Lima Homecare 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 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 positive and proactive safety culture that promoted openness and transparency. Staff demonstrated an understanding of their responsibilities to raise concerns about safety and incidents. Concerns were listened to, appropriately investigated, and reported in line with agreed processes. The provider used learning from incidents and near misses to inform improvements and embed safer practice.

People and staff were supported and encouraged to escalate concerns about risks to safety and demonstrated confidence in doing so. The provider investigated concerns and shared learning with staff through newsletters, targeted ‘lessons learned’ communications, and meetings. This supported continuous improvement and helped reduce the likelihood of similar incidents occurring. The management team recognised the importance of strengthening assurance arrangements and told us they were developing systems to check that key learning and messages were consistently received and understood by staff.

The provider worked with people and relevant healthcare professionals to establish and maintain safe systems of care. Staff followed agreed processes to monitor and manage risks, which helped to ensure continuity of care, including when people moved between services.

There were effective arrangements in place for partnership working with external professionals. Stable systems supported joined up working and positive professional relationships, which helped to promote safe care and coordinated decision making. External professionals provided positive feedback about the service’s approach to multidisciplinary working and advocacy for people.

Governance systems supported safe transitions, with professional advice, actions taken, and outcomes recorded and followed up appropriately. People were involved in decisions about their care, and care plans were reviewed and updated to reflect any changes in need following transitions, such as admission to or discharge from hospital. This helped to ensure people received safe and continuous care.

The provider worked in partnership with people and relevant professionals to understand what being safe meant to individuals and how this could be achieved. Staff supported people to live safer lives while promoting their rights to be free from abuse, bullying, harassment, discrimination, neglect and avoidable harm. Safeguarding concerns were recognised and shared appropriately with the relevant agencies in a timely way.

There were effective safeguarding systems in place. The provider had clear policies andprocedures, and staff had completed safeguarding training appropriate to their role. Staff demonstrated a good understanding of different types of abuse and knew how to escalate concerns. Safeguarding records showed referrals, actions taken and learning identified.

People and their relatives told us they felt safe when supported by staff. People were involved in decisions about how to keep themselves safe, in ways that respected their independence and preferences. One person said, “I do feel more than safe. I have full confidence in the carers’ abilities. I can’t fault them - certainly, no abuse of any kind.”

The provider worked with people to understand and manage risks in a holistic way. Staff supported people to receive care that was safe and responsive, while enabling them to do the things that mattered to them. Risk management approaches focused on promoting independence and choice, alongside safety.

Risks to people were identified, assessed and kept under review. Care plans and risk assessments reflected people’s individual needs and preferences and supported positive risk taking. Staff worked with people to agree how risks could be managed in a way that respected their routines and abilities. One person told us, “I can tell them my routine. They are trained to let me go upstairs first, which is safe for me to do, and for them.”

There was effective oversight of risk. The service used an electronic care record system which enabled managers to share critical updates with staff in advance of visits. This supported staff to respond to changes in people’s needs and provide safe care in real time. Staff understood their responsibilities under the Mental Capacity Act. Where people had capacity, staff respected their right to make unwise decisions, ensured risks were explained, and escalated concerns appropriately when a person’s well-being was at risk.

The provider detected and controlled potential risks in the care environment to help ensure people received safe care. Risks within people’s home environments were assessed and reviewed. The provider used structured assessment tools to capture environmental risks, such as access arrangements, utilities, smoking, pets, hoarding, use of oxygen and lone working considerations. Where risks were identified, measures were put in place to reduce these and reviewed as people’s needs changed.

Care records showed staff took proactive action when environmental risks were identified. This included providing fire safety reminders, using appropriate personal protective equipment, ensuring safe disposal of continence waste and escalating concerns when risks increased, such as following a hospital discharge where people were at higher risk of falls. These processes supported staff to respond effectively and maintain safe environments for people receiving care.

The provider ensured there were enough suitably skilled and experienced staff to support people safely. Most people gave positive feedback about staff skills and competence. One person told us, “They [staff] all seem to be well trained to look after me; I never feel unsafe.”

Staff received up to-date training through a mix of online learning and practical sessions. Competency assessments and follow-up checks were used to confirm staff could carry out their roles safely. Staff told us the training was relevant and supported them in their work. New staff completed an induction programme before working independently, and all staff received regular supervision to review their practice and maintain safe care.

The provider completed appropriate recruitment checks before staff commenced employment. Managers responded promptly when a one-off gap in recruitment documentation was identified. Recruitment checklists were reviewed and updated to ensure they aligned with legal requirements, supporting safe and effective staffing arrangements.

The provider assessed and managed the risk of infection effectively. Systems were in place to identify, reduce and control the risk of infection spreading.

Personal protective equipment (PPE) was readily available and used appropriately. Staffreceived infection prevention and control (IPC) training, and competency checks to support safe practice. Leaders reinforced IPC expectations through regular communication, including guidance on safe waste disposal. Care plans included clear, task specific IPC guidance such as hand hygiene, use of PPE and cleaning procedures. Audits were completed to monitor compliance with IPC practices and identify any actions needed.

Staff demonstrated good knowledge of IPC and described how they applied this in practice. One staff member told us, “PPE is worn every time when giving care and is changed after personal care before preparing meals to avoid infection. It is always available, and we receive training on how to put it on and dispose of it safely.”

People confirmed staff followed good IPC practices in their homes. One person told us, “Yes, they always wear PPE.” Another said, “There is good hygiene in the kitchen and staff wear aprons.”

The provider supported people to receive their medicines safely and in line with their individual needs, capacities and preferences. People were involved in decisions about how their medicines were managed, including when changes occurred.

Where the service administered medicines, effective systems were in place to ensure medicines were given as prescribed. People told us staff supported them appropriately and responded when they were unwell. One person said, “The carers check that I have taken my medication and react appropriately if I am not well.”

The service used an electronic medicines administration system (eMAR), supported by PRN (as required medicines) protocols and routine audits. Alerts prompted staff to record reasons for non-administration, and managers provided oversight through audits and communications to ensure records were accurate and up to date, including for topical medicines.

Staff received medicines training appropriate to their role and were regularly observed to ensure safe practice. Records were monitored so any concerns could be identified and addressed promptly. Where errors occurred, these were reviewed and actions taken to support learning and reduce the risk of recurrence.