Guardian Homecare (Basildon)

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

Care and treatment was planned and delivered in a way which was intended to ensure people's safety and welfare. Risks were assessed and people were supported to make choices that balanced risks of harm with positive choices about their lives. Staff had been supported to complete training and develop the skills they needed to support people safely. There were enough staff to meet people’s needs. Staff were employed after the appropriate recruitment checks were completed.

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 felt safe using the service. They felt able to voice their concerns and that action would be taken. A person told us, “I’ve spent 2 years with Guardian Homecare and the staff are very good. I normally have morning calls which are down to a treat. For me half an hour is perfect, I’ve had no missed calls.”

Staff told us they had the training available to do their job. They felt supported by the management team and were clear about their responsibilities. Staff knew how to speak up and could described how to do this and the actions that would be taken. A staff member said, “Yes, I can speak up and know the process of reporting. I have received feedback from the office of any actions they have taken.”

The registered manager had processes in place to learn from accident, incidents, safeguarding and complaints at the service. Staff had received training in how to report any issues and had the systems available to them to raise alerts directly with senior staff. The registered manager investigated any issues and lessons were learned and changes implemented to improve the service. Information was shared with staff through emails, supervisions, and staff meetings.

People were supported to access services and supported to aid them returning home from hospital. This included admissions and discharge from hospital, and referrals to professionals, where people needed specific support. A person told us, “I’ve been supported by Guardian since I came out of hospital, and I have staff 3 days a week. All set up well.” A family member said, “My [relative] has a social worker and dementia nurse who come to review our case. They understand their mobility is getting worse and we needed handrails around the house.” Another told us, “My [relative] wears a necklace that calls staff out in an emergency.”

Staff gave us examples of enabling people to leave hospital and dealing with issues such as ensuring they have the right medicines and the right equipment but try to get people home with support. This could be either on an enablement package or long term. One such example given was when staff go the extra mile to support people by getting groceries, making sure the home is ready and settling them back home when they have no relatives to support them.” One staff member said, “We become like their adopted family.”

There was positive feedback from professionals about the support offered by the service. A professional told us, “I feel the support workers are doing an excellent job to provide compassionate and flexible care.”

The registered manager told us they worked with other services such as the community nursing service and occupational therapy service. They also liaised with the local hospital to help people transition back home with the support of care staff. The registered manager told us, “The supervisor visits the person in their home or hospital to undertake the assessment. The care plan is used as a template to gather information to provide the support the person needs to go home, we put this in place as quickly as possible. “ The service had an alert process in place. A manager told us, “If the system alerted a pressure area concern, then a manager would pick this up. The manager would ring the person and/or relatives to gain consent and then inform them that the referral has been made to the district nurse. This is then noted on the system and the staff can see that action has been taken. This ensures everyone is in the loop.”

People were protected from the risk of abuse and told us they felt safe using the service. One person said, “I’d rather have someone that I know than having someone different every week, I’ve got to know my usual staff member, they help me run the house arriving on time. I enjoy their company and I feel like I can talk to them without any hassle.” Another told us, “I’ve got no problems at all with staff at this service, they give me good care and the office ask me how I am. I’m happy with the care company for sure.” A family member said, “My [relative] definitely feels safe because they have regular staff on a daily basis. Staff call me if they’re going to be late.”

Staff had received training in how to safeguard people and knew how to raise any concerns with management or external agencies. One member of staff said, “I am very aware of cross contamination and maintaining people’s welfare. I ensure people’s privacy; and show respect to them; and that their equipment is in good order. Any concerns I will raise quickly with the office.” Another told us, We need to ensure equipment is safe and in date. I am very aware of safeguarding people and don’t take anything for granted.”

The registered manager evidenced they had safeguarding policies and procedures in place including ‘whistle blowing’. They were confident that staff knew how to report abuse and had done so to protect people. One member of staff said, “We have information on our phones regarding people which is good, and any changes reported are dealt with promptly. I haven't had to deal with any safeguarding issues but I would know what to do. I have had plenty of supervisions and appraisals which always cover a wide variety of subjects including keeping people safe.” The registered manager had raised safeguarding concerns and notifications appropriately and worked with a number of local authorities to investigate these to ensure people were being safeguarded.

