Caremix Ltd

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 newly registered service. This key question has been rated Good.

This meant people were safe and protected from avoidable harm.

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 learning, where safety events were recorded and reviewed to improve practice. Records showed incidents, accidents and complaints were documented, including an unwitnessed fall where actions were identified to reduce risks such as ensuring clear walkways. Complaints were investigated and used to reinforce person-centred care, for example, discussing preferences about bed making with staff. Staff received training in incident reporting and emergency first aid, and policies supported openness and learning. However, as a newly registered service supporting a small number of people, these systems had not yet been fully tested over time.

The provider had systems in place to support safe transitions and coordinated care with partners. Policies guided processes such as onboarding new people, hospital discharge and communication with healthcare professionals to ensure care was reviewed and updated, including changes to risk assessments and medicines following discharge.

Pre-assessment processes considered risks, including lone working and behaviours that may challenge. Guidance supported staff to access up to date information through care plans and communication systems. Information sharing with hospitals and other professionals helped promote continuity of care.

The provider had systems and training in place to safeguard people from abuse. The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the capacity. Staff demonstrated an understanding of the MCA and their responsibilities to support people to make decisions wherever possible. Policies reflected current legislation and covered a wide range of risks, including modern slavery and online exploitation, and promoted empowerment and the least restrictive practice. Staff had completed safeguarding, mental capacity and equality training. A safeguarding log was in place, with no concerns recorded at the time of inspection. Policies supported partnership working and advocacy where required.

Systems were in place to protect people’s rights under the Deprivation of Liberty Safeguards (DoLS). At the time of assessment, no one was deprived of their liberty or had restrictions placed on them.

People were involved in managing their own risks and maintaining independence. Care plans and daily records showed risks, such as falls, were assessed and managed, including use of mobility aids, pendant alarms and environmental adjustments. Staff supported people to make choices, including encouraging independence while reducing potential hazards in the home. One staff member said, “We have to be close when the person is having a shower and be observant that there are no risks.”

Leaders described working with people and their families to balance safety and independence. The provider communicated regularly with relatives, who were able to contact the registered manager directly to raise concerns or provide feedback. Reviews were carried out through ongoing communication and regular visits.

Systems were in place to ensure people’s environments were safe. Environmental risk assessments considered fire safety, equipment, access arrangements and hazards within the home, including lighting and clutter. Care plans detailed emergency information such as utility locations and evacuation considerations. Staff completed training in health and safety, moving and handling, and fire safety. Policies supported staff to identify and manage environmental risks. These arrangements helped reduce risks within people’s homes. A relative told us, “[Person] is always clean and tidy and so is the house” indicating the environment was maintained safely.

The provider did not consistently follow safe recruitment practices. Although policies required appropriate pre-employment checks, we found gaps in recruitment records. These included an instance where a Disclosure and Barring Service (DBS) check had not been obtained prior to staff starting work, incomplete employment histories and missing references. In addition, a staff member’s right to work check had been completed shortly before the inspection.

These issues meant the provider could not always be assured that all appropriate checks had been completed in a timely way to confirm staff were suitable to work with vulnerable people. This increased the potential risk that recruitment decisions were not fully informed.

Although staff received training, supervision and observational checks, and relatives reported consistent and reliable care, recruitment systems were not always effective in ensuring all required checks were completed before staff commenced work. The Registered Manager ensured there were sufficient numbers of staff available to meet people’s individual needs.

The provider had systems to prevent and control infection. Staff received training and followed hygiene practices, including handwashing and use of personal protective equipment (PPE). Observations carried out by leaders confirmed staff adhered to infection control procedures when preparing meals and providing care. People and their relatives gave positive feedback about hygiene practices; 1 reported, “I know they wear their gloves.” PPE was available and monitored through spot checks.

People were supported to manage medicines safely in line with their needs. Care plans clearly described levels of independence, with staff supervising administration and ensuring medicines were taken as prescribed. Staff had received training, and competency assessments confirmed they followed care plans when supporting medicines. Feedback from relatives indicated staff monitored medicines appropriately, “The care staff supervise medicines because [person] is able to take those themselves, they just make sure [person] does.” Systems supported safe practice; however, as people were largely independent, there was limited evidence of staff administering medicines directly.