Hambleton Independent Living Limited (Head Office)

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

Policies and information gave clear guidance to staff on the action to take should they have any concerns. Staff had received training in safeguarding. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The provider was meeting the requirements of the MCA. People's capacity to make decisions about their care and support had been assessed. Records were kept of accidents or incidents. The registered manager monitored accidents and incidents and identified any lessons that could be learned to prevent future occurrences. People’s needs were assessed prior to them starting to use the service. This was to ensure the service could meet their needs. Risks to people were identified and well managed. People, and where appropriate their families, were involved in all decisions about their care and support and how it was provided and developing the plans of care. Risk assessments were completed regarding risks to staff or people within the environment of people's homes. Staff received the induction, training and support they needed to carry out their roles effectively. Safe systems of staff

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.

People and their relatives told us staff helped them to keep safe and manage known risks. A relative said, "Yes, they keep [person] safe, they keep an eye on any changes to his skin and meet his needs."

Staff told us they received ongoing training to manage and respond to any allegations of abuse which helped to keep people Safe. A staff member said, "Yes, we have all training we need, we deal with hazards, speak with family, contact other professionals. We are kept up to date with what’s going, and we discuss any safeguarding's and outcomes."

Records were kept of accidents or incidents. The registered manager monitored accidents and incidents and identified any lessons that could be learned to prevent future occurrences.

Relatives told us information was available and reviewed to ensure care remained relevant following access to, and transition between other health services. A relative said, "[Relative] is supported to attend their GP, they received support to attend the eye hospital."

Staff worked proactively to support people to remain healthy with input from other health professionals where required. One staff said, "If the District Nurse visits, for example, for pressure sores, they provide feedback and we follow their advice, on one occasion we purchased a pressure cushion to keep the person comfortable and to help with their recovery."

People were supported holistically with their care and support needs, the service worked closely with external health services and partners which included Doctors and District Nurses.

Staff ensured care records remained up to date and available to other health professionals which helped with continuity of care.

Relatives told us they felt the service helped to keep their loved ones safe from the risks of abuse.

Staff told us they had received appropriate training to understand the types of abuse to look out for an how to escalate any concerns. They told us systems and process ensured all concerns were recorded, investigated and responded to with actions implemented and discussed to keep everyone safe.

Policies and information gave clear guidance to staff on the action to take should they have any concerns. Records confirmed staff had received training in safeguarding. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The registered manager and staff had a good understanding of, and was meeting with the requirements of the MCA. People's capacity to make informed decisions about their care and support had been assessed and recorded with provision for the involvement of advocates including relatives where this was required.

People and their relatives were involved in planning their care and with ongoing reviews which ensured risks were known and managed. People told us their planned care and support helped them to maintain their independence where ever possible.

People received initial and ongoing assessments of need which identified known risks. Staff told us, "We discuss care plans with people where they can or we speak with the family where they act as advocate. People are involved [with their care planning].

Policies and procedures were followed to ensure people's care records remained up to date and relevant. Known risks were recorded with information to provide people with safe care.

Relatives spoken with told us the service helped to support their loved ones remain safe and as independent as possible in their own homes. One relative said, "An occupational therapist put handrails in a while ago. "He has definitely benefited from living at home. Could find his way around even with sight issues."

Staff told us they had access to information to ensure they remained safe when accessing homes to provide people with safe care and support. One staff member said, "The registered manager completes an initial assessment of the homes, its all written down."

The service completed checks and recorded information to ensure staff and others had information to support safe access into and around people's properties.

Enough staff were employed to meet peoples needs. A relative said, " Yes, we have regular staff. I would say they are competent. New staff get better as they learn."

Staff told us they benefited from a small staff team which helped to deliver consistent person centred care .

Staff recruitment included appropriate checks to ensure those employed were suitable for the role. During the inspection the registered manager was enhancing a checklist of all required pre-employment checks in recruitment files, to ensure easier oversight and audit. There were enough suitably skilled staff deployed to meet people's individual needs. Rotas for visits were arranged around geographical areas to allow staff to travel more easily between visits.

People received care and support with consideration of effective infection prevention and control. A relative said, "They [staff] follow good infection control. They wash their hands and wear PPE".

Staff had a clear understanding of the requirements to effectively manage infection prevention and control. They told us they had good access to personal protective equipment and the process for it's use and disposal.

Records confirmed staff received training in infection control and prevention and policies provided up to date guidance. This included the importance of hand hygiene and use of personal protective equipment.

Where people required support to take their medicines they told us this was completed as required with no concerns raised about the processes involved. A relative said, "Yes, they give support with medication. I let them know if there are any changes, no concerns."

Staff told us they were required to complete medicine training and receive observations of their competence prior to supporting people with their medicines. A staff member told us, "We do online training, and we are supported on call with a senior. We mainly administer from blister packs, complete medicine administration records electronically which includes any refusal with detail. One lady is on antibiotics, we were informed by the District Nurse and GP so we know exactly what we are doing."

Processes in place ensured records of administration of medicines were fully completed. Training records confirmed medicines training was up to date along with regular recorded checks by the registered manager to ensure staff remained competent and continued to follow best practice guidance.