Home Sweet Home Care Limited

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

Systems were in place to protect people from the risk of abuse. Staff had undertaken training about safeguarding adults and understood their responsibility for reporting allegations of abuse. Risk assessments set out how to protect people from harm and people were involved in developing these assessments. However, staff were often late for calls and did not always stay for the full amount of time allocated.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were able to tell us about the training they undertook to enable them to do their jobs. They told us that there was a range of face to face training which included safeguarding as well as training to support people with specific medical needs. They also told us that there were additional on line resources to enhance their training further. Staff told us how they were able to learn by mistakes and were able to give a specific example of an error and how they were supported to understand and learn from their mistake. Managers told us how they ensured their staff learned from practice. They told us about the range of ways in which they talked to staff about practice, such as team meetings, supervision performance meetings and through their newsletter to raise awareness around specific lessons learnt. We learnt that staff were given a monthly reading list of policies sent via a Whatsapp platform and e-mail for staff to refresh their knowledge of organisation policies and procedures. We saw that the provider was using an electronic platform that enabled managers to verify that staff had read the policies. Managers told us that they then tested staff knowledge by carrying out on site visits to ask questions around practice. The platform also provided quality statements aimed at excellence in care which the provider used to benchmark their own standards of care. Managers told us that following feedback from people supported, their relatives and their staff they collated the information into reports and discussed issues as a management group, deciding on the best outcomes.

The provider had a learning culture in place. Accidents and incidents were reviewed to see what action could be taken to reduce the risk of similar accidents or incidents re-occurring. For example, reviewing risk assessments where people had fallen or referring issues to the local authority where people were at increased risk due to a change in need. The provider had a complaints policy and procedure, which people were given a copy of. This set out how to make a complaint and included timescales for responding and details of who people could complain to if they were not satisfied with the response from the service.

People generally told us their experience of using the service was positive. A person said, “I couldn’t manage without the carers, I couldn’t live at home, they have improved my quality of life. They allow me do what I can and are very supportive, I enjoy their company.” A relative told us there had been a smooth transition into using the service. They said, “When we initially signed up with the company someone from the office came to visit us both and we went through in detail how they could support my loved ones needs and what times were available and we agreed the times. I feel fully involved in my loved one’s care. Communication is very good."

In reviewing the providers care files we saw their assessment processes. In delivering care to new clients they received a report detailing the person’s needs from the local authority before undertaking their own assessment. The providers assessment was person centred with information about the history of the person and things that were important in their lives. The assessment is an in depth overview of the person's needs, whilst also forming as an agreement between the provider and the person receiving care. We saw evidence of where people were in hospital at the first point of contact with the provider, detailed information was shared between the hospital and the providers assessment team.

As part of our assessment we spoke with professionals in the local authority for their feedback and views on the service. They told us that since the last visit by the Care Quality Commission an action plan had been put in place and that all actions had been completed. They also added that the local authority had undertaken a series of visits which had been positive and had highlighted areas of excellent practice. A number of relatives we spoke with told us how they were also involved in the care plans of their loved ones. Families told us how staff referred to the care plans on their phones if they needed clarification about aspects of support. One family member told us about their involvement with the care plan and how their loved one was involved in the review of the plan and any necessary changes to it.

The provider worked with other agencies both when providing care and in the initial transition for people to begin using the service. Pre-care assessments included information provided by other agencies including the NHS and local authority. Where people’s needs changed, the provider worked alongside the local authority to access support that was required, for example, from specialist health care providers.

People told us they felt safe using the service.

Staff were able to tell us the process of reporting their concerns if they felt a person they supported was at risk. They told us how they felt confident in approaching all managers within the organisation if they felt they needed to. They were able to explain to us how they were required to immediately provide a written account of events which they then pass on to their manager. Staff were able to tell us about other bodies they could approach outside of their own organisation which included the local authority and the Care Quality Commission. A staff member was able to give us a specific example where they had raised concerns about the welfare of a person they supported and how raising it as a safeguarding matter and showing such awareness brought about a satisfactory conclusion to the matter. Managers were able to demonstrate their processes for reporting to the local authority and the information they sent in relation to a safeguarding matter. Following a safeguarding matter or a complaint the provider told us about their processes under the duty of candour. They showed us how that, following an investigation they met with the person impacted by the event, explaining what happened and apologised for what went wrong. We saw that the provider then confirmed this in writing and sent it either via post or e-mail.

There were systems and processes in place to safeguard people from the risk of abuse. The provider had policies about safeguarding adults and whistleblowing. These made clear their responsibility to report an allegation of abuse to the local authority and CQC. We saw allegations of abuse had been dealt with in line with their policy. Staff had undertaken training about safeguarding adults and were aware of their responsibility to report any allegations of abuse to their manager.

People and relatives told us the care they received was carried out in a safe way. A person said, “I am hoisted by 2 carers, the carers are extremely competent. If there are new members of staff they don’t come together, they are always with a carer who knows the routine.” A relative told us, "The carers are well trained and know what they are doing. My loved one feels safe when they are transferring. We have the same staff 3 times a day. They always turn up on time and stay the length of time they should.” Another relative said, “The carers are very competent and my loved one has no concerns when transferring."

