Jireh Homecare

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.

Good: This meant people were safe and protected from avoidable harm.

This service scored 75 (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.

People were protected by systems and processes that promoted learning and continuous improvement to ensure their safety and wellbeing.

The provider demonstrated a commitment to learning by actively sharing information about areas for improvement identified by both the organisation and local commissioners. This information was communicated to all staff so lessons learned could be embedded into everyday practice across the service.

The registered manager provided an example of learning in response to identified risks. Previously, out-of-hours calls taken on the duty phone were recorded on loose paper, which sometimes resulted in lost information and gaps in the electronic records. To address this, the provider commissioned wire-bound duty books specifically designed for the agency. These books follow the staff member on duty and are used to record all calls received. The compliance manager and registered manager review the duty books to ensure appropriate and timely action has been taken in response to concerns raised. This change demonstrated effective learning from incidents and had improved oversight and accountability. Care records confirmed that concerns raised by people were acted upon within the provider’s internal timescales and were managed effectively.

Staff spoke positively about this improvement, with one staff member telling us, “The duty book is working well, with clear prompt questions to complete when taking calls. Now all calls are logged in one place, it’s easier to locate, check outcomes, and see what actions have been taken if we receive further calls.”

Learning was also shared through effective communication systems. Staff told us that when a person declined personal care, this was clearly recorded in daily notes and reported to the office so all staff attending subsequent visits were informed. This supported staff to take appropriate steps to re-offer care at the next scheduled call.

Staff described how changes and incidents were promptly shared using a team WhatsApp group, ensuring timely updates between shifts. One staff member explained, “If something has changed in a person’s care times or an incident has happened, we read about it in the WhatsApp group chat, and we talk about it in supervision and staff meetings.” This demonstrated an open learning culture where information was shared, reflected upon, and used to improve outcomes for people.

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.

When new people started to use the service, arrangements were in place for assessment to be completed to establish people’s needs. These assessments informed care planning support from the outset of their care.

Where there were emergency situations at the service, staff supported people to access the services or care they needed. Where people required emergency healthcare such as a hospital visit or admission, the service shared key information about people’s needs with health professionals. This helped to promote safe transitions and continuity of care.

The provider had developed a service user guide which was given to people new to the service. It clearly outlined what people should expect from the service, including what staff could and could not support them with.

People and their relatives gave positive feedback about the referral process, and confirmed staff were always introduced to people so they were familiar with the care staff. Information about new referrals was shared with staff during these introductions to ensure they were fully aware of people’s needs.

At the time of the inspection the registered manager told us they were supporting people with specific needs related to learning disability and autism. Training records confirmed staff had completed training on Understanding Autism and Learning Disabilities to help support safe.

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 using the service and with the staff that supported them. One person said they felt “Very safe” and told us, “They (staff) are very careful when helping me. I would probably speak to one of the senior carers or manager if I didn’t feel safe.” This demonstrated people felt confident to raise concerns and trusted staff to respond appropriately. A relative told us “No [my loved one] never said that they felt unsafe or any problems with care.”

Systems were in place to protect people from the risk of abuse. Staff confirmed they had received safeguarding training, and training records supported this. Staff showed a good understanding of safeguarding procedures, including how to recognise potential signs of abuse and what actions to take if concerns were identified or disclosed. The provider’s safeguarding procedure provided guidance about listening to and recording concerns. The procedure signposted people, relatives and staff to the local authority and CQC.

The registered manager maintained clear records of safeguarding concerns and ensured these were reported to the relevant external authorities when required. Records showed the registered manager had taken appropriate and timely action in response to concerns raised, including implementing measures to reduce the risk of recurrence. This demonstrated effective oversight and a commitment to keeping people safe.

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.

Risks associated with people’s care were usually identified and discussed with them when they started to use the service. However, we found that some risk assessments were not fully detailed or supported by robust strategies to guide staff consistently. For example, records identified that people required mobility support but did not clearly describe the specific equipment to be used or the risks associated with mobility needs.

Staff told us they discussed any changes in people’s needs or risks with the individual and reported these to the office so updates could be made promptly. When people declined support, such as personal care, this was respected, recorded, and communicated to ensure staff responded appropriately at subsequent visits. This demonstrated people’s choices were respected while ensuring safety remained a priority.

