Highgate Home Care Also known as Willerby Office

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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Managers reviewed incidents through regular care manager meetings and lessons‑learnt processes, which were used to identify themes and improve practice. Where staff breached professional boundaries, necessary and proportionate action was taken.

The provider worked with people and professionals to maintain continuity of care, including when people moved between services. Electronic systems supported rota planning, late‑call monitoring and electronic medicines administration records (eMAR), enabling managers to track visits and alerts in real time.

However, safety systems were not always effective. We identified gaps in care records, including one person receiving care without a completed risk assessment. These omissions meant staff did not always have complete or up‑to‑date information at the point of care. However, we found no harm had occurred to people. The registered manager took immediate action to address these concerns.

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 and relatives told us they felt safe and spoke positively about staff and managers. Records showed safeguarding concerns were investigated, referrals made to the local authority when required, and outcomes monitored through a central log that also tracked medicines errors, missed calls and lessons learnt.

The provider did not always work well with people to understand and manage risks. However, staff were able to provide care which met people’s needs, and was supportive and enabled people to do the things that mattered to them.

People and relatives described being involved in day‑to‑day decisions, and staff liaised with families and professionals when they noticed changes, for example deteriorating mobility or concerns about home conditions. Staff told us they would contact the office or professionals to review packages when risks changed. However, there were gaps and inconsistencies in how risks and people’s involvement were documented. For example, some risk assessments were missing or incomplete, there was no specific risk assessment for flammable topical creams and specialist guidance was not always reflected in care plans. It was not always clear how people or their representatives were involved in understanding and managing their risks. This meant there was an increased risk staff did not have the correct information when delivering care.

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 used audits and risk assessments to monitor environmental safety, and staff escalated concerns so these could be addressed with families or professionals. Equipment, including hoists and specialist devices, was subject to servicing and checks, with evidence of joint working with occupational therapists as people’s needs changed.

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.

Recruitment checks were completed, supported by an electronic vetting system, and managers used audits to monitor supervision, appraisal and spot checks.People and staff told us all scheduled care calls were allocated to named care staff and continuity was prioritised. Staff described a supportive team culture and said on‑call and managerial support was available when needed.

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.

Staff had access to personal protective equipment (PPE) and people told us this was used appropriately.Care plans and risk assessments considered infection risks, and staff described how they maintained hygiene and used equipment safely during visits. Audit processes included checks on PPE availability, equipment servicing and environmental cleanliness.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

There was a structured process for building and checking electronic medicine administration records (eMARs), including competency assessments for care managers and scheduled medicines audits. Staff described how the electronic system helped them see which medicines were due at each call and generated alerts for late or missed doses. Records showed staff contacted the office or health professionals when they had concerns. Despite these systems, we identified discrepancies between eMARs, medicines care plans and risk assessments. We also found a lack of information about where topical creams were prescribed to be applied and (as‑required) protocols that were incomplete or ambiguous about dose and indications. This meant there was an increased risk staff did not have the correct information to administer medicines safely.