Complesso Healthcare Solutions Also known as Community Response Service

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 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.

The provider had a positive culture of safety. Staff listened to concerns about safety and investigated and reported safety events. Staff told us they shared details of incidents with care managers using the care recording app. This was then reviewed and action taken to reduce the likelihood of reoccurrence. The registered managers shared with us examples of how learning had been identified which improved outcomes for people. For example, 1 incident led to a review of a person’s needs and referrals to specialist services were then made to improve the person’s experience of care. However, the registered managers acknowledged their monitoring systems could be further developed to include analysis of any themes or trends, which would help to improve oversight.

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.

Managers and staff were mindful of people’s individual needs when supporting them through change. Care managers we spoke with shared examples of how people had been supported to move into their services. Transitions were planned according to each person’s needs and involved the person meeting their staff team as well as familiarising themselves with the properties they were moving to. Processes were in place to ensure that in some cases staff were specifically recruited to support a person, in line with their needs and preferences.

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 we spoke with told us they felt safe when receiving care from staff. One person said, “In general I am looked after and feel safe with staff.” Staff had received training in safeguarding and were aware of processes to follow to report any concerns. Incidents relating to people’s safety and wellbeing had been reported appropriately and the provider had notified us as required by law.

Where people were subject to restrictions, Deprivation of Liberty Safeguards (DoLS) applications had been submitted to the appropriate body for legal authorisation.

The provider worked with people to understand and manage risks, however in some cases this was not reflected in the person’s care plan or care records. For example, we reviewed the care for 1 person who was at risk of constipation, but no assessment of this risk was in place. During our visits to people’s homes, we observed a person whose care plan stated they required the use of a specialist pillow to support them safely, but this was not in place. Following the inspection the registered managers submitted evidence to show they had taken action to address these concerns.

Staff shared with us some examples of positive risk management which had enabled people to fulfil their wishes. This included assessing risks to enable people to go on their preferred holidays or attend leisure activities which interested them. Processes were in place to enable staff to raise concerns relating to changes to people’s risks and reviews took place to ensure people’s needs were being met and staff had the relevant guidance to follow.

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

Risk assessments were in place relating to people’s home environments, and any equipment they used to support them. For example, mobility aids, such as hoists. Staff were aware of how environmental issues could pose a risk to people and reported any concerns that were identified. Management teams then took action to ensure environmental improvements were made and risks were reviewed.

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, and we observed, there were enough staff to meet people’s needs. One relative told us, “I would say there is enough staff. [Person’s name] has a primary carer. The carer goes above and beyond, and they know what they are doing.''

Staff told us they felt staffing levels were managed well and the management team shared examples of how people were supported to express their views on who supported them. Staff told us they were supported by an on-call system so any evening or weekend queries could be raised with the manager on-call.

The provider followed safe recruitment practices and ensured pre-employment checks were undertaken to make sure staff were safe to work with people.

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 had received training in infection control and told us they had access to adequate supplies of Personal Protective equipment (PPE) such as gloves and aprons. The management team monitored the use of PPE by including observations as part of regular spot checks carried out to review staff performance.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The provider used an electronic system for the recording of medicine administration, however in some people’s homes staff were using a combination of electronic and paper Medication Administration Records (MAR). This meant that some records were partially or inconsistently completed. There were also restrictions on who could update electronic medicines records which meant on occasion staff could not confirm medicines had been administered as prescribed.

Systems used for the storage of medicines were safe and people received their medicines as prescribed. Where people were prescribed medicines to reduce anxiety or distress there were clear protocols in place to ensure these were only given as prescribed and after other non-medicinal options had been explored.

There were systems in place to monitor any errors in the administration of medicines and alerts generated by the electronic recording systems were discussed in a weekly manager’s meeting and action taken to address any concerns.