Highlands Care Solutions

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 72 (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. The provider encouraged staff to listen to concerns, investigate incidents, and report safety events. Lessons were regularly identified and embedded into practice to improve service delivery. People, their families, and staff felt confident raising issues, expressing that their concerns would be addressed appropriately by the provider.

Leaders maintained effective oversight over incidents, accidents, and complaints, using feedback to inform and drive improvements. One staff member shared, “They do give feedback … and you change what you do based on the feedback.” Another staff member noted that supervision provided an opportunity to reflect, stating, “During supervision, we get some help where we debrief about the incident, and the care plans detail how and what to do.”

A key aspect of this commitment was a clear and robust complaints procedure, ensuring complaints were thoroughly investigated and reported with transparent communication throughout. Learning from complaints, incidents and concerns was viewed as an opportunity for growth, with staff and leaders providing examples of how insights from incidents had directly influenced improvements. For example, a change to a policy in relation to planned staff absences in response to feedback. This demonstrated how the provider had developed and improved their service.

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. The provider ensured care was organised flexibly, with adjustments made to meet people’s changing needs. This included when their health needs changed or when they were admitted to or discharged from hospital. This helped to promote continuity of care for people.

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 their families told us they felt people received safe care and support from staff. Staff demonstrated a good understanding of safeguarding procedures and understood how to recognise signs of abuse. The provider had effective policies and procedures in place around safeguarding. Leaders demonstrated a thorough approach to investigating safeguarding concerns to help reduce the risk of people being subject to abuse or coming to avoidable harm.

The provider worked with people to understand and manage risks. On the whole, people and their families confirmed safe practices were followed and the care staff provided to meet people’s needs was safe, supportive and enabled people to do the things that mattered to them. People’s risk assessments were detailed, and staff were aware of the identified risks for people and the measures in place to manage those risks. For example, in relation to diabetes and epilepsy. Staff demonstrated their knowledge about people’s healthcare needs and the support needed. Such as support needed in the event of a seizure, fall or choking incident. The provider had effective systems to monitor care call times and durations, care tasks completed and medicines administration. This helped leaders to have real time oversight and pro-actively identify issues or concerns related to care and take appropriate action.

The provider detected and controlled potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. The provider carried out assessments of people’s home environments to identify and reduce risks relating to the delivery of care. Staff were able to describe safe use of care related equipment and potential risks they had to mitigate. For example, ensuring the equipment was in good condition and had been serviced. The provider had systems in place to monitor care related equipment to ensure it was maintained appropriately and was fit for purpose. The provider utilised electronic care planning systems and telephone systems to enable them to monitor how care was delivered and helped to improve safety.

The provider had recruitment processes and systems in place to ensure all necessary checks were carried out for new staff and that the required information was available. However, we found full employment histories for some staff had not always been consistently recorded. The provider promptly addressed this during the assessment to reinforce compliance and strengthen recruitment practices.

The provider ensured there were enough qualified, skilled and experienced staff, who received effective support and supervision. Some family members noted that, while staff were well-trained, they provided additional guidance specific to the individual’s health condition and personal preferences to enhance care. Despite this, they remained confident in staff’s skills and competence. People and family members told us the addition of a clinical lead to the leadership team was positive and had further enhanced the training provided to staff. We found staff received training relevant to their role, and systems were in place to promote their ongoing learning and development. The provider championed ‘lived experience training’, which incorporates insights from individuals who have firsthand experience. This supported staff in developing a stronger understanding, informing their practice, and promoting meaningful engagement with people. This approach reinforced the provider’s commitment to compassionate, high-quality care, ensuring training remained adaptable to people’s unique needs.

We found overall, people and their families told us they received consistent staff at the agreed times. Some people and their families told us there were times care calls were not always on time, or for the expected duration, however these were not a regular occurrence. The provider told us there were times care calls could be longer than scheduled where a person’s needs had changed. However, they monitored care calls closely and worked with people to promptly increase or decrease their care calls as necessary to minimise the impact on others.

Staff were supported with regular team meetings, supervisions and checks of their competency and practice. Staff new to the service received an induction. Staff were positive about the induction. One staff member told us, “Only once felt ready was I left to do the care, there was no pressure, it was only when I was ready and signed off.”

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. People and their families raised no concerns in relation to infection control. They told us staff wore appropriate personal protective equipment (PPE) whilst they were providing care. Staff told us there were sufficient supplies of PPE and they had received training in infection prevention and control. The provider had effective infection control policies and procedures in place. This helped to ensure staff were following effective infection control procedures.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The provider had policies and procedures in line with national guidance, which supported staff in following best practice in relation to medicines management, storage and administration. People’s care plans detailed the support people needed to manage their medicines, any associated risks and levels of independence people wished to maintain. Staff were consistent in their awareness of ensuring people were informed about which medicines were being administered and in gaining their consent. Where people were not able to communicate verbally, staff were able to describe how they understood their preferred communication methods. One staff member told us, “Before I administer, I need to seek consent and if they say ‘no meds’, have to record that they didn’t give consent to administer.”

Staff mostly demonstrated a good understanding of best practice in medicines administration, although some staff lacked confidence and knowledge in relation to the disposal of medicines if required. However, they were all consistent in how they would seek support and advice in the correct method for disposing of medicines if required. The provider had effective systems to electronically monitor medicines administration and to promptly update medicines records if people’s prescriptions changed. There was a system to audit people’s medicines records and care plans. This helped to ensure they were accurate, correctly completed and reflected people’s needs.