Spire Homecare Limited

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.

The provider did not always have a proactive and positive culture of safety, based on openness and honesty. Although staff listened to concerns about safety and investigated and reported safety events, lessons were not always learnt to continually identify and embed good practice. For example, the provider had a tracker for all incidents that had happened. The tracker did not list what actions had been taken, whether further action was required or if the incident had been resolved. This meant the provider could not demonstrate that lessons were always learned or that actions were taken to prevent similar incidents from happening again, increasing the risk of recurring safety issues and reducing assurance that improvements were embedded.

People and staff knew how to raise concerns outside of the management team. All staff told us what they would do to help prevent the development of a closed culture. For example, if staff witnessed unsafe practices when delivering care, they told us they would raise a concern with their line manager. Comments included: “Safeguarding people and upholding their rights is really important.” Staff knew who to contact outside of the organisation in the event of identified concerns not being effectively addressed by leaders.

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.

For people who had frequent hospital visits, care planning documents demonstrated a joined up working approach. For example, collaborative planning showed the provider had shared a person’s risk assessments and medication documentation with the hospital once people had been asked for their consent. This meant all relevant professionals were able to work together to implement a discharge plan for the person.

The provider had supported people to move from a hospital environment back into their own homes. The provider made sure they asked for comprehensive discharge plans to ensure people received continuity of care.

The provider worked with people 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.

People told us they felt safe in their homes and that staff actively supported their safety. All staff we spoke with demonstrated a clear understanding of safeguarding principles and shared practical examples of how they keep people safe during care delivery. Staff spoke confidently about recognising signs of abuse and explained the steps they would take to protect people.

All staff had completed safeguarding training, and records showed when refresher training was due.

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 to people’s health, safety and welfare had been assessed and action taken to manage those risks. For example, people at risk of choking had a support plan and risk assessment in place. There were detailed and individualised risk assessments for a person whose home contained hazards and was in a state of disrepair. Another person experienced regular changes to their physical health, and these changes were identified and assessed frequently to enhance their safety.

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

The provider assessed the home for risks and took action to ensure people, staff and visitors remained safe. People had individualised environmental risk assessments which detailed hazards in the home. This included flammable emollient-based creams and how to safely support people in the event of an emergency.

Another person shared they were worried about experiencing health problems. Leaders ensured they met with the person to reassure them. The provider put additional support in place for them. Comments included “The welfare calls and increase of hours have really helped me”.

The provider did not always make sure there were enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They did not always work together to provide safe care that met people’s individual needs.

Staff did not always receive supervision in line with the provider’s policy. Of the staff files looked at on the day of the assessment, none had received regular supervision. This meant the provider could not be assured staff were encouraged to discuss well-being or that they were receiving support in their role. This also meant there was a risk of shortfalls in staff performance or practice going unnoticed. However, the supervisions that had been completed were of good quality and aligned with the Care Quality Commission’s (CQC) regulations.

However, pre-employment checks had been completed for staff before starting work. New staff received an induction, including shadowing experienced staff. Staff told us they received regular training. Some people told us they had some concerns over staff knowledge. Comments included: “Staff are sometimes unsure of how to perform tasks” and “I think they have an issue with training”. We shared this with the provider who made arrangements to review this.

The provider assessed and managed the risk of infection and told us they would raise anything with appropriate agencies promptly.

Staff completed infection prevention and control (IPC) training and told us they had access to all the personal protective equipment they needed. We saw evidence of completed IPC spot checks and staff spoke about the importance of maintaining hygiene standards.

People confirmed that staff helped them keep their homes clean. One person said, “Staff will help me have a sort out and a tidy up” and “Staff wear gloves when they support me with personal care”. These statements reflected the provider’s commitment to maintaining a safe and hygienic environment.

Meeting notes showed that leaders regularly emphasised the need for staff to maintain clean and professional uniforms as part of IPC standards. This was discussed to ensure hygiene, reduce the risk of cross-contamination, and promote a professional image when delivering care. Staff were reminded that wearing clean uniforms is not only about appearance but also about safeguarding people’s health. The provider reinforced this expectation during team meetings and spot checks, making it a standing agenda item to maintain high standards of cleanliness and safety, however issues identified in spot checks were not always followed up. For example a spot check identified that a staff member was wearing inappropriate footwear but this was not followed up.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning their medicines support, including when changes happened.

People told us staff provided good support for them to take their medicines. Staff had completed training in the safe management of medicines and leaders regularly observed their practice through spot check visits. These and medicine audits ensured staff knew how to dispense and administer medicines safely.

Medicines errors were appropriately recorded and escalated in line with the provider’s policies and procedures. Each person had a comprehensive medicines risk assessment, body maps for emollient application and clear guidelines to support safe administration. Medicine Administration Records (MAR) showed all prescribed medicines, including topical creams, were administered as required. This ensured people received the correct medicines at the right time, promoting safe care delivery.