Home Instead Senior 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 the same. This meant people were safe and protected from avoidable harm.

This service scored 81 (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. There were processes in place to learn from safety incidents and there were opportunities for staff to discuss and learn from these incidents during regular staff and supervision meetings. When incidents had occurred a lessons learnt process was followed which identified what had happened, lessons learned and what actions had been taken.Systematic work was undertaken to understand the sources of risk and causes of safety events. There is evidence of improvements in delivery of care and treatment as a result of learning.

Safety and continuity of care was a priority across this service. Staff and local leaders worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people moved between different services. Staff had an awareness of the risk to people when transitioning to different services throughout their care journeys. Care and support is planned and organised with people, together with partners and communities in ways that ensure continuity of safe care. People and relatives told us they had been part of their assessment planning process and had their needs assessed before they started receiving support. These assessments recorded important information essential for people’s safety so these could be shared with other healthcare partners if required. One person told us, “When the lady (registered manager) first came we made a plan with my relative”. A relative told us, “The plan says what to do and what they want. We discussed with Home Instead about their needs”.

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. All the people and relatives we spoke with told us they felt safe. One relative told us, “They do keep them safe and care for their welfare. They have discussions with them and they are very patient”. Another relative said, “It is safe, definitely. The carers are fastidious to lock up and know what they need with washing and sitting them up properly”. Staff had received safeguarding training and told us they were aware of how to raise any concerns and felt these would be listened to.

The provider worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. People and relatives were involved in their care planning, this was evidenced in people’s care plans. Where risks were posed for people who chose to make specific decisions about their health and wellbeing, these had been discussed with them and documented in their care files. People told us staff had gone above and beyond to support their specific needs. Where other providers had not managed to support them in the past, Home Instead had worked alongside them to help manage their risks and respected their decisions. They told us this had made significant improvements to their life and wellbeing. The registered manager had explored and actioned ways to ensure when people chose to take risks they considered both people and staff safety. Risk assessments had been completed, and where necessary additional safety equipment had been purchased. Risks were reviewed and monitored.

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 carried out environmental assessments to guide staff in the event of an emergency such as gas, electric, or heating problems and carrying out emergency evacuation procedures. The service had a detailed contingency plan in the event of emergency situations such as extreme weather and data loss.

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. The service had recruitment processes in place. Pre-employment checks were completed for staff. These included employment history, references, and Disclosure and Barring Service checks (DBS). A DBS is a criminal record check to ensure the staff member is of good character to work with people at the service. People and relatives told us they were supported by enough staff. Some people told us they enjoyed having regular care staff who knew them well. One person said, “I get 5-6 carers who are regulars. No new people, I’m glad about that” Another person said, “I’ve had the same ones (carers) since I came out of hospital. Regular ones who know me”. All people we spoke with told us the majority of the time staff arrive on time; however, staff can be 10-15 minutes late if they have difficulties at certain times with city traffic. All people told us, when staff were going to be late, they were notified by either the staff member or the office. The provider employed a registered nurse to mentor the care staff and provide ongoing training, raising clinical competence and confidence. There was an electronic monitoring system in place where staff used their phones to log in and out of each visit so the provider could check staff were punctual and stayed for the full amount of time, we reviewed this data as part of the inspection process. The service had a training coordinator who monitored staff training progress to ensure they were kept up to date with training and best practice.

There was a comprehensive system for assessing and managing infection control risks, incorporating policies, procedures, roles and responsibilities, training and monitoring. Local leaders assessed and managed the risk of infection. Staff detected and controlled the risk of infections spreading using individualised risk assessments and appropriate preventative measures. Staff shared concerns with appropriate agencies promptly. Where required people and relatives told us staff supported them with maintaining a clean environment, and this was evidenced in people’s care plans. The service had a policy and procedure in place for Infection Prevention and Control (IPC). A registered nurse took a lead role within IPC, ensuring staff had received training and 'on the job' support.

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. People and relatives told us they received their medicines safely and on time. People had administration charts which were monitored by both staff and leaders to ensure any concerns could be addressed in a timely manner. Medicines incidents were appropriately reported and investigated, so measures could be put in place to prevent a recurrence and learning could be shared. Staff had received training in the safe administration of medicines and had their competency assessed.