Priority Home Care

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 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.

Staff reported concerns appropriately around accidents and incidents and these were fully investigated by the registered manager. Lessons learned were recorded, to prevent safety concerns from happening again.

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.

Pre-assessments were completed prior to people receiving a service and a guide was in place to provide additional support for the transition. People’s information was kept up to date. The providers care planning system enabled paramedics to log in, to access peoples current records.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 did not always identify and share concerns quickly and appropriately.

Staff had completed safeguarding and mental capacity training. Staff had undertaken training in safeguarding to provide them with guidance on types of abuse and reporting concerns. The provider had a safeguarding policy in place, however the registered manager failed to identify and report safeguarding incidents we found during our inspection. This meant the provider did not receive appropriate external challenge and scrutiny to help support and drive learning within the service. At the request of inspectors, the service reported safeguarding incidents retrospectively to the local authority during our assessment.

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.

We found people had been assessed for risks and measures had been put in place to reduce the likelihood of harm. For example, we saw a moving and handling risk assessment was in place and information was available to staff around the signs and symptoms of dehydration for people. We found risk assessments were reviewed regularly. Staff told us they would report any risks to the manager and that they would update the clients care plan and inform staff. Relatives told us, “Absolutely safe as we have been with them a long time and completely trust the registered manager and their team.”

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 had assessed people’s home environment for potential risks. When people’s needs changed, the provider had identified equipment they felt the person would benefit from and contacted professionals, such as Occupational Therapists, to request an assessment. The provider also had policies in place around safeguarding, accidents and incidents and complaints. Staff knew who to report any concerns to.

The provider did not always make sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

Regular staff supervision, spot checks and competency assessments took place. However, staff training did not include all training required to meet peoples' needs safely and effectively. For example, dementia awareness, catheter care, first aid, end of life care, contractures and GDPR and data protection. During the assessment staff completed dementia training and were booked onto death, dying and bereavement and first aid training. Staff had not received training in how to support people with specific health conditions, such as catheter care and contracture care. Even though training had not been completed, we did not see incidents of harm. Relatives told us that people have regular carers who know people well and were confident their loved one was receiving appropriate support. Recruitment records showed staff were recruited safely. This included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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 completed infection control training, and their practice was observed during spot checks completed by the registered manager. Staff told us that there were systems in place to access stock of their personal protective equipment.

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.

The provider completed medicines risk assessments. These detailed the level of support people required and who was responsible for the ordering, collection, administration and disposal of medicines. There was clear documentation around the changes in medicines for people. PRN (as and when required) protocols were not in place during our on- site inspection. However, these were put in place during the assessment. The registered manager provided evidence these were completed and shared a plan to ensure the effects of PRN medicines was reviewed for all service users. People and relatives told us people received their medicines with the support of staff.