At Home Support Services Limited

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

Systems were in place to protect people from the risk of abuse and harm. People's support needs were risk assessed and care plans provided staff with the information they needed to manage the identified risk. Staff had regular training opportunities and training specific to people's individual needs was provided. People received their medicines as prescribed. Infection control policies and procedures were in place to keep people safe. The provider recruited staff safely. We made a recommendation about monitoring staff deployment.

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.

People were supported by staff who knew and understood their needs. People told us staff were aware of their likes and dislikes. People and relatives were involved in the development of care plans and reviews. People and their relatives felt the service listened to their concerns and worked to resolve them. A person told us, “I complained about too early a visit at night. It’s been resolved and the carers come later. They (managers), listened to me.”

Staff knew how to report accidents and incidents. They told us there were regular opportunities, such as meetings and supervisions, to discuss issues and improvements. A staff member said, “I am aware of the process to follow if someone has a medical emergency or a fall. I would call for medical assistance, call the person’s relatives if present and would ensure person is safe. I would inform the office as well and complete an incident form as required.”

Accidents, incidents and safeguarding concerns were clearly recorded. There were regular staff meetings, including office staff and care workers meetings, during which lessons were discussed and shared; meeting minutes confirmed this. Following meetings, relevant guidance (e.g. IPC awareness, managing people’s health, service improvement etc.) were sent to staff by email to promote learning and improvement.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives told us the agency provided safe care. Everyone we spoke with said the agency staff were very good and did their job well. One person said, “I feel safe. I didn’t like one carer and I reported her, and the office listened, and she hasn’t been since.” A relative told us, “The carer understands him [person]. We always have a chat before they take him out and a debrief when they return.”

The registered manager and staff had a good understanding of safeguarding. Staff could explain different types of abuse and what signs and symptoms to look out for. Staff told us if they suspected or witnessed any form of abuse they would report it to the manager. The registered manager told us that safeguarding was a regular topic at team meetings and supervisions.

The provider had a clear process in place to safeguard people against abuse. Staff received training in safeguarding, this meant they were able to notice any concerns and report them to their managers. There were safeguarding and whistleblowing procedures in place. This meant staff had guidance to use if needed.

People and relatives told us they felt safe with the care and support they received. One person said, “I have observed the carers working. They are very mindful of pushing him through the doorway as he can catch his arms on the doorframe.” Risk assessments were person-centred and covered a range of areas, including people’s health, mobility, catheters, choking, pressure ulcers and behaviour.

Staff told us risk assessments provided them with clear information about the risks people faced and how to manage them safely. Staff were confident about reporting any concerns about people's safety.

Risks to people's personal safety were assessed, monitored and managed effectively. The provider had a business contingency plan in place which provided information and guidance on actions staff should take in emergency situations.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We received mixed feedback from people on timekeeping. Some people and relatives told us, “Time keeping is very good. Fits in with me. Times are convenient for me” and “Timing okay, they stay the allocated time. Male and female Carers. I was given a choice.” Other people and relatives told us about instances of lateness and timekeeping issues and care workers were in a rush when they visited. For example, comments included, “Sometimes early, sometimes late Sometimes they call me, not always. I will phone them and then they find out what happened. Eventually they turn up” and “Always in a hurry. Don’t stay allocated time but always ask if there is anything else to do.”

Management told us they recently implemented the use of an electronic monitoring system and they experienced some teething problems. They reassured us this was now under control and there were measures in place to ensure a smooth transition. Staff members confirmed they received their rosters in advance and were allocated travel time.

We looked at 529 calls for 32 people. Of 529, 10 were delivered within 15 minutes and delivered on time. Average lateness was 36 minutes. 519 calls were more than 15 minutes late. There were 0 missed calls and 177 short calls. A short call is when less than half the planned time is delivered. We gave the detailed information to the registered manager so that they could look into the concerns and address them. We recommend the provider review their monitoring systems to ensure staff are effectively deployed and to ensure the timeliness of calls in accordance with best practice. Staff were safely recruited. The registered manager carried out checks to ensure staff were suitable to work with vulnerable people. Pre-employment checks included references from previous employers and Disclosure and Barring Service (DBS) checks.

Safe practices were followed to help prevent the spread of infection. People and their relatives told us staff used and disposed of personal protective equipment (PPE) safely. Comments included, “Carers wear gloves, aprons and covers on their shoes.”

Staff knew how to reduce the risk of infection and they followed good practice guidance. They used personal protective equipment (PPE), such as disposable gloves and aprons, to help prevent the spread of infection. Staff members said, "We have regular training and the managers keep us updated.” And “We wear correct PPE and follow correct guidelines, for example, washing hands and changing gloves between activities.”

Staff received training in infection prevention and control (IPC) and the use of personal protective equipment (PPE) and they were provided with up-to-date government guidance. The registered manager carried out spot checks to assess staff knowledge and practice in this area.

People received their medicines by trained staff as they had been prescribed. One person told us, “Carers give the medication from the boxes. They put them in a lid and then into my hand. I order my medication. I am happy with the system.”

The registered manager told us staff were trained, and their practice monitored to ensure it was safe. Competency assessments took place to help make sure that their medicine administration practice was safe. Regular spot checks took place which included a medicine observation.

Processes were in place to ensure people received their medicines safely and as prescribed. People’s medicines support needs for their individual medicines were assessed and recorded. Care plans described how staff would meet people’s needs to take their medicines safely. Records of medication administered were accurately maintained. Medicines records were regularly audited, and appropriate action was taken if any shortfalls or errors were identified.