Individual Homecare Services

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 72 (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.

Staff morale was good and the staff team enjoyed working with the provider. There was a good sense of teamwork. Lessons were learnt to continually identify and embed good practice. The registered manager had a clear direction for the service which demonstrated a desire for people to achieve the best outcomes possible.
 

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 provider had processes in place to ensure safe systems, pathways and transitions were maintained. This included an initial needs assessment at the start of a service being provided. People were supported to access a range of external health care professionals to improve their well-being.

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 told us they felt safe receiving care. Staff received regular safeguarding training. The provider had a safeguarding policy and procedure in place, and staff told us they knew how to report any concerns, to ensure people were protected from abuse.

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’s care records included information around individual risks and the support staff needed to provide. For example, risks around mobility, falls and equipment use, skin integrity, specific health conditions, eating and drinking were all assessed and information regarding any involved healthcare professional advice was recorded.

Information about changes in people’s care needs was shared with staff so support could be changed to reduce any recurrences. People, and their relatives where appropriate, were involved in deciding how their individual risks would be managed and mitigated.
 

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

In people’s own homes, CQC does not regulate the environment in which people live. However, we do ensure people’s safety is still assessed and monitored.

People were cared for in their own homes. The provider had environmental safety assessments in place to identify any potential risks in the person’s home which may have an impact on the person or their care staff. This included access, pathways, steps, handrails, lighting, floor coverings, and information on water, gas and electrical appliances. Any potential environmental concerns were discussed with the person receiving care, as the provider was mindful it was the person’s own home. The service made sure any equipment and technology were appropriate and supported the safe delivery of care.
 

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support and development. They worked together well to provide safe care that met people’s individual needs. However, we found some specific staff training and individual oversight had not been kept updated. The provider did acknowledge this and took immediate action to improve these areas and provided assurances to confirm they had taken action. There was no negative impact on people, because we found staff demonstrated strong knowledge of people’s current needs and staff confirmed they were able to directly approach the provider should they have any concerns relating to their training and oversight.

People confirmed the care staff were well trained to carry out care and support for them, or their relatives. One person shared, “I get a weekly rota saying which carer is coming and the time. At times this changes, due to events out of their hands. I do have a regular carer for most of my calls and they know what I need.”

The provider had a recruitment procedure to ensure staff were suitable to work with vulnerable people. We reviewed a selection of staff files and found pre-employment checks had been completed prior to staff commencing in post.
 

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 was an effective approach to assessing and managing the risk of infection, which was in line with current relevant national guidance. The provider ensured their staff had access to the necessary personal protective equipment (PPE) to support effective hygiene and infection prevention.

The provider’s infection prevention and control (IPC) policy and procedures set out the roles and responsibilities for staff around infection prevention and control to ensure this was managed 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.

People who required assistance with their medicines had them appropriately administered in line with relevant legislation. Although people’s medicines were sometimes managed by the person themselves, or their relatives, the provider worked with people to ensure they had the necessary prescribed medicines available to them.

The registered manager ensured people’s individual support plans specified exactly what each person needed from care staff in respect of their prescribed medicines. Medicines audits and competencies were completed to identify any errors in recording, or with the timing of prescribed medicines given to people.