Cecile Healthcare UK

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

This is the first assessment for this service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 69 (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 proactive and positive culture of safety, openness and honesty within the service. Staff listened and responded appropriately to concerns about safety and events. Lessons were learnt to continually identify and embed good practice.

People were supported to make informed choices and risks were assessed and managed safely. There were systems in place to ensure accident and incidents were reported, recorded and investigated. Lessons were learnt with opportunities to learn from safety events being shared and communicated to staff to help drive service improvements. Policies and procedures were in place to ensure people’s safety, such as safeguarding and whistleblowing.

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.

Records showed effective communication and good working partnerships with health and social care professionals when required. The registered manager told us they worked closely with people and their families, GP’s, and community nurses to ensure people received appropriate care and treatment. The registered manager was a nurse by profession; they told us how this helped them to support people to access medical care promptly when required.

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 and their relatives told us they felt safe with the staff who supported them. Comments included, “Definitely, they [staff] are very careful and strong, we don’t ever feel that [loved one] is at risk”, “Yes, absolutely safe, they [staff] are professional”, and “Absolutely, I don’t know what I would do without [staff]. [Staff] opted to stay sitting in [loved ones] room when [loved one] came out of hospital as we were scared [loved one] might fall out of bed.”

The registered manager was aware of their responsibilities for reporting safeguarding concerns to the local authority safeguarding team and the CQC. However, at the time of our assessment there had not been any concerns of abuse or harm raised at the service. Staff understood safeguarding and how to take appropriate action to keep people safe. Staff had completed safeguarding training and understood their responsibilities about protecting people from the risk of abuse and harm. A staff member told us, “If I had a concern, I would follow our procedures and report the issue straight away to the manager.”

Although we were assured staff provided care to meet people’s needs that was safe and supportive and staff worked well with people to understand and manage risks, some risk assessments and care plans required further detail.

Risks to people were identified, assessed and documented. However, some risk assessments and care plans required further detailed information to provide clear guidance to staff. For example,1 person required support with transfers with the use of mobility equipment. Whilst this was documented, there was no detailed guidance for staff on how this maneuverer should safely be carried out. Staff were able to tell us how they identified and managed risks to people, including how to safely support people to transfer and to keep them safe when using equipment.

People and their relatives told us they felt safe when receiving care. Comments from people included, “[Loved one] has a ceiling hoist, [loved one] doesn't complain. [loved one] is blind and they [staff] constantly talk to [loved one]”, “[loved one] feels safe in the hoist”. “When [loved one] is coming down the stairs they [staff] walk in front”, and “They [staff] use a hoist. The NHS staff don’t know how to use it, but the Cecile staff do.”

Following our assessment of the service, the registered manager took immediate action and reviewed people’s care plans and risk assessments ensuring further detailed information and guidance was included for staff.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Processes were in place to help ensure the safety of people’s home environment. For example, risk assessments of people’s home environments were completed to ensure the safety and well-being of both people and staff. The registered manager told us; risk assessments were completed with people in their homes to ensure everyone’s safety. If required, referrals to health care professionals were made such as occupational therapists to adjust or install equipment as needed.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The registered manager showed us a staffing rota which covered people’s care calls. This indicated there was enough staff to meet people’s care and support needs. They used an electronic system to allocate staff to support people. Staff logged into the system when they commenced providing care to a person. The system alerted the registered manager if there was a late or missed call. If a call was late the registered manager told us they would contact the member of staff, enquire on their whereabouts and let the person know when the carer would arrive. They told us they had never had any missed calls. A staff member told us they supported people that lived near each other, and they had plenty of time to get between calls.

Records showed that all staff had completed an induction in line with the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme. We also saw a training matrix which indicated that staff had completed training in areas such as fire safety, infection control, food hygiene, moving and handling, nutrition and hydration, safeguarding adults, the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Records showed that staff received regular formal supervision sessions with their line managers. A staff member told us they received lots of training and they received regular supervision and support from the registered manager.

Robust recruitment procedures were in place. Staff recruitment records included proof of identification, application forms with employment histories, employment references, health declaration and right to work in the UK checks. We saw evidence that Disclosure and Barring Service (DBS) checks had been carried out. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had an infection control policy in place. Staff told us the service provided them with all the personal protective equipment (PPE) they required to support people with their care needs. Training records confirmed that all staff had completed training on infection control and food hygiene. A staff member told us they were the providers infection prevention and control link. They made sure staff had access to PPE and they carried out unannounced spot checks on staff to make sure they followed good infection control practices for example using PPE and handwashing correctly.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Some people looked after their own medicines and some people required support from staff to take their medicines. Where people required support to take their medicines this was recorded in their care records. The registered manager monitored electronic medicines records (MARs) on a live system daily, to make sure people were receiving their medicines as prescribed. We saw MARs and medicines audits completed for 2 people using the service, these indicated that people were receiving their medicines. Training records confirmed that staff had received training on the administration of medicines and where required staff’s competence in administering medicines had been assessed by the registered manager. These measures ensured that people were supported to take their medicines as prescribed by health care professionals.

Staff had also completed paper MARs when they administered medicines to people. These MARs included codes for medicines administered, missed, refused or if the person had already taken their medicines. We noted there were gaps in one person’s MAR with no codes recorded. The registered manager told us this was because the person had gone into hospital and there was no code for this omission. We also noted that the paper MAR did not include a code for discontinued medicines. Following our assessment of the service the registered manager sent us a new paper MAR that included codes for when people were admitted into hospital and for discontinued medicines.