Honest 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 requires improvement. At this assessment the rating has changed to 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

We found the management team were open and transparent and wanted to drive improvement at the service. Accidents and incidents were reviewed and lessons learned were completed which were shared with the staff team through team meetings and discussions.

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.

Partners told us the service worked well with them. One professional told us, “Honest Home Care are an exceptional care agency to deal with. The staff are quick to respond to emails and telephone calls. They are experienced in service user care plans, times of visits and their current needs. They are prompt to report any issues but are also resilient in working through issues.”

The provider was transitioning from paper care records to an electronic system. This was being completed in a planned way with paper records remaining in place whilst information on the electronic record was being completed. This ensured staff had sufficient guidance to support people appropriately and mitigate risk.

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.

Overall people and their relatives told us they felt safe with the support provided by Honest Home Care. One relative told us, “We don’t have any issues about them not being safe. They’ve the right skills to provide the care.” Another told us, “I feel [Name] is safe just by the conversations I’ve had with [Name] and the carers while I’ve been there.”

Staff were trained and understood their roles in relation to safeguarding.Staff told us they knew how to raise a concern and were confident their concerns would be listened to and acted upon. One staff told us, “I’d speak to [Name of Manager] and feel confident in talking about it and know they’ll do something about it.”

Effective systems to provide robust oversight of accidents and incidents including safeguarding’s were in place.

Records showed safeguarding concerns were reported promptly to the local authority and to CQC with follow up actions documented.

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.

The service was in the process of transitioning to an electronic care recording system. Processes were in place to ensure that staff had detailed and up to date information to allow them to support people appropriately and mitigate risks and this was confirmed by staff. One staff told us, “Yes absolutely as always updating (care plans). It gets put on straight away (if anyone’s needs change). It’s all up to date for everyone.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Prior to support starting an assessment of the environment is completed with regular review by the provider to ensure both people and staff are safe. Staff were aware of risks associated with the environment and knew where to find the information to guide them.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always work together well to provide safe care that met people’s individual needs.

We received mixed feedback from people, relatives and staff at the service regarding call times and the continuity of staff. One person told us, “I never knew what carer was coming next. They were always in a rush; they had no time to chat. They turned up so late that I had to wash and dress myself.” Another commented, “Half the time I don’t get the same carers, and they do a lot of running behind.” One staff told us, “I think we could do with more when sickness and things go down. A lot of us feel under pressure as got to cover all clients so get extra work. Could do with a few more staff.” Another commented about not having sufficient travel time for some calls, “I feel we need the proper travel time for the clients to have the call and call times allocated to them.”

We reviewed the electronic records of support provided and noted issues with the recording of call times, unlogged calls and overlap times for double handed support. We discussed this with the provider who advised of some system issues. Documentation was provided which explained the issues noted and also evidence of call monitoring. However, the provider acknowledged that recent high sickness levels had affected call times and continuity. We advised they review options to assist with staff deployment during busy times as well as addressing system issues to allow clearer oversight.

Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. However, it was noted that a record of follow up was not always recorded where references were not provided by previous employers. The employment history for candidates also did not always provide sufficient detail or include information from leaving school. The provider agreed to action this immediately.

Staff told us they felt supported, were receiving supervision and felt the training they received allowed them to be confident in carrying out their role. One staff told us, “Yes feel comfortable with everything we do. We have a client who is peg fed and as soon as (the service) set up we had training so comfortable and confident in doing it.” The provider was in the process of implementing new training options to facilitate more flexible training for staff and provide more face-to-face training. Once implemented this would address some of the current training difficulties and address staff requests for more face-to-face training.

People and their relatives overall felt that staff had the relevant skills and training. One relative told us, “The staff all seem trained.” A person told us, “I’ve not discovered any reason to doubt their training.”
 

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 received training in infection control and no concerns were raised by staff about the availability of personal protective equipment (PPE).

People and their families also raised no issues with the management of infection. One person told us, “They’re all clean and neat. They wear uniform and PPE.” Another told us, “They do wear aprons, gloves and tunics and when they get a cold they put on a mask.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff were trained in medicines administration, and their competency had been assessed. People were supported by staff who followed systems and processes to administer, record and store medicines safely.

Overall people and their families raised no concerns about medicines. One family member during the inspection raised that staff were unable to administer paracetamol. This was discussed with the family member and processes put in place as indicated by the providers policy to allow staff to administer this safely.