People were involved in planning their care and managing risks. Care plan and risk assessments were person centred and aimed to provide positive outcomes for people whilst maintaining their choice and independence. People told us staff completed an initial assessment of their needs and then this was reviewed with them. One person said, “[Name of staff member] arrives weekday mornings at 7 am. I chose this time when my review was covered a few months ago.” Another said, “Staff do anything that is written in my notes that I need, I’m simply okay with the staff I have no concerns and I’m not sure when my next review is but if I had complaints, then I would say.” A family member said, “We get on well with the staff and managers come out and review [relative]. The staff individually are wonderful, they do what they can for people.”

Risk assessments and care plans provided guidance to staff to mitigate risks to people. A manager told us, “I go out and undertake new assessments, reviews, staff competency checks, undertake medicine and moving and handling risk assessments, and monitor staff and visits. This is to ensure people are happy with their care arrangements.”

When people first start using the service, they were assessed by a manager and a discussion on risks was documented in people’s care plans. Risk assessments were completed to mitigate any risks identified. Mental capacity assessments were carried out to identify people’s ability to make informed choices and consent to their care which were recorded in their care plan. Family members or their representatives were involved in discussions and decisions about risks and people’s needs.

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

The majority of people were satisfied with the times they received their calls and the staff involved in delivering their care calls. Where some were not this was due to not having a rota or not being told about the times changing but most accepted this happened occasionally. A person said, “The staff always care for me, and I don’t see any problems. They arrive any time between 9.30 to 10.30 and this suits me nicely because I get to have a lie in and listen to the radio whilst I’m patiently waiting.” Another told us, “The staff have never said no to helping me. I’ve been very fortunate with my regular staff. They’re brilliant people. Timesheets and daily notes are all completed via their telephone in the time they’re with me.”

Staff told us there was generally enough staff with the right skills and experience to care for people. They received support, supervision and training in their role. They worked together effectively to provide safe care that met people’s individual needs. A staff member told us, “I have just finished my annual training on health and safety, Infection control, food and hygiene, abuse, and medicine administration. Spot checks are being done to ensure I am providing safe care to people which I think is a good thing.”

There were appropriate staffing levels, and a consistent staff team who worked well together. Improvements had been made to include more travel time for staff which had made calls a bit easier to get to and less rushed. The duration of people’s calls was being monitored and processes in place to manage this through monitoring and staff supervision. We saw information and discussions with staff via emails and team meetings where call times and their duration were being monitored. A staff member said, “There has not been a high turnover of staff.” Another told us, “Last year was a bit tight with staff but since June 2023 it has much better.” There was an induction programme for new staff including face to face training, shadowing more experienced staff and regular reviews of performance. Staff were supported to complete national recognized training such as the care certificate or diplomas in social care. Staff had regular supervision and staff meetings to share learning and review performance. Appropriate checks were in place before staff started work including taking up references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. There were some gaps in people’s employment history and we made the registered manager aware of this and action was taken to remedy this.

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

Most people we spoke with managed their own medicines. Where people were supported by staff they did not raise any issues. A person said, “The staff administer my medicines and watch me take my pills and record how much I’ve eaten.” A family member told us, “They [staff] handle everything with care, medicine is given on the times required. Afterwards they electronically write and sign the relevant papers.” Another said “[Relative] requires medication and that was the biggest things for me is knowing staff are giving it to them on a regular basis. That was one of my [relative’s] problems that they were not taking their medicines properly. Now having staff with them, watching is certainly helping.”

Staff told us they had received training in medicine management and had their competency checked to support with medicines. A staff member said, “We have monthly supervision, I had mine about medicines 3 weeks ago. We do a general review, check the medicines record and note taking.” Another said, “With medicines given as and when needed, we look to see if correct hours apart. I will ask the person if they have any pain, I visit most on a regular basis so understand their needs and can read their body language.”

Improvements had been made to the management of medicines. Staff had clear instructions on how to support people with medicines and the level of support people required. Ongoing management and monitoring ensured people had their medicines as prescribed, records were completed, and any issues picked up and resolved quickly.