Vestra Homecare Sunderland

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• 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

This is the first inspection for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

The registered manager had effective systems in place to identify and act on safety incidents, accidents and other events. They learned from incidents and ensured staff were supported to reflect on any errors. They worked well with staff, people and partner organisations to maintain safe care. Risks were explored from the outset and acted on to reduce them.

Staffing levels were consistently safe through proper planning and ongoing recruitment, training and supervision.

Medicine management was safely maintained and regularly reviewed. The provider had a range of policies and procedures to ensure safety around core topics such as mental capacity, safeguarding, infection prevention and control and lone workers.

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.

People were involved from the start regarding how their care should be planned and delivered to reduce risks and to build on staff knowledge. One relative said, "They checked everything with us before we started – they were very thorough."

The registered manager and nominated individual ensured lessons were learned from incidents, whether they occurred locally or in one of the provider’s other services. They also proactively shared safety information that came from other sources, for instance national alerts about specific risks.

The registered manager understood the importance of reviewing quality and performance to identify emerging risks before they grew significant. They were responsive to our feedback about minor improvements to the auditing of care logs.

People felt safe and had every confidence in staff doing the right thing to keep them safe. One person said, “They never send anyone inexperienced, and they know what they are doing. No complaints at all.”

The provider had a range of policies and procedures to ensure there was a consistent approach to understanding risks. People’s safety was a priority, and this was evident in how the provider planned care calls, travel time, leave arrangements, training and communication.

External partners praised the service for their proactive approach in making sure people’s needs were met and they got the right treatment they needed. One external professional said, “They were very responsive when the request went out and they worked in collaboration with commissioning, social work and others, ensuring that assessments were carried out and care plans and risk assessments put in place to enable people to have a smooth transition of provider.”

The registered manager ensured care plans were sufficiently detailed and up to date. Where there was an opportunity to improve risk assessments in line with best practice, the registered manager was responsive to feedback.

The registered manager and other leaders took steps to ensure people’s immediate safety was paramount. For instance, in the previous year the service had suffered a cyber-attack, meaning staff access to care records was compromised. Leaders acted quickly, and through the night, to ensure staff had access to people’s care information in an alternative format and that no one missed a care call.

People raised no concerns about their safety and relatives gave positive feedback about how confident they were in the service. One relative said, “I have no concerns regarding safety. I sleep well at night knowing they are coming in to see to [person]. It’s great for peace of mind.” One person said, “I feel very safe, and they can’t do enough for me.”

There were a range of appropriate policies and training in place to support safeguarding. The provider ensured people and relatives were sent information leaflets about what areas of risk they may face, and how best to prepare (for instances, scamming risks and adverse weather risks).

Staff were well trained in safeguarding principles and acted effectively when there were any concerns.

There were effective systems in place to monitor risks and to update care plans and risk assessments when required. Risk assessments were detailed, person-centred and effective. Where there was scope for improvement, the registered manager was responsive to our feedback. For instance, diabetes care planning needed improvement, and this was actioned immediately.

People’s independence and right to choose was respected, so that safeguards were never restrictive. People and their relatives were involved in designing how their care could be planned in the safest way. Some relatives particularly valued the fact they could access their loved one’s care records remotely, via the electronic care records system. This gave them peace of mind regarding people’s safety.

Staff proactively raised concerns and worked well as a team to share information and escalate any concerns.

Risk assessments of people’s environment formed a key part of initial assessments. These had regard to people’s and staff safety.

The provider ensured the right professionals were involved if there were environmental factors or equipment that needed particular advice or training. One relative said, “The Occupational Therapist (OT) came out with two of the carers because the OT had changed the slings. It’s all written down in the book.”

People and relatives confirmed how respectful staff were and how they ensured people’s homes were left tidy and clean.

People and their relatives were complimentary about the reliability of staff. One person said, “They are on time and they stay for how long they say, sometimes more – they always make sure I am okay.” Another said, “If there is an occasional delay they will always let me know – the office staff are great.” One relative said, “There is a rota which we get. They come on time and we get the same group, which is brilliant.”

The provider’s online care records system meant family members could log in and see rota planning in advance. One relative said, “I have the online app so I can look at the rota and I can tell mum who is coming – really helpful.”

The staffing mix was strong, with a good proportion of experienced staff and good levels of retention. The provider worked hard to retain staff and had a range of staff wellbeing and reward initiatives in place. One staff member said, “The 3 day induction massively helped me get started in care, it covered everything I need to know.” All staff we spoke with said they had confidence in the leadership.

The provider ensured there were a range of appropriate pre-employment checks and new staff went through a comprehensive induction package. This included face to face training, shadowing and competence checks.

The provider was responsive to feedback about potential ways to include people who used the service in recruitment moving forward.

People and their relatives raised no concerns about infection control. They said staff used Personal Protective Equipment (PPE) when needed and maintained good hand hygiene and food preparation practices.

Staff received Infection Prevention and Control training as part of their induction. They confirmed there was always ample PPE for their needs.

The provider had policies and procedures in place to reduce the risks of people and staff catching and spreading infections.

People’s medicines were managed in a safe manner. The registered manager maintained close oversight of medicines administration records to identify any errors or patterns. They had rolled out an electronic records system which made the administration of medicines safer.

People and relatives had confidence in staff. One relative said, “They give him medication and get him dressed for the day. I can’t praise them enough. They are a really, really good care agency.”

Staff received regular competency checks of their practice to ensure they were safe and confident. The provider’s policies regarding medicines were up to date and in line with good practice.