Homescare Ltd - Peacehaven

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

People lived safely, protected from avoidable harm. Staff had received safeguarding training and knew what steps to take in the event of an incident. Staff had been recruited safely. There were no records kept of the induction process completed for new staff and some staff told us they had not received all training modules. Staff knew how to report accidents and incidents however there were no processes in place for capturing lessons learned. Errors were found on medicine administration records (MAR). People and their loved ones described smooth transitions between services. Day to day staff managed risks to people. However, some risks had not been identified and some care plans did not have risk assessments in place to advise staff, for example, some people lived with catheters and there was a lack of instruction for staff. The service was clean throughout with plentiful supplies of personal protective equipment (PPE). The service environment was clear of trip or other hazards however there was no evidence to suggest that actions from the most recent fire service inspection had been completed.

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.

People and their loved ones told us that there were good lines of communication between them and the service and if there was an accident or incident that relatives would be contacted. A relative told us, “A week ago, the staff called me to say dad had a fall, they also made several follow up calls, so I was aware of what was happening.”

Staff were confident to deal with incidents and knew how to report when things went wrong. A staff member said, “We are trained to assess needs and we know what to do with falls. Some are very likely to have a fall.” Staff told us they relied on handover meetings to hear about accidents and incidents and that there was no formal de-briefing process in place.

A process was in place for reporting accidents and incidents however there was no system for capturing lessons learned and therefore no means of reducing the likelihood of a recurrence, or analysing trends. Not all injuries and accidents had been reported to the registered manager. For example, some people were known to be at risk of falls and slipping out of bed. Following one fall an injury had resulted that had not been reported. Some people had experienced several falls during their time living at the service but little had been done to find out why the falls were occurring or identify steps to prevent further falls from happening.

All relatives we spoke with told us of a smooth process of transition to the service either from a previous residential placement, hospital or from home. However some relatives told us that they had not been involved in any assessment or review process. Similarly, those who had experienced short stays in hospital told us that the transition process was managed well by the service. A relative said, “Very happy with how the home handled the move, they are settling in nicely.”

The registered manager told us that senior staff were involved in the pre-assessment process. They also told us of positive working relationships with other health care professionals which led to safe and effective transitions and support for people. The registered manager however did acknowledge that people’s loved ones needed to be involved in discussions about people moving between services.

The registered manager had been in post for just over a year and had developed positive working relationships with the local authority and most other statutory partners. Some partners told us that at first the registered manager was reluctant to engage but that this had improved. The local authority were supporting the service with developing their processes and helping with the transitions of people between services. Some of these processes needed time to embed.

Care plans were being reviewed and updated. Care plans did contain details of important contacts for example, relatives or advocates to call in an emergency along with details of key professionals who could support if needed.

People told us they felt safe living at the service. Comments included, “Happy here and safe,” “Yes I do feel safe” and “Yes I’m safe. Staff are kind.” Similarly, relatives told us they felt their loved ones were safe and protected from avoidable harm. One relative said, “She is safe here. When (relative) had their fall they dealt with things and told us what was happening.”

Staff had received safeguarding training and were able to tell us what incidents amounted to a safeguarding and the steps they would then take. A staff member told us, “Examples would be mistreatment, abuse, neglect. I’d report to senior or manager, record everything and make safe.” Some staff were not aware of the whistleblowing process. A policy was in place but staff had not been instructed how to use the process. Whistleblowing ensures anonymity for people raising concerns.

In communal areas, the lounge and dining areas, there were enough staff and we saw them supporting people when needed and responding to any requests they made for help in a timely way. However, when people used the call bell from their rooms these were not always immediately responded to. We observed one call bell went unanswered for 7 minutes.

Safeguarding and whistleblowing policies were in place. The registered manager and other senior staff knew the reporting processes to follow in the event of a safeguarding concern. However, policies were not easily accessible to staff and some staff were not aware of their existence.

People were encouraged and supported to move around the service as independently as possible and to achieve daily tasks. Relatives told us that they felt known risks were generally managed well. A relative said, “Yeah, once they know the situation they are very good.”

Staff knew people well and most were confident to report any changes in people’s needs to senior staff. A member of staff said, “Any changes or concerns I’d tell the seniors. We have handovers and there is enough time to get up to speed.” Some staff however told us that they did not always have the time to catch up with all of the changes with people’s support needs, one saying, “I’ve not read all the risk assessments.”

There were enough staff in communal areas to support people and respond to needs. However, one person who had specific dietary needs and required one to one attention when consuming food, was left alone. This did present a potential choking risk, which was immediately pointed out to staff.

Risk assessments were in the process of being reviewed and updated and the registered manager acknowledged that they needed improvement. Some risk assessments were missing and others only contained very basic information. For example, some people lived with catheters. Although basic information was contained in the assessments, there was little instruction for staff about how to manage if things went wrong. Body maps were used to monitor people’s skin integrity but these too lacked information for example, not showing leg ulcers and sacral sores.

