Supreme Homecare

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 as 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.

People and their relatives told us they would speak with staff if they had any concerns. One relative told us, “When several different carers attended on Fridays, I contacted the office because consistency was important for [person], who lives with dementia. I said this to the provider who listened and arranged for the same Friday carer to attend." Another relative told us, "I would be the first to complain if there was anything wrong but had never needed to because she was "100% happy" with the service.”

Staff we spoke with told us they felt confident about reporting any concerns or poor practice to their managers. One staff member told us, “Yes, I would say they have, if you have an issue they make it right.”

Systems were in place to ensure lessons were learned following incidents and accidents. Where incidents occurred, they were appropriately recorded, investigated, and reviewed, with actions taken to reduce the risk of recurrence. Records demonstrated concerns were addressed promptly and that measures had been implemented to mitigate future risks and improve outcomes for people using the service.

Staff had access to the information they needed to provide safe and effective care. Office staff completed regular spot checks and observations to monitor staff practice and ensure staff remained competent and confident in their roles. These checks also helped to ensure risks were being managed appropriately and enabled the service to identify and respond to any changes in people’s needs. Staff told us that where people’s needs changed, they worked closely with healthcare professionals, including GPs, pharmacists, and other health services, to ensure people continued to receive appropriate support.

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 worked collaboratively with external professionals to ensure safe and well-coordinated admissions, as well as smooth transitions when people required hospital care.

Prior to admission into the home, an initial assessment was completed. Where possible, this was completed by telephone interview or people’s own homes to help ensure that the provider could meet the person’s assessed needs and expectations. A relative told us, “When [person] care started, staff came and did a full assessment, recording details of their medication, mobility and support needs before care began. [Person] felt they had a good understanding of what assistance [person] required.” This process provided reassurance to the family that their loved one was moving into a home where staff already had a clear understanding of their needs and personal preferences.

Care plans were formulated in more detail following detailed discussions with the person and their relatives or representatives. These personalised care plans included comprehensive information such as clinical needs, medicine requirements, past medical history, identified risks, allergies, communication preferences, and contact details for those important to the individual. Care plans were reviewed regularly and updated promptly when a person’s needs changed.

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, and their relatives, told us they felt safe. Comments included, “Yes, 100% safe with the staff” and “[Person] feels safe with the carers and felt reassured.”

A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse to ensure people were protected. A safeguarding care plan was in place with risk assessments that detailed people’s background and on how to keep people safe.

People told us that they felt safe when supported by staff. A person told us, “I felt reassured because a small, consistent team of staff provided for my care. Staff has been supporting me for around ten years and had always been reliable.” A staff member commented, “Yes, people are happy here and well cared for.”

Staff knew about safeguarding processes and had received training in this area. Staff told us that they received safeguarding training. A staff member told us, “If a person tells me about abuse, I will listen to them carefully. I will document the concerns and report it to my manager. If my manager would not listen to me, I will follow whistleblowing procedures and contact CQC.”

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.

Risks associated with people’s care and support had been identified and appropriate guidance was in place to help staff respond safely and consistently. This included information relating to the use of equipment to support people’s safety and independence, such as shower stools and mobility aids. Risk assessments were completed in areas including falls prevention, nutrition, and hydration.

One person told us, “A full risk assessment of [person’s] home was completed after they returned from hospital. Staff checked the shower, equipment and layout of the home before discussing the support they required.” A relative said, “The carers encouraged her [person] to continue using their walking frame but stayed close behind them to minimise the risk of falls while maintaining their independence.”

Staff completed a range of training designed to support them in providing safe care. The management team also carried out competency assessments and observations of staff practice to help ensure care was delivered safely and in line with people’s assessed needs.

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 risk assessments in relation to the person’s home environment to indicate if there were any possible risks and how to reduce them. Environmental risk assessments included checks on any equipment used, cleaning products used and other possible risks.

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.

Systems were in place that showed the training staff had completed and the dates the training were completed to ensure management oversight. A staff member told us, “I have been trained in my role to do my job.” Another staff member told us, "They [provider] enrolled me to complete my Level 2 in NVQ Health and Social Care, they [provider] are helping me to develop with my career."

Staff also received spot checks to check if they were competent in their roles. Welfare checks were carried out on people to get feedback on people’s views on staff approach and delivery of care, which formed part of staff supervisions. A staff member told us, “I receive regular supervision and spot checks to ensure I am carrying out my role effectively.”

People told us staff arrived on time and stayed the full time they expected, only leaving slightly earlier if there was nothing more they needed. Comments included, “[Person] had been supported by the same carers for two years and that the constant care is really important to me and my [person] because of [person’s] dementia.” and “[Person] was supported by one regular member of staff alongside a small group of carers.”

There were recruitment practices in place to make sure that all staff were suitably experienced, competent and able to carry out their role. Disclosure and Barring Service (DBS) checks were carried out. These 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.

Staff confirmed they had completed training in infection prevention and control and demonstrated a good understanding of the measures to manage and prevent the spread of infection.The provider had a policy on infection prevention and control to provide guidance to staff in this area. Staff were provided with personal protective equipment [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.

Medicines were recorded using an electronic medication administration record (EMAR) system, which enabled medication records to be integrated into each person's daily log on the digital care planning system.

One relative told us, “Staff always asked [person] permission before carrying out any aspect of their care, including administering medication, despite supporting [person] regularly over a long period.”

The service had contingency arrangements in place in the event of a technology failure. This was evidenced by printed copies of medication records that were stored both in people's homes and at the office.

Staff told us they had received the appropriate training and were confident in administering medicines to people, when required. The provider had effective medicine management systems. For example, staff had received training in medicines administration and there were relevant up to date policies in place.