Starmedi Healthcare Services 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 registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice.

The provider did not have effective oversight of adverse events and did not always act to prevent a recurrence. For example, 1 person who lacked capacity to manage their medicines, had accessed their medicines. To manage this risk, the provider planned to implement a lockable cabinet. However, at the time of this assessment, this safety measure was not in place. Additionally, 1 person was involved in an incident involving equipment. The incident form did not include details about actions taken to reduce the risk of re-occurrence. While people had not been harmed, the provider failed to review adverse events, act to prevent a recurrence or share potential learning with staff.

Staff told us, “We record accidents and incidents on the accident and incident form which stays in the file at the client's house and i call the office to the care coordinator or the manager. I feel able to raise safety concerns.”

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. There was a process to follow where, if people were admitted to hospital, a form was completed which contained key details about the person. The manager said, “We can also support people when they are in hospital.” People told us staff supported them to access healthcare services when 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. People did not raise any safeguarding concerns with us. There had not been any safeguarding incidents at the service. The manager told us they would investigate and obtain as much information as possible and report any incidents to safeguarding and CQC. Staff had completed training in safeguarding and had a good understanding of how to safeguard people. Staff knew how to raise concerns and felt listened to.

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 had detailed information within their care plans about any risks and how to mitigate these. People’s care plans and risk assessments were reviewed regularly to ensure they remained relevant. One staff member said, “I do feel that I have enough information available to me.” People did not raise any concerns in relation to the management of risks.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

One person had been involved in an incident where a piece of equipment broke while it was being used. At the time of the assessment, the manager was not documenting checks on equipment, and checks were carried out informally. This meant the provider could not be assured checks were completed routinely or that any shortfalls with equipment were acted upon. The manager told us they were going to be completing 6 monthly health and safety checks on equipment going forward.

Staff had completed training in relation to health and safety, including fire safety, moving and handling, and lone working. The manager had assessed the risks relating to people’s environments.

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.

Staff were recruited safely and received training appropriate for their role. People told us staff came on time and stayed for the duration of their visits. Comments included, “They help with whatever needed, they have never missed any calls, they message me if they are running late”, “They stay for right amount of time” and “Staff come on time.” The manager told us they managed the on-call phone for any out of hours contact. Staff felt supported in their roles and the manager completed spot checks of staff to ensure they were competent in their roles.

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. Staff received training in infection control and hand-washing. People told us staff wore personal protective equipment (PPE) where appropriate. The provider had an infection prevention and control policy which outlined procedures for staff to follow to ensure they remained compliant.

The provider did not always make sure that medicines and treatments were safe. We found discrepancies in stock counts for some medicines and the service’s audits had not identified these. Additionally, there was no risk assessment available for a person who was taking a high-risk medicine. This medicine was a blood thinner which presented a risk of excessive bleeding. This meant staff may not be aware of how to mitigate the risks relating to this medicine.

Finally, the provider had not followed the Mental Capacity Act (MCA) in relation to conducting mental capacity assessments and best interest decisions in relation to the administration of a person’s medicines. This meant the provider was not working in line with the MCA in relation to medicines administration.

Staff had received training in medicines. Directions on MAR charts were clear. There was no evidence the person had come to any harm as a result of the concerns with medicines.