Right at Home Camden, Hampstead & Golders Green

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 said they felt safe and supported by regular staff who knew them well. The service supported people to be safe from abuse and neglect. People’s care and risk management plans were person-centred, recognised people’s preferences and promoted their independence and safety. There were safe medicines management processes in place. These were reviewed regularly with people and their relatives. The provider encouraged openness and transparency to report and learn from incidents and concerns. The registered manager used learning from incidents to improve the service and this was shared with staff. The registered manager ensured there were sufficient numbers of competent staff to support people safely. The provider had appropriate recruitment procedures in place. Staff received induction, supervision, support and assorted training so they could support people effectively. The service worked well with other agencies to provide people with joined up care and help them to use other services.

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.

Feedback from people and relatives indicated that any issues they raised were responded to promptly by the provider. The registered manager used lessons learned from any issues to review and update people’s care plans.

Staff knew how to report incidents and concerns and told us the registered manager actively encouraged them to do so. Staff were listened to when they raised issues and had confidence the managers always took their reports seriously. The registered manager and director shared lessons from incidents both from this service and the provider’s other branches with the staff team. This helped to continually identify and embed good practices. The registered manager was aware of their Duty of Candour responsibilities to be supportive, open and transparent with people and relatives and to apologise when things went wrong.

There were appropriate systems and Duty of Candour procedures in place for managing complaints, incidents and accidents effectively. These were addressed with transparency and in a timely manner. The registered manager monitored records of any concerns or adverse events on a daily basis and then audited these regularly. This enabled them to identify any incident patterns or trends and take remedial action to address them and improve the service. The provider periodically audited the service to check the registered manager was doing this.

The service supported people to access other services to meet their needs and promote their wellbeing, including hospital and other care services. A relative described how care staff had acted promptly when noticing their family member became ill and commented, “If it weren’t for the carer who called the ambulance when they saw something was wrong, [the person] would have died. [The care worker] is responsible for saving their life.” Staff supported people and their families with compassion and sensitivity so they experienced a smooth transition to other services such as residential care. For example, staff helped a relative source prospective care home placements for their family member and continued to provide care to them after the person’s move. This provided continuity of care to help both the person and the relative adjust to their new arrangements.

Staff and the registered manager demonstrated a clear awareness of working with other agencies that supported people, such as professionals providing diabetes support to a person. A care worker told us, “Usually I chat with [the visiting professional], to see if there is anything I should be knowing.” The registered manager and director liaised with other services, such as GPs and care commissioners, to help ensure there was a joined up approach to people’s experiences. For example, when the service was starting to provide care to a new client. The registered manager attended multi-agency meetings when required to work with other services to plan for and meet people’s needs together.

Professionals we spoke with said the registered manager always asked for their views about how best to support people and the agency worked well with other services to meet people’s needs. For example, when a person’s needs changed and when a person was transferring from one service to another. Professionals described this as effective joint-working and they had “a very good experience of working with them.”

Service records demonstrated how the registered manager liaised with other agencies and helped to coordinate care arrangements for people. People’s care plans set out how other services were involved with them, such as visiting district nurses and speech and language therapists. The views of people, their relatives and other professionals clearly informed people’s planned care arrangements.

People and relatives told us they felt safe using the service.

Staff had completed training on and had a good understanding of adult safeguarding, how to recognise signs of abuse and the appropriate action in response to concerns. This included reporting concerns to statutory agencies. The registered manager understood how to respond to allegations of abuse and neglect. They promoted staff awareness and encouraged staff to raise any concerns.

The provider had suitable adult safeguarding systems and procedures in place. The registered manager maintained and monitored records of concerns to help ensure these were responded to effectively and learnt from. Records showed concerns had been looked into appropriate and in timely manner.

People told us they felt their care and support was managed and provided safely. Their comments included, “I feel very safe when they are here” and “I feel completely safe in their hands.” A relative had reported to the service, “I always feel assured that [the person] is in excellent hands. I have complete confidence in their care when I am away.”

Staff demonstrated a good awareness of managing risks to people’s safety, such as supporting people to mobilise or eat safely. Staff had a good understanding of people’s needs as they provided live-in care or visited the same people regularly and this helped staff get to know them well. Staff said people’s digital care plans provided good information and direction on how to support people safely. Staff told us the provider always gave them information about a person, their needs and potential risks before they visited them for the first time. The registered manager demonstrated how they monitored, reviewed and updated people’s care plans to ensure they were current and met people’s needs appropriately.

