Home Instead Brentwood, Billericay & Upminster

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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

Evidence demonstrated the service was safe. People were safeguarded from abuse. Risks to people were assessed. There were enough staff to meet people's needs. The service ensured proper and safe use of medicines.

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.

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

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

There was a low incidence of safeguarding concerns at the domiciliary care service. A consistent and robust approach to managing safeguarding concerns was in place and demonstrated safeguarding concerns raised were addressed in an open and impartial manner. Evidence we viewed demonstrated staff escalated concerns and the management team took appropriate actions to notify and submit the relevant information to the Local Authority and Care Quality Commission.

Discussions held with the management team demonstrated they fully understood their roles and responsibility to safeguard people and to keep them safe. Staff confirmed they had received safeguarding training. Staff demonstrated a satisfactory understanding and awareness of the different types of abuse, how to respond appropriately where abuse was suspected and how to escalate concerns about a person's safety to the management team and external agencies, such as the Local Authority and Care Quality Commission. Staff told us they would not hesitate to raise a safeguarding alert if they suspected abuse. A member of staff told us, "If there are any concerns with clients, it would be reported to the office."

People using the service and relatives told us they had no concerns about their safety or their family member’s safety. People's comments included, “I have them for 1 hour 3 times a week, mainly for my shower and I have 3 different carers. I’m happy with what I have, they do what I need them to do, and I feel safe” and, "I feel very safe when any carer calls, as they are well trained and I trust them." Relatives told us, “There have been no incidents, and my parents are safe. They trust and like the carers” and, “[Family member] knows their carers and feels safe with them. They are very good and [family member] has a great relationship with them.”

Risks to people's health and wellbeing had been assessed and each person had personalised risk assessments, which identified the risks they could be exposed to, and the support needed to minimise these and to ensure their safety. Risk assessments had been reviewed regularly to identify when people's needs changed. The service had also completed an assessment of people's homes to ensure that they were free from hazards that could place them, their visitors and staff who supported them at risk of potential harm.

Staff spoken with had a good understanding of the individual risks to the people they supported and were able to explain how they promoted positive risk taking to enhance people’s daily lives. One member of staff told us, “I support a person who is unsteady when walking, I have to help them walk slowly and balance properly. They do have a wheelchair for times when their balance is poor. I also always look out for any potential trip hazards which may place the person at risk.” Another member of staff was aware of a person's specific dietary requirements relating to dairy intolerance.

People and their relatives told us how staff knew the people they supported well and were able to identify risks to them and or their loved ones to ensure their safety and wellbeing. Comments from relatives included, “[Family member] did have some falls because they were dehydrated and so they [staff] had a notebook for recording food and drinks which helped”, “They [staff] are very good at seeing if [family member] isn’t very well, sometimes they notice when I haven’t because I’m with them all the time. They will advise me what to do. I really value their experience and I will talk to them and ask advice because a lot of the carers are very experienced. They support me to understand” and, “When the manager came to organise care for my loved one, they advised me on reducing risks and suggested I have additional bedrails fitted to assist them to walk around our home, which would keep them safe.”

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

People and relatives feedback regarding timing and duration of their call times were extremely positive. One person told us, “They [staff] always stay the full hour, and they will do anything I ask, they will pop to the shop or empty the dishwasher for me, all sorts of things. I chose 9.15am as my time and that’s when they come." Another person told us, "I have never had a missed call but even if they [staff] are going to be 10 minutes late, they will phone me. They also phone if there is a change to the staff I am expecting too." Relatives told us, “The carers always stay for the time they are supposed to and [family member] says they never feel rushed”, “We have never had any missed calls or the need to contact the office if the service is running late, they are very good with timekeeping” and, “They [staff] arrive on time and have never missed any calls." People and their relatives spoke positively about staff’s knowledge and experience in relation to their role and responsibilities. Comments included, “[Staff member] is very well-trained and understands [family member's] condition. They have a wonderful way with [family member]”, “They [staff] are well trained, they know what they are doing, and they are aware of things and report to the office and to us if there are any issues. They have made suggestions to help with eating, like red plates and cutlery and smaller plates to encourage [family member] to eat” and, “I am very happy with the carers, they are well trained, and we are very pleased."

Recruitment records showed thorough recruitment procedures were in place to keep people safe. Relevant checks were carried out before a new member of staff started working at the service. These included processing applications, the obtaining of references, ensuring that the applicant provided proof of their identity, conducting employment interviews, and undertaking a criminal record check with the Disclosure and Barring Service [DBS]. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff employed at the service had attained up to date mandatory or specialist training relating to the needs of the people they supported. Staff had received regular supervisions and competency assessments and 'spot' visits had been undertaken. The latter is where a representative of the organisation can observe the member of staff as they go about their duties and check they are meeting the organisation's standards and expectations.

Staff told us there were enough staff to meets people’s needs. One member of staff told us, “Yes, there are enough staff. I have been a carer for over 20 years. You have time for the clients. You are able to do your job without rushing, able to have a chat. People’s needs are all different.” The registered managers advised no agency staff were being used, they had a rolling recruitment plan and held weekly recruitment meetings. These meetings took place to discuss any new staff referrals, progress with new staff and any recruitment events taking place. The registered managers also spoke of staff incentives centred around recruitment which included a monetary payment after completion of their learning and development, private healthcare programme and regular coffee afternoons where staff have the opportunity to meet and have a chat over coffee and cake.

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.

The provider ensured the proper and safe use of medicines. The service used an electronic system which meant information was recorded at the time peoples medicines were administered. There were individual plans in place to direct staff on providing the correct medicines support. MAR forms viewed provided assurance people using the service received their medicines in line with the prescriber’s instructions. Medication audits were completed daily and weekly to make sure MAR forms were completed to a good standard or to identify errors and lessons learned. The care coordinator followed up on any concerns immediately.

People and relatives we spoke with told us they had no concerns regarding the management of medicines. Comments from people using the service included, “All my medications are checked and documented” and, “If I have any new creams which need to be applied the office is informed and it is included in my care plan. The carers are aware of any changes, you don’t need to tell them, they are on the ball." Relatives provided positive comments and these included, “They [staff] prompt medication and [family member] takes it in front of them” and, “Although [family member] can take their own medication, they have to take some tablets half an hour before they eat. The carers always check to ensure they have had their tablets before they have a shower and breakfast.”

We spoke to the person responsible for overseeing the management and monitoring of the service's medicines processes and arrangements. They told us, “I carry out daily and weekly audits. I check people's Medicines Administration Records [MAR] weekly in detail and investigate any issues. Any amber alerts on daily checks I aim to resolve.”