District Healthcare Limited Also known as District Homecare

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

We assessed all of the quality statements within this key question. Our rating for this question is good. People and staff could confidently raise safety concerns, and these were listened to and acted on by the registered manager. Systems were in place to help safeguard people from abuse, bullying, harassment, neglect and avoidable harm. The registered manager and staff had a strong awareness areas with the greatest safety risks. Staff had the training and knowledge they needed to support people. The management team ensured there was enough skilled staff to deliver safe care that promoted choice, control and individual well-being. Safe recruitment practices and processes were in place. Staff followed nationally recognised best practice to ensure infection risks to people were minimised.

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 spoke with people to learn more about their experience of using the service. People’s feedback did not highlight any concerns they had about the registered manager listening, learning and acting on safety events.

Staff told us they were informed and kept up to date when incidents had occurred and learning from incidents was shared with them by the registered manager. One staff member told us “We have documented conversations around lessons learnt and that it is done through staff supervisions and team meetings”.

The registered manager had systems and processes in place that protected a positive culture within the service which was based on safety, openness and honesty. People and staff were encouraged and supported to raise concerns to help identify and reduce risks. Lessons were learned from safety incidents or complaints, and this was communicated to staff, through different methods such as team meetings and through the service’s electronic care planning system.

We spoke with people to learn more about their experience of using the service. People’s feedback did not highlight any concerns and we were satisfied the service was working with people to establish and maintain safe systems of care.

The management team told us they worked closely with the local district nursing team and how they worked together to provide joined-up support for one person. The registered manager told us and were able to give examples of where they needed to make contact with other professionals if for example, a person’s health worsened.

Professionals who worked with the service described how the service had supported a person through a recent transmission to another service. They told us, this included an introductory visit to the person and staff from each service shadowed each other. This meant the person was at ease with the transition between services.

The registered manager had processes in place to work collaboratively with healthcare professionals to ensure people were kept safe. The registered manager described to us a situation where a person was moving to the service from another service and how this was planned to ensure continuity of care.

People told us they felt safe, and they knew how to raise concerns when they did not feel safe. One person told us “I feel very safe with all my carers”. Relatives told us “I know (persons name) is safe”.

Staff told us they had received safeguarding training and records confirmed this. Staff told us they knew how to respond to concerns and this information was in the policies and staff handbook. Staff were aware of how to recognise abuse, protect people from different forms of abuse and to report any concerns to the registered manager.

The registered manager had a safeguarding policy and processes in line with current, relevant legislation. Records showed any safeguarding concerns were reported to the registered manager, recorded and reported promptly to the relevant professional. There were systems in place to enable staff to report concerns should they arise. Staff were provided with guidance on different types of abuse and how to raise concerns. Staff undertook training in safeguarding and the management team completed competency assessments with staff to ensure the training had been put into practice. The registered manager had created a system where people were supported, encouraged and empowered to raise concerns about possible abuse in a safe and confidential way.

We received mixed feedback from people about being involved in creating and reviewing their care plans and risk assessments. Relatives told us “I was involved with (person’s name) care plan and it is all followed properly”. However, some people could not recall being involved.

Staff were able to describe how they supported people safely to reduce the risk of harm. The management team and staff knew people well and understood risks posed to people and how they could reduce risks. Staff told us care plans and risk assessments were very accessible and easy to follow. The registered manager told us and records confirmed people and their relatives were involved in creating their care plans and risk assessments.

The registered manager had systems in place to understand and manage risks by thinking holistically so that care met people’s needs in a safe way. Risk assessments were clear and comprehensive. There was a good level of detail in people’s health risk assessments and care plans. For example, care plans for people with diabetes gave clear information about complications, for example, high or low blood sugar levels. There were instructions for staff about when to seek support from other health professionals. Staff had access to people’s care plans and risk assessments through the electronic system, this was also accessible to people and their relatives.

We spoke with people to learn more about their experience of using the service. People’s feedback did not highlight any concerns around their environment. People’s care plans contained detailed assessments of their environment which identified hazards such as slip, trips, falls, fire safety and Legionella.

Staff told us they received training on equipment and health and safety, records confirmed this. Staff told us “Everyone gets manual handling training and even for equipment we don’t use that might come into someone’s own home”.

The registered manager had systems and processes in place to assess risks in people’s care plans which detailed environmental safety risk assessments such as those relating to legionella, fire safety and extreme weather. They provided guidance and control measures to manage the risk so it was as low as reasonably possible.

We received positive feedback from people using the service about staff. People told us “I can’t fault them at all. I am quite happy with them all. Nothing needs to be improved. They do their job really well”, and another said, “They are all well trained and confident in what they are doing”.

Staff told us they received regular supervision and training, and records confirmed this. Staff also told us about spot checks completed by the management team. The registered manager told us about staffing levels and how they staff care packages to ensure consistency of care. They explained they provided a pool of staff regularly visiting the same people and this ensured staff know people well.

The registered manager had robust and safe recruitment practices in place to make sure all staff were suitably experienced, competent and able to carry out their role. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working in care services. The registered manager was able to provide us with evidence of supervision, competencies and support to develop staff, to ensure they were provided with support to deliver safe care. We were assured there were sufficient staff to meet people’s needs.

People told us staff wore gloves and aprons through-out their care. One person told us “They always tidy around really thoroughly before they leave. They wash their hands before they do any food prep”.

The registered manager told us where PPE (Personal protective equipment) was stored and ensured staff always had access to enough PPE. The registered manager also told us about the most recent guidance for infectious diseases and who they would contact for additional support or guidance. Staff told us “We have masks, aprons and gloves and we just go to the office and pick it up when we need it and we have hand sanitiser”. We observed staff wearing PPE.

The provider had infection prevention and control policies in place, this was regularly reviewed and fit for purpose. Most staff had received infection prevention and control training. People’s care plans included risk assessments relating to COSHH (control of substances Hazardous to Health). This provided guidance to staff to ensure safe storage, use and disposal of chemicals.

People told us they received their medication and relatives we spoke with confirmed this. One relative told us staff document medication administered on an app which could be monitored by relatives or the person receiving their care.

Staff told us they received medication training and records confirmed this. Staff told us “The management team check how I am doing and give me feedback and they check on us and how we are doing with things like medication”. The registered manager told us they received relevant Patient Safety Alerts issued through the Central Alerting system (CAS).

The registered manager told us about a system they have in place where visits and medication are alerted to the management team and the staff member attending the visit 15 minutes prior to the arranged time. For example, an alert will show 15 minutes before the medication is due to minimise the risk of missed medication. The registered manager was proactive with identifying and acting on near misses. Medication was audited on a daily basis. The provider had systems and processes in place to manage medicines safely. Some people were prescribed medicines to be taken only when required known as (PRN) medicines. Guidance on PRN medication was in place to help staff give these medicines consistently. Medicine care plans and risk assessments were detailed and provided good information to support staff to understand most people’s care needs such as diabetes and the risk of flammable creams. Processes were informed by Nationally recognised good practice (NICE- National Institute for Health and Care Excellence).