Sevacare - Kingstanding

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 remained good. This meant people were safe and protected from avoidable harm. People told us they felt safely supported by staff. Staff understood how to identify and report safeguarding concerns. Lessons were learnt and shared when things went wrong. People were supported to manage risks safely, including medical health conditions such as diabetes and epilepsy. Staff recruitment systems were robust. However, we did find that some carers were working without the time off they were entitled to. People were happy with the support they received to take their medicines. Most people and their relatives were happy with the carers support to maintain a good hygiene.

This service scored 66 (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 fostered a proactive and 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. Staff told us about examples of information shared with them about lessons learned from when things had gone wrong. One staff member told us, “We get emailed about incidents and complaints. They give advice about how to avoid issues.” The management team had an escalation process for concerns and complaints depending upon the nature of the concern. A complaint about the safety of care provided to someone had previously not been responded to in a timely way. Changes had been made to ensure future risk of delay was mitigated. People and their relatives told us they knew how to raise concerns. The service had an easy read complaints procedure for anyone who needed it. People whose first language was not English were matched with staff who spoke their desired language wherever possible. This enabled clear communication to facilitate any concerns or complaints. People with a learning disability or autistic people were supported mainly by a team of staff they knew well. Staff received spot checks regularly to ensure they were providing appropriate care. Reviews included people’s loved ones if they could not communicate their own concerns easily. These measures reduced the risk of closed culture.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. The service specialised in EICT (Early intervention community team) care packages. These care packages enable people to return home from a hospital stay with additional support. A process was in place to review the information provided by this team within 48 hours of the care commencing. This enabled people to be provided with a welcome pack and communicate any needs or wishes not detailed in their referral. All staff received training in various health conditions people may experience to prepare for key health issues people may experience. The care plans did not include a single page summary which could be shared with other health professionals if people’s care was being transferred to a hospital. In most cases people who may find it difficult to communicate their needs were supported by family who would accompany them. The registered manager advised that the service was transferring to a new electronic system which would provide a single page summary of a person’s care needs if needed.

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. Staff were able to identify safeguarding concerns and knew how to escalate their concerns appropriately. People and their loved ones told us they felt safely supported. One relative told us, “We have always felt that [our loved one] was safe with their carers.” The registered manager oversaw a system to record and investigate any safeguarding concerns identified. They also analysed the information gathered to look for any themes and trends.

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 and their relatives consistently told us they were involved in the development of care plans and risk assessments. Risk assessments detailed how people could be supported to manage risks safely. For example, guidance for staff about epilepsy was detailed and enabled staff to maintain an accurate record of people’s seizure activity. Staff also understood what the diagnosis of epilepsy meant for each person and how this could affect them day to day. They knew about potential triggers for seizures and what steps they could take to keep people safe if they experienced a seizure. Some people receiving care could not communicate their needs verbally. Carers knew people well and told us about the ways in which they could understand their needs and wishes. One carer told us, “I know it sounds strange, but even though [the person] cannot speak, we can still have a chat… I can tell if they are in any pain.”

The provider ensured risk assessments were completed to detect potential risks in people’s homes. They made sure equipment was safe and practical for people to use. The registered manager gave examples of occasions when they had worked alongside occupational therapy teams to ensure equipment reviewed when people’s needs changed.

The provider ensured there were enough qualified, skilled and experienced staff. However they had not always checked staff were taking the breaks and days off they needed and were entitled to. This meant care staff were at risk of poor health and wellbeing which could lead to unsafe care delivery.

We identified a particular example of a carer working for 31 days without a day off. The provider’s electronic call monitoring analysis had not alerted them to this. The registered manager took immediate steps to ensure the carer was supported to take the time off they needed. They worked together well to provide safe care that met people’s individual needs. Staff teams were separated into zones across the areas of the city the service covered. The teams worked within the zones to limit travel time and make punctuality to care calls easier. Most carers supported both people receiving long term care, and EICT care packages. The registered manager ensured that enough staff were available to respond to the varying needs of the EICT team and could potentially arrange for a carer to attend a person’s home within 4 hours of receiving the care referral. Most people and relatives we spoke with told us the carers were well trained and had the right experience to care for people well. Staff told us they were happy with the training and support they received. One staff member told us, “We have a lot of training, and if we feel less confident and we need a refresher, we can call the office, and they will arrange it.” Staff we spoke with who supported people with a learning disability and autistic people, understood the person’s strengths and areas of need. They told us about ways in which they made sure people’s needs and wishes were understood. Recruitment systems were robust and included DBS (disclosure and barring service) checks to assess the suitability of candidates for work with vulnerable adults.

The provider assessed and managed the risk of infection. Most people and their relatives told us they were happy with the support they received to maintain good hygiene in their homes. One relative told us they had raised concerns about the support received by carers. We shared this concern with the registered manager who told us they had discussed the matter with carers to ensure it would be addressed. Staff told us they received all the PPE (personal protective equipment) they needed to ensure they could provide safe and hygienic care. We saw spot checks of staff included ensuring they wore the correct PPE.

The provider made sure medicine management was safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Medicines administration charts (MAR) were checked to ensure people were receiving safe and appropriate support to take their medicines. We saw that one check had failed to note a person who required time critical medicines had not always received their medicine within the required window. We shared this observation with the registered manager. They re-designed the MAR chart to show more clearly which medicine was time critical, for both the staff administering the medication and the person checking the MAR charts. We found no evidence the person had been harmed by the delayed medicines. People and their relatives told us they were happy with the support they received to take their medicines. Staff told us they received regular refresher training and spot checks to make sure they were supporting people safely. Any errors with medicines administration were investigated and appropriate actions taken to mitigate future risk.