People were supported to raise concerns or share changes in how they felt about their care. Information was shared effectively with staff through handovers, daily notes, and communication systems to ensure consistent and safe support. This approach demonstrated the provider involved people in managing risk while promoting choice, dignity, and independence.

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

Managers completed a risk assessment of people’s homes when people first started using the service and reviewed this annually. The risk assessment covered different aspects of a person’s home and any necessary safety considerations. For example, access, lighting, fire and specialist equipment.

Staff completed training in fire safety, health and safety and manual handling, to help support their knowledge and understanding of environmental risks. Staff carried out visual health and safety checks at people’s homes, and concerns about the environment or equipment was shared with relatives and the appropriate health or social care partner.

The provider ensured the office environment used to manage and coordinate home support was safe, secure, and well maintained. Health and safety arrangements were in place, including fire safety procedures and secure storage of records. The office environment supported staff to carry out their roles safely and effectively, contributing to safe oversight of care delivered in people’s own homes.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited safely in line with the provider’s recruitment procedure and best practice guidance. Staff had completed the necessary training to enable them to carry out their roles and support people safely. This included training linked to people’s specific health conditions so they could meet those needs and identify when medical intervention might be required. Staffing numbers were determined in accordance with care calls required and we saw there were sufficient staff to complete the required care calls. Staffing levels ensured people received their care calls from staff they knew, at the times they expected and for the length of time agreed. Staff supported all people that used the service, so they got to know them and their needs.

New staff received a thorough induction which outlined their duties and the expected standards of conduct. A staff member told us, “I was supported by the management throughout my induction, and it was only when I felt ready that I shadowed the experienced staff.” Staff without previous experience working in the care sector completed the Care Certificate to ensure they had the knowledge and skills needed to deliver safe, good quality care.

Staff recruited under the sponsorship licence had been appropriately recruited, and all mandatory pre‑employment and compliance checks had been fully completed. The provider confirmed that a recent inspection by UK Visas and Immigration (UKVI) awarded the service an A‑Star rating for compliance in recruiting staff under the sponsorship programme.

The provider’s training matrix provided assurance that staff training was completed and refreshed in line with the provider’s policy. The matrix was regularly reviewed to identify any outstanding or lapsed training, and staff were promptly informed and refresher training was arranged as required. Staff were allocated protected time within their rota to complete mandatory and refresher training.

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 told us they had no concerns about infection prevention and control. They said care staff wore appropriate personal protective equipment (PPE), such as masks, gloves, and aprons, when required.

Staff demonstrated a good understanding of how to keep people safe and prevent the spread of infection. They were clear about the actions to take should a person develop an infection and how to respond effectively. Staff confirmed they had access to sufficient PPE to enable them to work safely. One staff member told us, “There are always gloves and aprons for us to use. There is a good stock,” and another said, “We do training and have our practice checked.”

Records showed staff had completed relevant IPC training to support safe working practices. Staff had also completed food hygiene training to reduce the risk of infection related to food handling.

The provider had up to date IPC policies and procedures in place to guide staff on safe practice. Regular audits were undertaken to monitor compliance with IPC procedures and to ensure staff followed good hygiene practices. These audits also confirmed that staff areas were kept clean and tidy to help prevent the spread of infection.

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 were assisted or prompted to take their prescribed medicines by staff, and medicine records confirmed people received their medicines as prescribed. People told us they had no concerns about how their medicines were managed. One person said, “Carers will advise me to take pain killers if I am in pain. I have every confidence in the carers.”

The registered manager told us some people ordered and administered their own medicines and others were supported to order their medicines and staff administered them.

Staff had received medicines management training and understood their responsibilities, including how to accurately complete medicines administration records (MARs) and the actions to take if a medicine was refused or unavailable. Records reviewed showed MARs were completed accurately, with no unexplained gaps identified. One family member told us, “They keep the medication records accurate and up to date so we can clearly see what has been given.”

Where people required specific support with their medicines, this was documented to promote safe and consistent practice. The provider carried out regular medicines audits to monitor practice and support medicines optimisation.

However, we identified some gaps in the guidance available to staff where family members were involved in prompting or supporting people with their medicines. In these cases, the level of family involvement and staff responsibilities had not always been clearly recorded. This meant staff did not always have clear written guidance to follow, which could increase the risk of misunderstanding or inconsistent practice. The provider was advised that clearer recording of guidance was needed to ensure staff have clear instructions and that medicines are always supported safely and consistently.