Triple Home Care Ltd

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 had a proactive and positive culture of safety, based on openness and honesty. Lessons were learnt to identify and embed good practice. We saw evidence of learning being implemented following a previous incident, with appropriate action taken to minimise the likelihood of recurrence where reasonably practicable. People's care plans had been updated to reflect this learning and provided clear guidance for staff on the additional checks required. Daily care records confirmed that staff were carrying out these checks consistently and in line with the updated care plans.

The management and staff team worked collaboratively with people, their relatives where appropriate, and healthcare professionals to maintain safe systems of care. Processes were in place to help ensure continuity of care, including when people moved between services or required support from external agencies.

Staff liaised with a range of healthcare professionals, including social workers, GPs, district nurses and speech and language therapists, to obtain specialist advice and support to help meet people's needs safely. Staff understood the importance of partnership working and recognised the benefits of this. One staff member shared an example of working closely with social workers to support a person who was at risk of self-neglect. Reflecting on the wider impact of care needs, they told us, “Family need help sometimes as well as the service user.” This demonstrated staff considered the well-being of both people and those important to them when coordinating care and support.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve it. People and their relatives told us they felt safe using the service and receiving support from staff. One person said, when asked if they felt safe with staff, “Yes, I do.”

Staff demonstrated an understanding of the principles of the Mental Capacity Act 2005 (MCA) and the importance of supporting people to make their own decisions wherever possible. They understood the need to provide support, when needed, to help people make informed choices. A staff member told us, “Yes, we cover that in the deprivation of liberties training. To me it is not to assume someone does not have capacity unless medically verified by someone who is legally qualified to do so.” However, we found that some best interest decisions, whilst known by staff, could have been documented more clearly within people’s care plans. The registered manager responded positively to this feedback, recognised the need for improvement and acted during the assessment.

Staff had safeguarding training and understood their responsibilities to protect people from abuse, neglect and harm. A staff member told us, “Yes, I received safeguarding training and I learnt how to safeguard our clients, recognising risks, abuse and neglect.”

Staff were also clear about the actions they would take if they had concerns about a person's safety or well-being. They were aware of how to escalate concerns to external agencies where necessary. A staff member said, “I can report any safeguarding concerns to my manager… I can report any concerns to my local authority.”

The provider worked with people to understand and manage risks; however, guidance was not consistently clear for staff to follow to ensure delivery of care was safe, supportive and tailored to individual needs.

Staff demonstrated a good understanding of the people they supported and were knowledgeable about their individual needs, preferences and risks. This included awareness of specific health conditions, swallowing and choking risks, mobility needs and situations where people may experience increased anxiety or distress. However, we found that, on occasion, the level of detail contained within some care records were not sufficient to provide clear guidance for staff. Particularly for staff who were new to supporting the person. The registered manager responded positively to this feedback, recognised the opportunities for improvement and acted during the assessment to ensure a consistent level of detail within people’s care planning documentation.

Feedback from people and their relatives was positive about the support provided and that they felt involved. One person told us, “All in all I am happy with the support that I get.” A relative said, “They know all [family member’s] care needs.”

The management team assessed people’s home environment for risks. These assessments included guidance for staff on the action to take when present, in the event of an emergency, such as a fire. Staff carried out regular environmental safety checks, including verifying that smoke alarms and, where applicable, personal alarm systems such as lifelines were functioning correctly. Records confirmed these checks were completed. We also reviewed records which showed staff checked water temperatures before supporting people with bathing or showering to ensure the water was not excessively hot.

Where required, people had equipment in place, such as bed rails and or wheelchairs to support their safety. One staff member told us, “We always risk assess any activity before and during undertaking an activity. For example, before mobilising a client, we need to ensure that their level of mobility hasn't changed, that they are well, and that any mobility aids specified are in good working order and used as instructed.” This helped ensure people remained as independent as possible in their own home.

There were enough skilled staff to meet people’s individual care needs safely. Recruitment processes helped ensure staff were suitable to work with people. Prospective employees underwent pre-employment checks, including obtaining references from previous employers and completing Disclosure and Barring Service (DBS) checks. DBS checks provide information about a person's criminal history, including any convictions, cautions or other relevant information held by the police.

Staff told us, and records confirmed, they shadowed experienced staff during care visits to become familiar with people's needs and preferences before providing support. One staff member said, “Yes, I have been introduced to all clients in advance and care plans have to be read before attending any client and new clients.” A relative confirmed, “My [family member] knows the staff very well. They shadow shift when they bring someone new in.”

Analysis of care call monitoring records showed most care visits were completed on time. Where there were occasional late calls, the registered manager was able to explain the reasons for these. One relative said, “Staff call ahead if they are running late. This doesn’t happen often.”

Staff competency was monitored through spot checks and supervision meetings. These helped the provider assess staff performance and identify any areas where additional support or development was needed. Training records showed some staff had outstanding training in specialist areas. However, the registered manager responded promptly and positively when this was identified and took immediate action to arrange the required training.

Staff understood the importance of good infection control procedures to help prevent the spread of infection. Staff told us, and records confirmed, they had received training in infection prevention and control (IPC). The provider monitored staff practice through competency assessments and spot checks, which included observations of infection prevention and control procedures to help ensure safe working practices were consistently followed.

Staff had access to personal protective equipment (PPE) and understood when it should be used. Feedback from relatives indicated staff followed good infection control practices when providing care and support. One relative told us, “Staff wear PPE when doing personal care. Apron, gloves and a mask.” These measures helped reduce the risk of the spread of infection.

The managementand staff team ensured that, where required, people received their prescribed medicines safely and in accordance with prescribers' instructions. A person told us, “The carers do the medication and [named breakfast] to start the day.”

The provider's medicines policy referenced STOMP (Stopping Over Medication of People with a Learning Disability, Autism or both), which promotes the appropriate use of medicines and aims to reduce the unnecessary use of psychotropic (affects behaviour and mood) medicines.

However, most staff were unable to clearly explain the purpose and importance of this guidance when asked. The registered manager responded promptly and positively when this was identified during the assessment. They acknowledged the need to strengthen staff understanding and described plans to refresh staff knowledge of relevant guidance, best practice and legislation, including STOMP, through future staff meetings.

Staff responsible for supporting people with medicines had been trained and their competency was assessed through spot checks by senior staff. These arrangements helped provide assurance that medicines were administered safely and in line with their training.