seek family members' guidance on medication to be administered. The family had already shared this with the registered manager which was being investigated.

Another relative told us their family member’s morning medication was not always given at the correct time because staff did not arrive as scheduled. They explained this had led them to alter the care arrangements.

The registered manager assured us they would review this and implement immediate improvements to ensure staff have clear, accurate guidance to support safe and effective medicines administration. After the inspection the registered manager sent us further documentation which included guidance around PRN medication and time sensitive medication.