PHC 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

At our last inspection we rated this key question requires improvement. At this inspection the rating has remained requires improvement. The service had not made sufficient improvements to their medicines management systems and there were instances where it was not evident whether medicines had been administered. This was a continued breach of regulation in respect of medicines management. The majority of risks to people's safety and wellbeing had been assessed and risk assessments were in place to help protect people. Systems were in place to help investigate accidents, incidents, complaints, and safeguarding and ensure these were learnt from. Effective systems were in place to safely recruit staff. Staff were trained and supported appropriately. Systems were in place to help prevent and control infections. Staff and management communicated with other agencies to help keep people safe.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a system was in place to report, record and monitor incidents and accidents to help ensure people were supported safely.

People and relatives told us the service met their needs, and they were confident that action would be taken if they raised concerns and issues. Relatives told us they were able to easily access the management team and were listened to when they did.

The service worked with people and healthcare professionals to help establish and maintain safe systems of care where people’s safety was monitored and managed. Management focused on providing continuity of care for people.

Relatives told us the service kept them informed and updated of people’s care and support. A relative told us, “The office are in regular contact with me. They keep me updated with how my [family member] is doing.”

People and relatives were confident that care staff provided safe care. A person told us, “I do feel safe with the carers in my house.” A relative said, “I am confident that [my family member] is safe. Most definitely safe.”

Safeguarding procedures were in place. These provided guidance about the action to take if staff had concerns about the welfare of people. Staff had completed safeguarding training.

Staff told us they felt confident reporting concerns and wouldn’t hesitate to do so. Care staff described the action they would take if they witnessed any abusive or neglectful practice. Care staff were confident management would take appropriate action when required. Management was aware of their responsibilities of how to help protect people from abuse and the actions they would take where there was an allegation of abuse.

Risks to people’s safety and wellbeing were assessed. People and relatives told us they felt staff provided safe care which met their needs. A person said, “I am confident [care staff] know what they are doing. I rely on them.” A relative said, “[My family member] has complex needs. [Care staff] do look after [family member] very well and they meet their needs.”

Management had completed risk assessments and details of how to care and support people to manage these risks were in people’s care records. These included guidance about managing risks. We noted that some risk assessments were more detailed than others. For example, the diabetes risk assessment for 1 person was informative and included instructions for staff on how to support this person manage this risk. However, another risk assessment for a person on Warfarin did not include clear details of the potential risks associated with taking this medicine and action staff should take to mitigate these potential risks. We raised this with management, and they advised they would review all risk assessments to ensure they consistently included sufficient information.



Staff had completed training to understand how to safely care for people and mitigate risks. This included training in areas of potential risk such as first aid and moving and handling.

Staff told us they wouldn’t hesitate to raise concerns with management and had confidence that appropriate action would be taken.

The service carried out an initial assessment of people’s home environment to help identify risks so that they could help control potential risks in the care environment. They helped ensure equipment, facilities and technology supported the delivery of safe care. Management knew who to contact if they felt people would benefit from additional equipment to aid with aspects of people’s support such as their mobility.

People and relatives told us care staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE). A relative told us, “[Care staff] are very conscientious about infection control. They take extra care.”

Staff had completed training about infection prevention and control. Staff told us they had enough PPE.

Infection prevention and control policies were in place. Staff were given the information and guidance they needed.

People and relatives told us care staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE). A relative told us, “[Care staff] are very conscientious about infection control. They take extra care.”

Staff had completed training about infection prevention and control. Staff told us they had enough PPE.

Infection prevention and control policies were in place. Staff were given the information and guidance they needed.

Medicines were not always managed effectively, and we found a continued breach of regulation. The service had implemented an electronic monitoring system for medicines administration. However, they failed to ensure there was always a clear record of whether medicines were administered.

We looked at a sample of Medicines Administration Records (MARs) and found that the majority of those reviewed were completed with no unexplained gaps. However, we found numerous instances where the completion of MARs did not always clearly demonstrate whether people had received medicines as prescribed. There were instances where a code was recorded to detail the action taken regarding the administration of a medicine but that further detail about this was not documented in the care plan. For example, the code ‘F’ was used for ‘Other reason’. However, there was no further information recorded on the MAR as to what the reason for medicines not being administered were. We also found the code ‘L’ was used on a number of occasions. This was the code for ‘Left out’ indicating that medicines were left for a person to take independently. Use of this code does not clearly indicate whether medicines were administered, and we could therefore not be assured that people received their medicines as prescribed.

People’s medicines support needs were recorded in their care records.

Some people were prescribed PRN (as required) medicines. Protocols for staff on when and how to administer PRN medicines were in place. However, we noted that these were handwritten and not always clearly legible.