Social Care Solutions Ltd (Cambridge)

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 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 effective systems in place following an incident, accident and complaint. We saw evidence people and their relatives were involved in investigations and provided with a response. One person told us “Staff are here if we have any problems, and we know who to go to". The provider shared appropriate information with other professionals and shared lessons learnt with staff. One staff member told us “I can raise concerns easily and discuss issues often.” We saw evidence of how good practice had been embedded. For example, following a choking incident the service implemented a new recording process when meals were prepared for people with dysphagia. This reduced the risk of people choking.

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 worked well with healthcare partners and contacted professionals when someone’s needs changed to ensure people’s safety, this included GPs, psychiatrists and learning disability nurses. We received positive feedback from stakeholders, and staff gave examples of working with other services to support people with their physical and mental health needs. Staff told us how 1 person’s quality of life had greatly improved following effective joint working with the clinical team. One relative said their family member’s transition from their previous accommodation was well-planned and managed with known carers accompanying them.

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 living at the service felt safe. One person told us "Staff help me with things I can't do, they watch over me and make sure I am safe". Staff told us they had safeguarding training and understood the procedures to keep people safe.

The service worked with people to understand and manage risks while promoting their independence and supporting them to retain skills. For example, supporting people at risk of burns or cuts during food and drink preparation to prepare their own meals.

One staff member told us “Wherever possible, if a person expresses a wish to do a certain activity this is risk assessed, and made happen for the individual.”

Staff completed daily records to document how support was provided in line with the care plan.

The provider made sure equipment, facilities and technology supported the delivery of safe care.

We found people’s living environments appealing and we observed they met people’s sensory needs. Equipment was safe and clean. People had access to outside spaces. One person told us “I am able to move freely around in my chair. I have [equipment] to help me to transfer. I also have a shower chair.”

However, we found hot exposed water pipes in one setting that had not been identified by the provider. The provider addressed this during the assessment.

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.

The provider had robust recruitment practices in place. We found there were enough staff to meet people’s needs safely.

Staff told us they received training appropriate to their role, and they were supported by leaders to deliver safe care. They told us that they had a thorough induction, and their competency was regularly reviewed.

We received mixed feedback about staff training and skills. A relative said that staff seemed very well trained and used appropriate and effective “verbal de-escalation” however, 2 out of 10 relatives we spoke with raised concerns about the skills and training of staff following previous incidents.

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.

We found environments to be clean and Personal Protective Equipment (PPE) was supplied for staff to use when required. Some people we spoke with were supported to manage their own laundry and cleaning. One person told us “I do cleaning, but staff will help me with areas I can't reach".

We viewed infection prevention and control (IPC) audits and checklists and lessons learnt were shared with staff when required.

However, we identified an IPC risk relating to effective hand hygiene measures that had not been identified during audits and was not in line with the provider’s risk assessment. This was addressed by the provider during the assessment.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their prescribed medicines as intended.

Regular medicines audits were carried out to ensure systems remained safe. Medicines related incidents were reported and investigated, with actions taken to reduce the likelihood of these happening again.

Staff received the necessary training, and their competence was assessed regularly. They worked closely with other healthcare professionals to ensure people’s medicines were reviewed regularly and raised concerns promptly when needed.

Topical medicines were recorded appropriately, with clear body maps in place to support application. Risk assessments for people using emollients had been completed, with actions in place to reduce the risk of fire.

Where people received medicines via an enteral feeding tube, records showed care was delivered safely in line with clear instructions.

Records relating to covert administration (medicines given in disguised format, such as in food or drink) showed that appropriate assessments and decisions were made with relevant professionals. Clear guidance was available for staff.

Detailed, person-centred guidance was in place for 'when required' (PRN) medicines, including rescue medicines for seizures, pain relief and laxatives. These included clear instructions on when and how to administer the medicines based on each individual’s needs and behaviours.

However, at our initial visit, we found that medicines were not stored in accordance with people’s care plans and did not meet safe storage requirements. This was promptly addressed, and medicines were stored securely when we returned.