People’s care plans were informed by a range of personalised risk assessments that considered risks to people’s safety and wellbeing. Plans set steps to take to manage those risks while promoting people’s independence. For example, these considered areas such as personal care, mobility needs, eating, drinking and allergies, behaviour support and medicines. Staff completed assorted training to help them provide care safely, such as in moving and handling, health and safety, food hygiene, fire safety, and basic life support. The provider had business continuity plans in place to help the service continue in the event of a major disruption or emergency.

Feedback from people and relatives indicated people felt they were supported safely in their home environments. For example, a person told us they felt safe when staff used a hoist to help them mobilise.

Staff said they received training and support on how to provide care and use equipment safely. A member of staff told us, “We have had workshops on how we can better manage the working environment and risk assessment. Senior staff explained how they used moving and handling equipment in the office to demonstrate and train staff on how to use this safely.

There were systems and processes in place to ensure people were supported and staff worked in appropriate environments. Senior staff assessed people's home environments to identify risks to people and staff. This included potential hazards such as access, furniture and equipment, clutter, pets and fire safety. The registered manager ensure staff received induction and training to support people using equipment in their homes. A professional also told us the service was proactive in raising any concerns or seeking advice about equipment a person used. There were lone working and oncall arrangements in place to support staff.

People and relatives felt they were supported well by competent staff. A person said, “The carers are very experienced.” A relative told us, “The carer is fantastic and does everything my [family member] needs them to do and they do more.” People told us staff were punctual and never missed a care visit. A relative said, “The carers come on time and stay the full amount of time.” The provider informed people in advance about which staff would be visiting them. A person commented, “I get an email every week from the office with the rota for the week.” This helped people to have trust and confidence in the service.

Staff received regular supervisions and appraisals and felt very well supported by the registered manager, the director and the office team. Staff could get supportive advice and direction when they needed to. They found their mandatory and supplementary training helpful. They told us, “[Staff are] constantly doing training” and “There’s a lot of training that keeps us going.” Staff were provided with additional training and guidance when someone’s needs changed or were new to the care staff member. A care worker said, “They give you training on that new aspect before you go there.” For example, when a person needed to use a medicines device such as an inhaler. The registered manager was committed to investing in and helping staff to develop, including obtaining qualifications in care, and staff benefited from and appreciated this. A member of staff told us, “I have learned so much from [the registered manager].”

The registered manager ensured there was always enough competent staff to provide good care and support. Staff completed an induction and a variety of face to face and online training sessions. This included completing the Care Certificate. This is a nationally recognised set of standards that gives staff to new care an introduction to their roles and responsibilities. The service followed appropriately robust recruitment processes to make sure positions were offered to suitable applicants. These included establishing their employment history and reference checks as well as Disclosure and Barring Service (DBS) checks. A DBS check is a way for employers to check a potential employee’s criminal record, to help decide whether they are a suitable person to work for them. This protected people from receiving support from unsuitable staff.

People were protected as much as possible from the risk of infection. People and relatives had no concerns about how staff supported them. A relative commented, “They are good carers, they are clean and leave the place tidy.”

Staff completed infection prevention and control training so they could support people to be safe. This included how to use personal protective equipment (PPE) when required. Staff told us the training was helpful, that there was always a sufficient supply of PPE for them and the provider made sure they followed good practices. A member of staff told us, “They really emphasize having PPE, being safe, following the rules and regulations.” A care worker described how when a person had COVID-19 they had supported the person and their relatives sensitively and safely and this helped allay their concerns.

The provider has policies and procedures in place for preventing and controlling infection. These included regular promoting of safe practices to care staff and checking of their care practices. The provider monitored the supply and usage of PPE.

People were supported to receive their prescribed medicines as required. People were happy with this support.

Staff completed training in medicines awareness and medicines support. Staff said this training was helpful and they could always ask senior staff for more guidance and additional training if they wanted. The registered manager assessed their competency to provide this support safely. Staff we spoke with demonstrated a good understanding of supporting people with their medicines, including respecting people’s independence and how to support someone when they refused their medicines.

People’s care plans set out the support they needed to manage their medicines and receive these safely, including if relatives helped or other healthcare professionals helped them with this. There was guidance for staff on when to support a person with ‘as required’ medicines, such as paracetamol. Staff completed digital medicine administration records to indicate when they had supported people. We saw the registered manager audited these on a monthly basis and addressed any issues this identified. There was a clear medicines management policy in place.