Sinai Care Solutions Limited

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 requires improvement. At this assessment the rating has remained 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.

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 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’s systems to review accidents and incidents were effective. There was a tracker for accidents and incidents which recorded the time, location, individuals involved and actions taken by staff. Where incidents such as falls occurred, care plans were promptly reviewed and updated to reflect new risks and mitigation strategies. Where concerns were highlighted in the accident and incident log in relation to staff this was addressed via supervision and formal training. The registered manager told us they worked collaboratively with the person and their representatives and external agencies to promote a positive safety culture. Staff promptly sought medical attention. Staff were aware when to report incidents to the manager and had knowledge of what to do in the event of an emergency. An accident and incident policy was in place that detailed the process to manage accidents and incidents.

The service did not always have effective processes to support safe systems of care. The systems in place to support people were not consistently working to ensure people were supported safely. For example, we found contradictory speech and language therapy (SALT) recommendations in a person’s care plan. This placed the person at risk of harm from not receiving care in line with health professionals’ guidance. Following our inspection the registered manager informed us they had taken action to address this. We will check effective systems are in place to prevent reoccurrence at our next inspection. However, there were processes in place to ensure people’s needs were assessed before commencement of a care package. We saw the pre-assessment had been completed and used to record key information about people’s support and care needs to determine the support required. This information was then used to create care plans based on people’s preferences and choices on the support they required.

The provider did not always share safeguarding concerns with us as required. This meant we did not have access to accurate information to enable us to effectively monitor risk at the service. We found 2 safeguarding concerns which had not been reported to CQC. However, people and their relatives told us they felt safe. A relatives told us, “The staff are always happy and are just lovely.” Staff understood how to recognise signs of abuse and knew how to report any concerns. We saw there was a safeguarding tracker in place, and the registered manager reported safeguarding concerns to the local authority as required.

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 told us they felt safe when care was being delivered. Relatives told us staff were attentive and liaised with family when concerns arose. Risk assessments were in place and reviewed monthly. We saw risk assessments such as nutrition, hydration, mobility and manual handling. Risk assessments were documented throughout care plans with mitigating actions to reduce risks identified, to promote positive outcomes for people around their safety. This gave appropriate guidance to staff to provide care. Staff we spoke with were clear about these risks and how to mitigate them. Staff told us there was enough information and it was clear what they needed to do.For example, how to prepare food or drink to the correct consistency where a person was at risk of choking despite their being conflicting information in the person’s care plan.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Risks associated with people’s individual environments were assessed before staff started supporting people within their homes. We saw regular audits completed for equipment used.

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. One person told us staff were, “Well trained and very professional.” Relatives told us that carers attended based on a rota, and it was always the allocated staff for their relative. Records showed no gaps in mandatory training and evidenced staff had received training in a variety of topics, including safeguarding, medicines administration and infection prevention control. Staff were recruited safely. This included checking their identity, their eligibility to work in the UK, obtaining at least 2 references and Disclosure and Barring Service (DBS) checks. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had regular supervisions. We saw regular staff rotas. We saw records showing call monitoring which highlighted staff lateness. The registered manager was proactive and based on logistics staff rotas were adjusted accordingly.

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 wore Personal Protective Equipment (PPE) and staff disposed of it themselves. The provider had a policy in place for Infection prevention Control (IPC). IPC audits were completed monthly. The provider’s training matrix showed staff had received IPC training and staff told us they had access to PPE. The registered manager told us staff had competency checks for IPC and that staff had to complete mandatory training.

The provider did not always make sure that medicines were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.At our last inspection, effective systems were not in place to ensure that where people had ‘as required’ medicines, appropriate guidance was not in place to ensure these were administered in line with how they were prescribed. This meant we could not be sure people were receiving their medicines as prescribed. During this inspection, we found effective action had not been taken to address this as ‘as required’ medicines protocols were still not consistently in place when needed. This was addressed by the registered manager on the day of the inspection and subsequently ‘as required’ protocols were put into place. However, staff had received medicines training and had their competency assessed. This meant there was a process in place to ensure medicine administration was in line with staff training.