Apex Prime Care - Basingstoke

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to people’s safe care and treatment. People’s medicines were not managed safely and environmental risk assessments did not comprehensively address the risk of fire.

This service scored 53 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not consistently promote a proactive, positive safety culture based on openness and honesty. Staff did not always investigate or report safety events robustly. They did not always learn lessons that would help identify and embed good practice.

The provider had processes for staff to report safety incidents and near misses. These processes included reviewing incidents, learning from them, and adjusting people’s care to keep them safe. We reviewed incident and complaints records. Staff and leaders described some actions they had taken after incidents and complaints to maintain people’s safety. However, the records did not consistently show what lessons had been learned to prevent similar concerns from happening again. For example, one person slipped and sustained an injury. Staff recorded they needed to use correct moving and handling techniques, but there was no record of the remedial action taken to reduce the risk of similar incidents occurring.

Several historic incidents had no recorded follow‑up due to office staff leaving, and the records did not show that appropriate action had been taken. We raised this with the manager, who told us that action had taken place, although this was not reflected in the records.

The provider worked with people and healthcare professionals to establish and maintain safe systems of care. Staff actively monitored and managed safety and ensured continuity of care, including when people moved between different services.

The provider supported people to transition into the service, including from hospital, and maintained contact with health professionals to support a safe return home. Staff completed an initial assessment with each person and their representatives to identify needs and risks. The manager described how they stayed in regular contact with the hospital to confirm when the person was ready for discharge and to ensure the person returned home safely with the right support in place.

The provider did not always work effectively with people or healthcare partners to understand what being safe meant to each person or how best to achieve this. They did not consistently focus on improving people’s lives or protecting their rights to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider did not always share concerns in a timely or appropriate way.

The provider reported safeguarding concerns to the relevant authorities and cooperated with investigations. However, records were not always robust. Some entries lacked dates, outcomes, or evidence of learning to show appropriate action was taken. The provider did not always notify CQC promptly, as required by regulations. Notifications must be submitted without delay so CQC can monitor whether appropriate action has been taken.

Staff had received safeguarding training and were confident in recognising and responding to safeguarding concerns, including concerns about self‑neglect when people declined care. People told us they felt safe with their regular carers.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Assessments were undertaken to identify risks to people and to the care staff who supported them. These assessments included risks associated with personal care and moving and handling. While most records contained clear information and supported staff some records were not always clear.

People using the service told us they felt safe and supported with their regular staff. Despite gaps in documentation, most staff demonstrated a good understanding of how to support people safely.

The provider did not always identify or control potential risks in the care environment. They did not consistently ensure that equipment, facilities and technology supported the delivery of safe care.

Staff completed assessments of people’s home environments to identify and reduce risks related to the delivery of care. However, these assessments were not always robust. People who used creams with associated fire risks did not have risk assessments to determine the level of risk and what precautions needed to be put in place. Environmental risk assessments also lacked sufficient detail in how risks to people who smoked had been considered and whether any control measures were needed to keep them safe. For one person, the provider had not completed an environmental assessment, and risks relating to their pet had not been considered or mitigated.

Some people told us they felt safe in their homes with staff and that staff treated their home with respect. One person said, “I like them, because they put my scooter away and put it on charge.” Another told us, “They always make sure my home is tidied before they go so that I can get around safely.” Other comments included, “When I have a shower, they are very good at making sure the floor is dry and not slippery, and that I have appropriate footwear at hand,” and “The staff are very aware of safety and make sure my walking aids are within close reach.”

The provider did not always ensure staff received effective support, supervision and development. They did not consistently deploy staff in a way that enabled people to receive care from familiar and consistent workers. People and relatives told us they did not always receive care from staff they knew. Call times varied, and some people experienced late or rushed visits, which left them waiting for essential personal care.

Most people and families told us staff sometimes arrived late and did not always stay for the full agreed duration of scheduled care calls. They gave us several examples of this. One person told us they received their morning call late, and then only an hour later another carer arrived to provide personal care, which was too soon. They also told us a carer arrived after 22:00 for a call scheduled for 18:30, which caused them stress and anxiety. Other people told us they received morning calls at lunchtime because no female care staff were available. One person said their evening calls had been cancelled for the same reason, adding, “I have had 4 calls cancelled since they took over in August/September 2025.” Other comments included, “Waiting for people is stressful and makes me feel agitated. I like to know when people are expected,” and “It isn’t very safe because sometimes when they don’t turn up, we try and do things for ourselves, and I know this could be dangerous.”

Staff had mostly received relevant training, and systems were in place for supervision, competency checks and team meetings to support learning and development. However, some records showed these systems had fallen behind. The provider told us that this was improving following the appointment of a new manager and that actions were in place to ensure compliance. Staff were mostly recruited safely. Some staff had transferred to the service from a different agency. The provider was not clear on their responsibility to provide assurances that all staff were safely recruited even when transferring.

The provider had an action plan in place and informed us they had updated staff rotas to ensure less travelling for staff to achieve better calls times for people using the service.

The provider had infection prevention and control (IPC) policies and procedures in place to support staff to maintain safe standards. Most people told us staff wore appropriate personal protective equipment (PPE) during care. However, some people raised concerns about poor hygiene practices. One relative said, “Some just come in with their hats and jackets on and don't even take those off and just push up their sleeves to do the work rather than putting on PPE and being professional in the way that they help him.” Another relative told us, “We have had carers who turn up in coats and beanie hats. They keep these on to give [person’s name] his care! We had one recently who didn’t remove their coat and backpack for the whole visit.”

Staff gave us mixed feedback about access to appropriate PPE. Some staff who lived far from the branch office found it difficult to obtain PPE and either had to travel long distances to collect it or wait for deliveries. This was due to nearby branch closures, which left staff in some areas without local access to supplies. We raised these concerns with the manager, who told us they would investigate the issues reported.

The provider did not make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were not involved in planning. Although the provider had medicine policies aligned with national guidance, staff did not always follow these when administering medicines, which increased the risk of errors. For example, ‘when required’ (PRN) medicine records did not explain why the medicine was needed or how it should be administered as prescribed.

Most people told us their medicines were not administered safely. Many concerns related to late or poorly timed care calls, which resulted in medicine doses being given too close together or too late. Some people told us their medicines were time‑critical and delays affected their wellbeing. People also told us staff did not always inform relatives when new prescriptions were needed. As a result, some people went without essential medicines, including pain relief, for several days. Medicine administration records showed repeated occasions where medicines were unavailable because they had run out. Records did not clearly state who was responsible for ordering or collecting medicines, which contributed to these gaps.

Some people raised concerns about staff not administering medicines carefully. One person told us, “The tablets are in blister packs, and they do not follow the days properly; I can have Monday followed by Thursday. Sometimes they use a different blister pack each day, so I now have to hide subsequent weeks so they can’t use them. Several medications come in boxes of 28 and should be one per day, but at the end of the month there are different amounts in each packet. They have been told many times but it’s still wrong.”

Medicine risk assessments were not always robust or clear. For example, people prescribed anticoagulant medicines did not always have risk assessments identifying what action staff should take if the person fell or hit their head, despite the increased risk of internal bleeding. Records showed this was in place for only 1 person.

Although staff received medicines management training, the provider could not demonstrate that all staff had been assessed as competent to administer medicines safely. Some staff told us their competency assessments were overdue, or they could not recall having one.