Sylvian Care Farnham

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• 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 75 (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 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.

The provider had systems in place to record, manage and respond to accidents and incidents. A member of staff told us, “If there has been a fall, I do a visual body check as I may need to call 999. If they said they are not injured, or if they had bruises or broken skin. I Twill call 111 if they cannot get up by themselves. After all this I will write notes and raise this and then call the office.”

An accident and incidents log was maintained, and the registered manager told us there had been 4 incidents in 2025 and 1 in 2026. They told us, “It [the incident] comes as an alert on [electronic care system], I then talk with the carer and the client and an investigation is done.”

We saw after each incident there was a full investigation and lessons learned were shared with staff. For example, we saw from 1 incident that a person, whose mobility had reduced, had fallen whilst attempting to stand from their chair as they needed to use the bathroom. A new electronic chair had been ordered to assist the person getting up from their chair. Staff had been asked, in the interim, to ensure the person had the use a commode in their room to reduce further risks.

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 provider consistently completed comprehensive, face‑to‑face pre‑admission assessments for all people, regardless of referral source. This ensured a detailed understanding of people’s needs, risks and preferences and supported personalised care from the outset. One person spoke positively about the pre-assessment process and told us, “I was in hospital, they came there. Everything was done very well for me.” Staff received information about people’s needs before they visited the person. A member of staff told us, “Before I start with the [person], I receive information from the company and from the care plan.”

One person fed back to the service, ‘The service is based on a thorough assessment before any commitment is made but remains flexible and focused on my changing needs. I am wholly satisfied with the service provided and believe it has been a key factor in maintaining and even improving the quality of my life in what are, for me, very difficult circumstances.’
 

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 relatives fed back positively that people were safe with staff. Comments included, “If I don’t feel safe on my own, they won’t just leave me, they will wait until I’m safe in bed”, and “[Family member] is 100% safe, I think they are always respectful towards her. I have peace of mind, and [family member] would tell me if they weren’t.”

All staff had completed safeguarding training, which was recorded on the training matrix. Leaders were aware of their responsibility to report and investigate safeguarding concerns. The registered manager told us, “Any concerns I have has to be raised through [their care system], we so far have had no safeguarding incidents raised.” We also saw that safeguarding was included as part of the agenda at each staff meeting.

A safeguarding policy was in place and accessible to staff. Staff demonstrated an understanding of safeguarding processes and knew how to recognise, report and escalate concerns to help keep people safe. One member of staff told us, “I have report it to the office. I then record on the system. Then the office will take measures to investigate.”

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People and relatives felt staff understood the risks associated with people’s care and managed this in a safe way. Comments included, “They [staff] are perfect [when supporting me], gentle”, “They [staff] understand the risks with [family member’s care], they are professional.”

People and, where appropriate, their family members were involved in developing and reviewing care records and risk assessments. Staff worked with people to understand their needs, risks and preferences. Risk assessments included areas such as the risk of falls, malnutrition, moving and handling, medicines and skin integrity. One member of staff told us, “I have info about the clients, the conditions of the clients, moving and handling of the clients, day to day tasks, the equipment the clients use, medication, the risks associated with the clients.”

A staff member confirmed that people and their families were actively involved in care planning and reviews. People’s care and support arrangements were formally reviewed every 6 months. People had a choice about how these reviews took place, either face to face or over the phone. This helped ensure care plans remained up to date and reflected people’s changing needs, preferences and circumstances.

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

The provider completed environmental assessments as part of the pre‑assessment process to help identify and manage potential risks in people’s homes before care started. The registered manager told us, “That’s part of the pre-assessment is to look at the environment. For each part of the care there is an environment risk assessment.”

Environmental risk assessments were completed and clearly recorded within people’s care plans. This helped ensure risks were identified, monitored and managed appropriately, and that care was delivered safely in people’s own homes.

In the event of an emergency such as poor weather conditions, there were contingency plans in place to ensure those people more at risk would receive their care. The registered manager told us, “I will look into those that can be looked after by their wife or husband, those [care calls] that can cover. We prioritise those that are more vulnerable.” We saw this information in people’s care plans.

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.

People told us that staff always turned up for the care visit and stayed for the full duration. Comments included, “[Staff] always turn up on time, they give us a rota and if they are going to be late they will ring us up and tell us” and “They have never not turned up and they call [family member] if running late but it’s very rare that happens.”

Staff told us there were sufficient numbers of staff to be able to provide the support people needed. One member of staff told us, “I am very happy with the rota and have enough time between the clients.”

The PIR stated, ‘Due to our small, relationship-focused team, clients benefit from consistency and trust, being supported by familiar faces who understand their individual needs. There have been no missed or late visits.’ We confirmed this by reviewing staff rotas and records of when staff attended the care visit.

New staff were supported through a structured induction and shadowing process and worked alongside experienced staff until they were assessed as confident and competent. Staff were formally signed off before working independently. A relative told us, “When new [staff] came, she came with other staff. They are really considerate how new people coming into her home how that would make [family member] feel.” One member of staff told us, “I found it very useful and did the training online and also did face-to-face training like moving and handling first aid, medication and other training.” The registered manager told us, “We observe our carers on the field and when they deliver the support.”

Staff received regular supervision and an annual appraisal, which supported reflection on practice, development needs and wellbeing. Staff meetings were held every month, and leaders operated an open‑door policy, enabling staff to raise concerns and seek support when needed. A training matrix was in place to monitor staff training and compliance.

Robust recruitment checks were completed before staff started work to help ensure they were suitable for 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.

People and relatives told us staff always wore gloves and aprons when providing personal care. One relative told us, “The carers clean very well. They are very proactive. [Family member] is heavily dependent on support with keeping his house clean (due to the risks associated with their health)

The PIR stated, ‘Care Professionals [staff] receive comprehensive infection prevention and control training as part of their induction, which covers hand hygiene, correct use and disposal of personal protective equipment (PPE), safe cleaning practices, and the management of infection risks within client’s homes.’

Staff received health and safety training, which included infection prevention and control and food safety. This helped ensure staff understood how to work safely and reduce the risk of infection. Staff told us, “We have cover shoes, enough face masks, enough gloves. If I’m running out of PPE, I ask the office and I am given more” and “It’s important to protect the client and ourselves. The skin is very sensitive. We have to protect clients from infections.”

The provider monitored staff practice through regular spot checks, which included observing hand‑washing techniques and the correct use of PPE. These checks provided assurance that staff followed safe working practices during care delivery. Leaders also ensured staff were provided with sufficient stocks of PPE.

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. One relative told us, “[Family member] does her own medicines but they always check with them that they have it.”

All staff who supported people with medicines had received medicines training and were assessed as competent before administering medicines independently. Staff were formally signed off once they had demonstrated they were confident and capable. A member of staff told us, “I am confident (with medicines), and I think it’s such an important task. I will check the care plan to see what the medicine is and follow the proper procedures.”