7 Tips for Navigating Home Care Safety

December 11, 2023   |   Nurses

Protect your home care business with the right liability insurance

Each time Rachel Ramsey, RN, BSN escorted new moms and their babies out of the hospital at discharge, she’d see their desperation and have the same thought. “I knew these moms needed someone to catch them at home. So many times I wanted to hop in this car with them to help them get settled with their baby,” she says.

The idea for The Newborn Nurse began in those exchanges with new mothers as a hospital neonatal nurse. Ramsey officially launched seven years ago in Nashville, Tennessee. Today, she has a team of up to 25 nurses providing in-home care for new and expecting moms.

While working in homes has apparent advantages for new parents and their babies, many risks are involved in providing in-home services. In seven years of business, Ramsey has had to think about home care safety risks to protect her employees and her business. 

7 ways to mitigate home care safety risks

Ramsey offers the following tips to clinicians seeking to provide care services at home.

Stay within the scope of practice

As registered nurses, Ramsey says she and her team are overqualified for the home care work they do. But because they do not operate under a licensed physician or nurse practitioner, The Newborn Nurse staff only provide doula services. This means they cannot deliver medicine or medical treatment while working in homes. If they identify a concern, they instead tell the family to contact their pediatrician. 

Navigate client expectations

Spending time in clients’ homes means Ramsey and her team need to set clear boundaries. Staff members are careful only to use the parts of a home where they provide care, such as the nursery, kitchen and laundry room. They also only do tasks associated with the job. So while they might rinse bottles, they don’t perform chores unrelated to caring for the mom and baby. “If we ever are asked, we kindly say that’s not in our job description,” says Ramsey.

Train staff for safety

The day-to-day work of providing care in families’ homes allowed Ramsey to identify preventative measures to avoid accidents. For example, she and her staff never carry babies up or down stairs. They also wear socks with grips in homes after removing their shoes for cleanliness. 

For those in-home care businesses that provide clinical care, there’s an increased liability that comes with providing care to vulnerable individuals. There is always the potential for accidents or errors that could lead to injury or harm to clients. Ensuring proper training and supervision of staff, as well as maintaining rigorous safety protocols, is crucial to mitigate this risk. 

Consider extra germ-preventative measures

Ramsey and her staff obviously wash their hands before handling babies, but they also take other sanitary precautions to avoid spreading germs. The staff remove their shoes when entering homes and wipe down their phones with anti-bacterial wipes.

Set safety expectations with clients

Since Ramsey and her team often enter homes at night to care for babies, she asks clients to leave all outdoor lights on to make homes easy to find. They also give clients a magnet with their logo and ask them to place it on the mailbox. This helps staff know they’re at the right home. 

When Ramsey and her team teach prenatal education courses, they ask that dogs be put away so that they’re not a tripping hazard and so that there are no distractions.

Stay compliant with professional support

The home care industry is highly regulated, with numerous federal, state and local regulations designed to ensure the well-being of those who receive care. Ramsey can operate with fewer regulations by serving as a doula and not providing clinical care. 

Clinical regulations cover licensing requirements, caregiver training, compliance courses, record-keeping and more. One of the significant challenges for in-home care business owners is the dynamic nature of these regulations. Laws and requirements vary from state to state and change constantly. Failure to comply with the latest regulations can result in legal consequences, such as fines, license suspension or even agency closure. 

Ramsey recommends all in-home care businesses have a business attorney, an accountant and an insurance broker who understand your business requirements and can help you stay on top of the regulatory landscape.

Protect yourself with professional liability insurance

Professional liability insurance for in-home care businesses, also called malpractice insurance, professional indemnity, or errors and omissions insurance, is vital. Even if you’re not at fault, professional liability insurance protects you and your employees if you’re ever named in a malpractice lawsuit.


CM&F professional liability insurance policies include workplace liability insurance to provide coverage for claims of bodily injury or property damage brought by clients.

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