Health & Alliance 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. This is the first assessment for this service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always have a proactive and positive culture of safety based on openness. They did not always identify concerns about safety and therefore did not always investigate and report safety events. People did not have risk assessments based on known medical needs. For example, those living with diabetes did not have a risk assessment in place to guide staff on how to safely support them. The provider, management team and staff did not report or act on the lack of such assessments putting people at the risk of avoidable harm.

The service did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always manage or monitor people’s safety. They did not always make sure there was continuity of care. For example, we saw a specific request from 1 healthcare partner directing the management team to complete a specific assessment regarding a person’s skin health. This assessment had not been done for this person and there was no alternative assessment or explanation why this had not been completed. This put the person at the risk of avoidable harm as specific tasks directed by healthcare professionals had not been completed, potentially hampering this person’s transition between healthcare services.

The service worked with people to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. People told us they felt safe with the staff supporting them. One relative said, “[Person’s name] feels really safe with them (staff) and really looks forward to their company.” Staff had received training in safeguarding and knew what to do if they suspected abuse including how to contact the police or the local authority to keep people safe.

The service did not work well with people to understand and manage risks. They did not provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Known risks to people had not been assessed or mitigated. For example, 1 person had been identified as being a medium risk of falls. There was no risk assessment explaining how this conclusion had been reached. There was no plan in place on how to support the person safely or what actions needed to be taken on how to reduce the risk. This put people at the risk of avoidable harm. However, despite our findings everyone told us they felt safe with the support provided. One relative said, “[Person’s name] feels very safe and talks very highly about the carers.”

The service did not always detect and control potential risks in the care environment. They did not make sure that equipment, facilities and technology supported the delivery of safe care. People did not have comprehensive assessments of risk based on their known individual needs. For example, those at the risk of potential skin breakdown, risk of falls and specific medical conditions did not have risk assessments in place to direct staff on how to safely support them. Those with a sensory impairment or restricted mobility did not have assessments of their physical environment, including, but not limited to the risk of trips or falls, scalding from hot water or burns from hot surfaces. This put people at the risk of avoidable harm. Although people remained responsible for their own home environment, assessments for the provision of a regulated activity, the service did not account for these risks or advise the person on how to maintain a safe environment for the delivery of personal care.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. People and relatives told us staff arrived when expected and stayed for the agreed amount of time. One person said, owing to recent floods in the area the staff were late, but they had phoned ahead explaining the delay. They went on to say this update was reassuring.

The service assessed and managed the risk of infection. Staff had received training and had access to equipment such as gloves and aprons if needed. One person said the staff always wore protective equipment and disposed of waste safely.

The service made sure that medicines and treatments were safe and met people’s needs and preferences. They involved people in planning, including when changes happened. People were supported with their medicines by trained and competent staff. One person told us staff helped them get their own tablets from a safe box and made sure they were taking the correct ones at the right time. They went on to say the staff recorded this in their records. People had medication administration records which recorded what people’s medicines were, how much and when. These records were checked by the management team to ensure people received their medicines safely and as prescribed.