People said that the service was clean, homely and well maintained. A person told us, “I like my room and its definitely homely and warm.” Relatives told us that a lot of work had been carried out and that the service was now clean and well presented. One relative said, “They have done a significant amount of work, new carpets, new furniture, it’s very well maintained.” Another added, “I haven’t got any complaints about the service, plenty of room, nice gardens.”

Staff told us that there was a person responsible for maintenance issues who worked across two sites but would respond quickly to any issues or matters arising that required attention. We spoke with one of the chefs who confirmed that all the daily and weekly safety checks had been completed. Domestic staff were employed and the service was clean throughout.

The service had been recently decorated. Communal areas were free from any obvious trip or other hazards. People’s rooms were homely and contained personal items such as small items of furniture and family photographs. Safety equipment had been checked and was in date. Personal emergency evacuation plans (PEEPs) were in place. These were documented within care plans and a copy also kept in an accessible location for use in the event of an emergency.

A fire maintenance visit had taken place July 2024 and there were several action points the service were legally required to address within certain time scales. We asked for a progress report or update on these actions and the registered manager was not able to provide any details. Some of the dates for completion had passed. Maintenance certificates for example, gas and electrical safety testing and legionella certificates were all in place and up to date.

People told us there were enough staff working each shift however feedback from relatives was mixed. A person said, “There is usually enough apart from when they are on holiday.” A relative said, “From 2pm till bedtime there are only 2 carers on duty. It can impact mum’s care as she needs assistance to the toilet.” Another told us, “Not always enough. (Relative) had an appointment last week. No staff were available to take them to the appointment so it had to be cancelled.” Relatives also expressed concern that some staff had not been fully trained, one telling us, “A lot of them are young 17/18-year-olds just shadowing I’m not sure if they get formal training.”

Staff told us that there was some use of agency staff but only to cover leave and if people required one to one support. This was confirmed by the registered manager. Staff told us that when they joined the service they were given opportunities to shadow more experienced staff and to complete various training modules. Some staff told us that there were some gaps in their training. One had not completed mental capacity training and no staff said they had completed end of life training. Most staff told us they had received a supervision meeting but that these were very irregular.

In communal areas we observed enough staff to meet people’s basic support needs although during lunchtime, interactions between people and staff were minimal. Staff were busy supporting the chef and bringing meals to people. One call bell went unanswered for 7 minutes during the morning.

The registered manager told us there was an induction process for new staff however nothing was documented. We advised the registered manager to keep records of this initial induction and staff support. Most staff had received one supervision meeting in the past 12 months. The registered manager told us they were beginning to diarise these meetings to ensure none were missed. Similarly, although there were staff meetings for seniors and above, carers and support staff had not yet been invited to a staff meeting. Staff had been recruited safely and the correct documents were kept on file. This included the Disclosure and Barring Service (DBS) checks which helped managers make safer recruitment choices.

People and their loved ones told us that the service was clean. Comments included, “Yeah, the home is lovely and clean,” “It’s clean, not dirty” and “Oh yes, the home is clean, anytime I have visited the home is clear of dirt and dishes. If anything the home is too clean no mess anywhere.” Relatives also told us that they saw staff wearing personal protective equipment (PPE) appropriately, one saying, “I have witnessed staff with PPE when tending to other residents.”

Domestic staff were employed at the service and all staff told us that the service was kept clean and any spillages or incidents that required immediate attention, were dealt with straight away. Staff told us of ample supplies of easily accessible PPE.

The service appeared to have been newly decorated and was clean throughout. This included bathroom areas and fixtures and fittings within these rooms were also clean. There were PPE stations on each floor and we saw staff wearing PPE appropriately.

An infection prevention and control (IPC) policy was in place that had been reviewed recently. However the policy had the address of the service sister home on each page of the document. The policy was fit for purpose for this service despite the wrong address not being identified at the recent review.

Most people needed support with their medicines and people and relatives were positive about the support provided by staff. A person said, “They go through my medicines, it’s very good.” They told us that medicines were reviewed and they were informed about any changes. A relative added, “Yeah, dad’s medicines are reviewed by the GP. If there are changes the home will inform me.”

Some staff were not aware of the provider’s policy of keeping a running total of remaining medicines on the medicine administration record (MAR) chart or for the need to sign every entry. Some staff told us they had completed medicine training and received ongoing competency checks. They said they were given protected time during medicine rounds so they were not distracted by other tasks. Staff were confident with the process of dealing with a medicines errors, one told us, “If there is an error I’d check with staff involved and inform managers.” Staff were competent at administering medicines and were seen to take time with people, explaining what they were doing.

We looked at multiple MAR charts. Most did not contain photographs of people, which is best practice, confirming medicines being administered to the right person. Some entries on MAR charts had been crossed out and there were no initials or signatures. There were no running totals of medicines recorded. Handwritten medicine requests to the GP had not been signed. Some people self-administered their own medicines but there were no risk assessments in place for this. These issues were brought to the attention of the registered manager.