Senacare 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. At our last assessment we rated this key question good. This key question has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

We identified a breach of legal regulation relating to safe care and treatment in that risks were not always assessed and managed appropriately. This could place people at risk of avoidable harm.

This service scored 62 (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. A system was in place to report, record and monitor incidents and accidents to help support people safely. Incidents and accidents were documented. However, we noted that there was a lack of information recorded about lessons to be learnt following an incident/accident. We raised this with the registered manager who advised that they would address this and ensure this was consistently recorded.

People told us they were able to openly speak with staff and management. They were aware of the complaints process.

Staff told us they felt confident raising concerns with management and said that they would not hesitate to raise concerns outside of the management team to help prevent the development of a closed culture.

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.

People and their relatives where appropriate were involved in their care and support planning.

Staff spoke confidently about the processes to report concerns and raise issues about people’s safety. They were also confident; their concerns would be listened to and acted upon by management. A member of staff told us, “Management listen and find solutions.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Procedures were in place to help safeguard people from abuse and improper treatment. Staff knew how to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff knew how to report concerns and said that they wouldn’t hesitate to do so.

People told us they felt safe with care staff in their home. A person said, “I don’t know what I’d do without my [care staff]. I can’t get out of bed and so rely on them for almost everything.” When asked if relatives were confident their family members were safe in the presence of staff, a relative told us, “Totally”. Another said, “Much better than just good.”

Staff received training and demonstrated an understanding of their safeguarding responsibilities.

Potential risks to people's safety were not assessed appropriately and we found a breach of the legal regulation. People's care records included some risk assessments. However, these contained limited information about how to support people to mitigate these risks. For example, the provider identified that a person was at risk of choking but did not have detailed guidance for staff about how to mitigate this risk and support this person appropriately. We also found that some areas of risk did not have an appropriate risk assessment in place. For example, 1 person was at risk of seizures but there was not a risk assessment in place detailing signs to look out for and what action to take in the event of a seizure. Another person’s care plan stated that they were at risk of falls but there was not an appropriate risk assessment in place with detail of how to reduce the risk of this person falling.

We found no evidence that people had been harmed as a result of the deficiencies found in respect of risk assessments. Management and staff understood people’s individual needs and associated risks. People and relatives, we spoke with did not raise concerns about safety when receiving care. However, the lack of effective risk assessments meant people were at risk of receiving unsafe care and treatment because staff had not always been provided with suitable guidance to minimise the risk of people receiving unsafe care and lacked guidance on what to do in response to symptoms of conditions identified.

We discussed this with registered manager who told us they would take immediate action to address issues. Following the site visit, the registered manager sent us evidence that they had started to address the issues identified.

The provider completed an environmental risk assessment within people’s homes during the initial assessment to check if it was safe for staff to carry out the necessary tasks. They helped the provider to ensure equipment, facilities and technology supported the delivery of safe care.

An out of office hours procedure was in place for staff so senior staff could always be contacted for support. Staff confirmed this was in place and they utilised it when necessary.

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 staff arrived on time and stayed for the length of time agreed and carried out tasks as agreed. A person told us, “They’re lovely people, I have the same [care staff] 6 mornings a week. I never worry.” Another person said, “Barring unforeseen problems with a previous call, always on time.”

The provider used an electronic homecare monitoring system to plan and monitor care visits. This recorded care staff’ actual start and visit times to ensure they were adhered to, and people received their care as planned. The system promoted continuity of care by monitoring staff deployment.

Records showed that staff had received training in areas relevant to their roles. Staff received supervision sessions which provided an opportunity for them to discuss their performance and professional development.

Policies and procedures were in place to help recruit staff safely. Checks on the suitability of potential staff were completed. These included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

People and relatives told us care staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE). A person said, “Their hygiene is first class. Never had an infection.” A relative said, “The carer is meticulous, washes their hands between tasks and gets new gloves.” Another relative told us, “They are really meticulous.”

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

Infection prevention and control policies were in place. Staff were given the information and guidance they needed.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Some improvements were needed with medicines management. Medicines administration was recorded electronically on the care planning system. We looked at a sample of Medicines Administration Records (MARs) and found these were mostly completed fully but there were occasions where there were gaps. Reasons for not administering medicines were not clearly documented.

Where people were prescribed medicines on a when required basis (PRN), protocols were not consistently in place to help advise staff on what circumstances and how to give these medicines. We raised this with the registered manager who advised that they would review this and ensure such protocols were in place.

People's medicine support needs were clearly documented in their care plans.

Staff were trained in the safe administration of medicines.