Seraphim Home Care

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 requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm. The service had made improvements and had met the breach of legal regulations in relation to staffing and fit and proper persons employed.

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.

The provider had a positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Improvements had been made to ensure reported concerns were investigated and actions taken to mitigate future risks. Accident, incident and safeguarding concerns were documented and systems enabled actions to be taken. Lessons were learnt and shared within the staff team. Staff told us they were kept updated and informed of changes relating to people. Staff told us communication was effective and learning was shared. Staff member told us, “We are well informed,” and “[The manager] sends frequent messages, any changes of clients, all the information you need.” External agencies were notified of incidents and safeguarding concerns as required. For example, the Care Quality Commission (CQC) and the local authority safeguarding team.

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.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. People’s experiences had improved. People told us they felt safe and well supported. A relative said, “[Name of person] is very safe as he gets on very well with the carers.” Staff we spoke with knew how to identify and report safeguarding concerns. Safeguarding concerns, accidents and incidents were documented and information organised. The provider now had an overview of these events and reviewed these in their audits. A health and social care professional said, “I have found the service to be proactive in addressing [safeguarding] concerns.” People’s mental capacity had been considered in their care plan. A relative said, “Staff always ask permission before doing anything.” Staff received safeguarding and mental capacity act training. However, staff told us this needed to be further in depth to have a fuller understanding. A staff member said, “Mental Capacity Act gets covered slightly."

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. People's experience of risk management had improved. Staff knew how to support people safely and had access to up-to-date information regarding risks to people. People were supported in a person-centred way and their indepedence was promoted. A person said, “I am very safe. They do use my hoist very well. We are both comfortable using it.” A relative told us of the positive impacts to their family member through being supported to use their stand aid. They said, “Thanks to the carer`s, [Name of person] is getting stronger and stronger. Staff watch over him.” Regular spot checks and supervision of staff occurred to ensure the quality of care delivered was safe and met people’s preferences. People told us they could now effectively communicate with staff after the provider had made changes in staffing. This meant risks had been reduced as previously this occurred through miscommunication. Relatives said, “Communication is great now,” and “We have no problems and communication is fine.” Risk assessments guided staff how to mitigate individual risks and were regularly reviewed. Risk assessments around moving and handling procedures were now clear and accurate. An on-call system supported staff out of hours. Management of this system had improved. People and staff told us it was effective and support was available when needed. A business continuity plan described procedures to follow in a variety of emergency circumstances. Further detail was needed to ensure situations would be managed where operations were impacted by reduced staffing or adverse weather.

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

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective training. Staff were supported through supervision. Recruitment procedures had been reviewed and some improvements were evident. For example, Disclosure and Barring Service (DBS) checks were completed, education and employment history and satisfactory references were obtained. However, we found 1 person had started working before their references had been received. Interviews had been conducted but records did not give full and detailed information to demonstrate the candidate’s suitability for the role. A new interview form was being rolled out which would address this area. A recruitment checklist and the providers audit did not always support identifying where further information was still required. Exit interviews were conducted to gain feedback about staff experience working for the service. Staff received an induction when they started and shadowed a more experience member of staff. The induction was not fully documented to demonstrate all areas covered. The provider had addressed this by creating a new induction document.A condition of the providers registration for the service requires a manager to be registered with CQC. The manager submitted their application after the assessment.

Compliance with staff training had improved to ensure key areas were covered such as first aid and moving and handling. Other areas of training were now completed such as dementia, food and nutrition and safeguarding. People’s experience of care had improved and people felt confident in staffs’ skills and knowledge. A person said, “They seem well trained and know what they are doing.” Some people mentioned newer staff were still developing their practice. A person said, “90% of staff are well trained but the new ones need to do more shadowing.” Staff we spoke with highlighted training could be improved. A staff member said, “We used to have face to face training but now its basic online training. We get dementia training on the mandatory [course] but it’s not enough.” Another staff member said, “I think training could be better.” We found the providers documentation of catheter care training did not robustly demonstrate delivery of this area or ensure staff understanding and competence had been assessed. Staff were supported in further qualifications in health and social care.

People’s experience of staffing had improved. People told us they received care and support from a consistent staff team who knew people well and could communicate effectively. People had not experienced any missed care calls and if staff were late, people were kept informed. A relative said, “[Staff are] generally on time and never miss coming.” A person said, “We get regular carers for continuity.” People’s preferences around carers was listened to and supported. People had developed positive relationships with staff. A relative said, “[Name of person] has a laugh and a good chat with the staff and looks forward to them coming.”

Staff received regular supervision and felt well supported. Improvements had been made in the recording of supervision to ensure the manager and provider had oversight. Regular spot checks and competency assessments were conducted to ensure people received safe and person-centred care. Where any issues were identified these were managed and staff supported. A staff member said, “I always want to do better.”

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.