Allestree Health & Homecare Services

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 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. The service operated with an open and honest culture and staff followed clear procedures to report any accidents or concerns. Prompt action was taken when needed to help implement any changes that would promote people’s safety further. A member of staff told us, “The managers want and encourage us to share any concerns, even if they are little ones, and they will get it sorted, and we can discuss things and contribute our opinions on how it can get better.”

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. Procedures were in place to help share important information about people’s care needs and preferences with other health care professionals when needed. For example, information was shared when a person needed to go into hospital. This helped ensure continuity of care for people. People told us they experienced the same level of care from different staff members. They told us, “All the staff work well, they are consistent, and all know how to help.” Staff told us they would help identify if people needed any referrals needed for more support. For example, a member of staff told us they would notice if they thought a raised toilet seat would benefit a person and would inform the office so a referral could be made.

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. Leaders and staff had acted to promote people’s safety by making appropriate safeguarding referrals. Staff were knowledgeable on how to identify potential abuse and how to report any concerns. Everyone we spoke with felt safe and felt comfortable to raise any concerns with staff and leaders. People did not have any unnecessary restrictions placed on them and leaders had guidance to follow should a person not understand any decisions regarding their care.

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. Actions were taken to involve people in how any risks associated with providing care could be reduced. For example, 1 person told us, “They do work with safety in mind, every morning the carer will check to make sure my heel is in my slippers properly.” A relative told us how leaders had re-assessed a person after they returned home from hospital, along with some new mobility equipment they were now using. Emergency healthcare services were contacted when needed and relatives were informed of any emergency situations and how they were managed. These actions helped to ensure people were involved in managing risks.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People’s homes were assessed to ensure their care could be provided in a safe way. A person told us, “The manager pointed out risks when they first started and there is not much need now as we dealt with any risks at the start. Staff are aware of risks as they work as well.” Care plans identified where people used a personal alarm system that they could activate should they fall. Staff recorded in people’s daily care notes that they had left people with their personal alarm pendants when they finished their care call. These actions helped to ensure safe environments for people.

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. Staff providing care were reliable and people spoke highly of them. One person told us, “Staff always turn up. I have a good working relationship with them all. If they are late, and that is unusual, they always call to say we will be with you in 10 minutes. I can’t fault them.” A relative told us, “Staff are kind and caring and they try and keep the staff team consistent as they are living with dementia and so the staff all know them well and know their likes and dislikes. They double up their new staff and really explain to them people’s likes and dislikes and how they usually are. They’ve all put the effort and work in, they’ve kept the company small and use regular staff.” Leaders only agreed to care for new people if they had the staff available to support them. Leaders had additional members of ‘bank’ staff who did not always work regular hours however they were familiar with people and were there to help cover holiday periods and any staff shortages due to illness. This helped ensure people continued to receive care from staff that knew them. Leaders completed recruitment checks and interviews to appoint staff who could demonstrate the values needed to work successfully in care. Staff received support and relevant training. Training included practical based training for medicines, moving and handling and further training for specific areas of care such as stoma care.

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 understood when and how to use personal protective equipment; people and relatives confirmed this. Leaders ensured staff were regularly trained in hand hygiene and food hygiene and had up to date infection prevention and control procedures for staff to refer to and follow.

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. Medicines were managed in line with good practice guidelines and people received their medicines when prescribed. Staff understood how to reduce any risks associated with medicines and kept records of any medicines administration. Occasionally, when people had a new medicine prescribed, this had been added onto the medicines administration record by hand. Whilst people had not been negatively impacted by this, we discussed this with the registered manager as it is good practice for the handwritten entry to be checked by another member of staff for accuracy. The registered manager took action to implement a second check on handwritten medicines records during our assessment.