Chesterfield Home Care Ltd Also known as Home Instead

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 75 (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.

Safety concerns were reported, recorded and investigated. Records showed immediate actions were taken to ensure safety, and mitigate risk when things went wrong. For example, seeking appropriate healthcare advice. Leaders reflected on incidents and used these as opportunities to drive improvements in practice.

Staff demonstrated confidence in reporting accidents and incidents. One staff member told us, “I can raise a concern using the [care planning] app, or alternatively I could send an email or ring the office to report my concerns.”

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.

People were supported to transition into the service safely and in a planned manner. A robust onboarding process was in place to ensure all relevant documentation, assessments and support arrangements were completed as people started using the service.

The provider also utilised a, ‘skills matching’ approach, where the experience, skills and personalities of staff were considered when matching them with people using the service. This helped to promote positive relationships and ensure individual needs and preferences could be met effectively.

People and their relatives spoke positively about their experience of transitioning into the service. One relative told us, “Yes, I had a good phone conversation with them beforehand, and then they came out to speak with both me and [person] to make sure they were happy. The care plan was completed during a separate visit. During the first visit, they provided a brochure and, once we had agreed to use the service, another member of staff came out and carried out a very detailed assessment. I have a copy of it and can also access the care planning app.”

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.

The service worked with safeguarding agencies to ensure people were protected from the risk of abuse. Staff demonstrated a sound knowledge of the provider’s safeguarding policies and procedures.

People and relatives felt safe using the service, knew how to report concerns about safety and felt assured action would be taken. One relative told us, “[Person] feels very safe with them. I think [person] would speak to me if they were not happy for any reason. [Person] has never needed to do that.” Another said, “I would speak to the manager about any concerns.”

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.

People's risks were identified, assessed and reviewed. Staff had sufficient guidance to support people’s risks safely and consistently. Care plans reflected guidance from relevant professionals. For example, a care plan for a person with swallowing difficulties had detailed choking risk assessments in place, supported by information from speech and language therapy (SALT). Recommendations were reflected in care records and implemented in practice, including the use of appropriate equipment, dietary modifications and adapted support strategies.

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

Risks in people’s environment were identified and assessed. This included use of specialist equipment and aids. People and relatives confirmed staff used equipment safely and were respectful of people’s homes. During routine observations of staff practice, consideration was given to environmental factors that could impact on people’s safety, comfort and wellbeing. This included issues such as lighting, trip hazards, noise levels and the overall home environment, helping to promote safety and comfort.

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.

Analysis of care call times showed good punctuality. Additionally, people and relatives told us care calls were generally reliable and delivered by familiar staff. Where delays occurred, people said they were usually informed.

The provider aimed to ensure people were supported by a consistent team of staff who knew them well. The service used a matching process to help ensure compatibility between people and the staff supporting them. One person told us, “I think that’s one of the great things about that company. They have always made sure [person] only sees 4 or 5 different carers.” Feedback from people and relatives consistently reflected the benefits of this continuity of care.

Staff were appropriately trained to carry out their roles safely and effectively. Training records demonstrated good levels of compliance, and staff spoke positively about the learning opportunities available to them, telling us training delivery met their learning styles. One staff member told us, “I did receive sufficient training. In any area of concern I felt I was able to ask questions, and I was supported with information as well as support. I have had a wonderful experience of training with the training team; they have made my learning journey interesting.”

Staff received ongoing support by way of regular supervisions, appraisals, observations and competency assessments. They were also encouraged to maintain and develop their skills, with opportunities to strengthen existing roles, or create ones aligned to their strengths, interests and career aspirations. This demonstrated the provider's commitment to developing a capable and confident workforce.

Safe recruitment processes were in place to help ensure staff were suitable for their roles before commencing work.

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 were protected from the risk of infection as staff followed best practice guidance in relation to IPC.This included safe use of personal protective equipment. One person told us, “[Staff] change to gloves when they are preparing our meals. Staff are always particular about hygiene.” Relevant policies and procedures were in place to support IPC.

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.

Systems were in place to support the safe management and oversight of medicines. Care records contained relevant information about people's medicines, including the level of support required, the types of medicines prescribed and any specific instructions for administration. Medicine competencies were carried out routinely, to ensure staff practice remained safe.

We received feedback regarding a recent medicines error. We discussed this with the provider who confirmed that this was already under review and immediate actions had been taken to ensure safety.

Other feedback confirmed satisfaction with how medicines were managed. One person said, “Carers understand that when [person] has taken their medication, they must have their meal at a specific time.” And, “I have pressure stockings and they put those on, put cream on my legs as well and will take the stockings off. No issues, I am very satisfied.”