Harmony Homecare Suffolk

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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

We assessed a total of 3 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. There were enough staff to support people safely and safe recruitment practices were followed. All new members of staff completed induction training, shadowed an existing member of staff and received competency assessments prior to working on their own. Risks to people's safety were regularly reviewed and amended to meet changing needs with control measures identified to mitigate the risk.

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.

People who used the service and relatives told us they felt safe. One person said, “Very, very good, lovely. People look after us well. All across the board, they’re great.” Another person’s relative told us, “We always have people from the same team, they’re really good. They chat all the time and really brighten up [family member’s] day.”

Staff told us and records seen confirmed that they had received safeguarding training and knew how to identify potential signs of abuse and to report concerns appropriately. A member of staff said, “If I see something I think is not right [suspected abuse] I would contact the office for support and advice. I know the [external agencies] to contact if I need to.”

There were processes in place to safeguard people from abuse and harm. A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or see abuse to ensure people were protected. Staff undertook safeguarding training and an assessment of their knowledge following the training was competed. We spoke with the provider about ensuring staff were confident on who they could escalate any concerns to outside of the provider company, such as the local authority safeguarding team. Records showed that the provider has reported safeguarding concerns to the relevant authorities and where applicable had cooperated with investigations and conducted lessons learnt. Whilst there had not been any reported concerns, some processes were not embedded into day-to-day practice such as risks associated with relatives / couples working together and the safe handling of people’s finances. The provider took immediate action during the assessment to rectify the concerns we identified, to strengthen their processes.

People told us they had been involved with their care planning and they were supported by staff who understood any risks associated with their care. One person’s relative commented, “The care plan covers everything. [Family member] is really safe.” Another relative said “We’ve got a good relationship with our carers, I’m at home most of the time when they’re with us so they share any concerns with us we act quickly.”

Staff were knowledgeable about people’s needs and how to support them taking account of their individual preferences and what was important to them. Staff described instances where they were alert to changes in people’s needs and had acted to keep people safe. This included contacting the office to arrange a care review of the person’s needs, or a healthcare specialist such as district nurse, GP or occupational therapist for specialist advice. The leadership team explained how assessments were carried out in partnership at an agreed time with the person using the service, a member of staff and could also include the person’s relative and or representative if that was the person’s preference.

People’s care records provided the information to ensure people’s needs were met safely and reflected their involvement. Where we found some inconsistencies, such as duplication, details missing, this had been identified by the provider and planned improvements were being implemented. This included streamlining the format to reduce repetition and likelihood of key information getting lost. Work was also underway to make the electronic systems used for care records less generic to support a person-centred approach.

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

Most people told us they received consistently good care from a small group of staff who were familiar with their needs, preferences and daily routines. One person told us, “Only once [was there a delay] when their car broke down – it could happen to anyone, even then, they let us know. No, they are very reliable.” Another person’s relative commented, “If they finish the jobs, they have to do quicker than normal then they’ll sit and have a cup of tea and chat to [family member] – it brightens up their day.”

Most staff told us they felt supported by the management team and received appropriate training for their role. However, some staff acknowledged instances that were challenging due to personnel changes within the team. One member of staff said, “We have had management change in the office which has made the office turbulent at times. I do find the management to be supportive and approachable when needed and can remain professional, it’s just hard when job titles and relationships clash, and it makes working in that setting hard at times.” The provider had taken steps to address the staffing inconsistences through active recruitment. This was ongoing to ensure there was enough care staff to meet people's needs, cover absences, sickness and provide continuity of care. In addition, a manager had recently been appointed to provide stability and support in the office and within the service. A member of staff spoke about the arrangements in place for overseas workers, “Everyone is lovely, very positive place, very happy place. [Management] support the work force both in and outside of work and if needed, will help them to adjust [to living in the UK]. The rota has been improved, that was my only niggle; [did not always] include enough travel time and breaks, caused frustration [for people] but, clients are very understanding, and we let them know if running late.” The leadership team acknowledged that there had been disruption at times in the service due to staffing changes and rota inconsistencies. They confirmed a review of all planned visits on the rota had been undertaken with system changes made to reflect sufficient travel time and breaks for staff, and this had been positively received.

There were no missed visits and where late visits had occurred records reflected the reason and actions taken to prevent reoccurrence. Where people required the assistance of 2 care staff there were effective processes to ensure this happened. Records showed that staff stayed the allocated time unless people had said they could go as either all tasks had been completed or they were no longer required. Staff were recruited safely, with all the necessary pre-employment checks carried out. This included Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. References were also sought from previous employers.

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.

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