Staff told us that risk assessments were part of the overall care plan and that they had access to each one of these on their phones to be able to read whenever they needed to check and remind themselves about any risks associated with the person. They told us how they make sure they allowed people time to do things for themselves and in that process, made sure that people remained safe in doing the things they need to do.

Risk assessments were in place for people. These set out the risks they faced and included information about how to manage those risks. Assessments included risks associated with medicines, eating and drinking and moving and handling. Assessments were subject to review, which meant they were able to reflect the risks people faced as they changed over time.

During our visit we saw that when the provider carried out their initial assessment of a person it included an environmental risk assessment to make sure the property was safe for their staff to work in. The staff were able to tell us that if they encountered anything they saw as dangerous, they would report it to their managers, the people they support and their families.

As this assessment was of a domiciliary care agency which supported people in their own homes, we did not check people’s home environments. However, we noted that risk assessments did cover risks associated with the physical environment, such as slip and trip hazards.

People and relatives we spoke with had mixed experiences of staff timekeeping. A person told us, “The care I receive is great, the staff turn up on time give me my medication, they do everything for me.” Another person said, “I know the staff, they come on time they know what to do and always stay their time, we have such a laugh together.” A relative told us, “Time keeping is good if they are ever running late the office ring and let me know, we have never had any missed calls and the care stay the allotted time.” However, some people expressed some concerns around staff timekeeping. A person told us, “I have had a few missed calls in the past and issues with time keeping, it has improved recently. I would prefer consistency with the carers especially over the week-end calls.” Another person said, “On the whole, Home Sweet Home is not a bad company, but they could improve on their time keeping.” A third person told us, “The trouble is they are always late, they should have been here at 9.30 and arrived at 11.30 the other day, at the weekend it was 11.40 instead of 9.30.” A relative told us, “We have been let down and have had nobody turn up. It usually means family have to step in to cover.” Another relative said, “Morning call is unpredictable, either too early or late.” A third relative said, “Time keeping can be an issue, no continuity with staff especially on the morning call.” A further relative commented, “I have raised a concern on the 14/05/24 with regards to the timings of the evening call the carer was due at 8 pm and didn’t turn up until 10pm. My loved one became very anxious and uncooperative due to being overtired. I am still waiting for a response from the manager as to why the call was so late.” Another relative said, “We had warned the office that we had the breathing nurse coming and they just didn’t turn up which was most inconvenient and consequently kept the busy nurse hanging around waiting.”

The provider told us about an employment portal that has been set up locally to support and speed up the process of recruitment. We saw that prospective employees were able to upload their important employment information onto the system so that once a provider contacts them they are ready to commence employment following final verification checks. This system enabled prospective employees to start work within a few days of making initial contact. The managers and staff told us that following the commencement of employment new staff undergo a period of shadowing and assessment and are then able to either work alone or further training is identified to ensure the new staff have the correct skills.

The registered manager told us that from the week commencing after our site visit, they were changing to a new system of electronically monitoring staff attendance at calls. They told us this system would help to reduce the possibility of staff being able to log in and out of calls remotely when they were not actually at the person’s home. They also told us, after we raised concerns about staff punctuality, that they had handed back 13 clients to the commissioning local authority to help ensure staff were able to arrive on time for visits. The provider had robust staff recruitment policies and practices. Various checks were carried out on prospective staff to help ensure they were suitable to work in the care sector. These included employment references, proof of identification and criminal records checks. Staff undertook training to learn and develop skills and knowledge to support them in their roles. This included training about moving and handling, dementia care and oral health. New staff undertook an induction training program on commencing work at the service. This included shadowing experienced staff and completion of the Care Certificate. The Care Certificate is a nationally recognised qualification designed for staff who are new to working in the care sector.

People told us staff took steps to prevent the spread of infection, for example, by wearing PPE when providing support with personal care.

Staff told us that the provider supplied them with the personal protective equipment (PPE) whenever they needed it. During our visit we saw staff coming in to the providers office to restock their supplies of PPE. We also noted, supplies within the office were plentiful. Staff told us that they continued to wear face masks even though there is no current national guidance requesting them to do so. They felt that this still protects the people they care for which the provider supports.

The provider had an infection prevention and control policy in place to provide guidance to staff in this area. Staff were expected to wear PPE when providing support with personal care, and staff confirmed there was a ready supply of PPE made available to them.

People and relatives expressed satisfaction with the support they got in taking medicines. A person told us, “The carers assist with medication, I know what medication I am on and what it’s for. I always receive my medication.” A relative said, “My loved one is comfortable in the company of the carers and the carers know what they are doing. They support with the medication and personal care.”

We spoke with staff and they told us that they were responsible for making sure people took their medication. They aimed to keep people independent enough to manage it themselves but, in many cases, observed that it was taken and then sign to confirm it had been administered. Staff told us that as part of their work they received medication training.

During our visit we saw the providers processes for managing medication. We were able to see that all medication had been administered over the period we reviewed. Where people did not receive their medication, staff were able to use the appropriate coding which explained why medication was not administered on a particular occasion. However, we did see changes made to medication charts that should not happen. We saw that some of the medication charts had been changed with a pen making the original instructions illegible and updated changes difficult to follow. We discussed this with the provider and we are assured that this is an area that is regularly discussed with staff. We are further assured following information from the provider that an electronic system is to be implemented imminently which will see the end to this particular issue. We saw evidence of medication assessments being carried out to ensure that people were safe administering their own medication.