SureCare Rugby & North Warwickshire

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 inspection we rated this key question good. At this inspection 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.

Accidents and incidents were recorded and analysed to identify any trends or patterns so actions could be taken to mitigate emerging risks. Processes ensured any learning was shared with staff through handovers and staff meetings, to ensure they had up to date information to support people safely.

The operations manager told us, “We also share information and record on ‘significant discussion’ forms when we meet with staff to talk about an incident that needs to be explored or we need to ensure staff understand expectations.”

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.

People’s needs were assessed before they were supported by the service. This information was used to develop care plans and risk assessments to ensure staff had the information needed to provide safe, personalised care. One staff member said, “It’s important we monitor the person and report any changes to ensure the care plan is accurate and the person gets the right support.”

Staff knew people well and demonstrated a good understanding of their needs, working closely with health and social care professionals to ensure people achieved good outcomes. One staff member said, “We are always told about any changes or updates to a person’s care before each call. We can access any updates on the App (electronic care system), it works well. We are also expected to read the person’s notes from their previous call before we arrive at a call."

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 felt safe with staff. One person said, “I’m perfectly safe, the carers are very professional and helpful. Not pushy at all.” Another person told us, “Absolutely I am safe, they’ve had the training and know what they’re doing.”

Staff had received safeguarding training and understood their responsibilities to keep people safe. One staff member told us, “I would report any concerns immediately to the manager, who would definitely act on them to ensure the persons safety.” Another staff member said, “People’s safety is paramount.”

Records showed the management team had referred safeguarding incidents to the Local Authority (LA) and CQC appropriately.

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 and relatives felt staff supported them to manage any risks of potential harm or injury. One person told us, “They discussed my needs and any dangers with me. Falls were discussed and they inspected my home for any trip hazards.”

People’s involvement in risk management was evidenced in care records by clearly recording what people and or their families were able to manage independently and when staff should offer support.

Care records informed staff about risks associated with people’s health and wellbeing. For example, for people who had catheters or risks associated with skin integrity, guidance informed staff how to manage potential risks and the signs to look for. Records confirmed staff had followed this instruction.

Care records and risk management plans had been regularly reviewed and updated where needed.

Positive feedback shared from a healthcare professional who worked closely with the service was, “I work closely with the agency, usually in the assessment and implementation of a moving and handling plan. I find the care staff very knowledgeable and well trained in moving and handling and engage diligently to cascade safety information within the team."

Environmental risk assessments of people’s own homes had been completed to ensure a safe working environment for staff to deliver care. Risks included the home layout, utilities and any potential hazards and equipment.

The provider ensured staff were trained to use any required equipment. Discussions with staff demonstrated they understood the importance of checking any equipment prior to its use, to ensure it was safe and in good working order.

Staff had received health and safety training and understood their responsibilities to maintain a safe working environment and report any concerns immediately to the appropriate person, or services.

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 and relatives were happy with the support they received from staff. One person said, “I am very happy with my carers who are friendly, understanding and polite.” One relative told us, “[Carer] is remarkable and goes above and beyond.” Another relative said, “[Person] has complex needs which the carers know how to handle. I can hear the laughter, and the banter [Person] has with them.”

People and relatives confirmed they had not had any missed calls and staff stayed for the full duration of their care call. One relative told us, “To their credit, there has never been any late or missed calls since they started our care in 2018.”

Rotas demonstrated people were supported by a consistent staff team and received their calls at the times agreed. The service was flexible and responsive to people’s requests to change their call times. A relative told us, “They are very flexible and can accommodate postponed or cancelled calls if [Person] has an appointment.”

Staff had been recruited safely in line with the provider’s safe recruitment processes to ensure their suitability before they started working at the service. New staff received an induction which included training and working alongside more experienced staff to learn about their role and people’s individual needs. One staff member said, “The training is very good, we update this annually to keep our skills up to date.” Another staff member told us, “There are lots of opportunities to develop and learn new skills, the manager encourages this for our development."

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 confirmed staff wore personal protective equipment (PPE). One person told us, “Yes, they always wear gloves and aprons. When they finish, they put it in the dustbin and wash their hands. Their hygiene practice is 100%.” A relative said, “Infection control is always at the forefront of their minds too, so PPE is always used and there are unannounced spot checks by a supervisor to ensure that is being upheld.”

Staff had completed IPC training and demonstrated an understanding of how to reduce the risks of infection. One staff member said, “There is always plenty of PPE, it’s important to change this and to wash your hands regularly to reduce the spread of any infections.”

However, some staff practice did not always promote good infection prevention and control. During our visit, we saw some staff wearing jewellery and nail varnish and when asked, they confirmed they had been undertaking care calls prior to attending the office. This was not in line with best practice and posed potential risks to people. The registered manager assured us this would be addressed.

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.

We found 2 people who were prescribed ‘as and when required’ (PRN) medicines did not have specific plans in place to provide staff with clear guidance on the safe administration of this medicine, as directed by the Provider’s policy. The operations manager took immediate action to address this during our visit.

Despite this shortfall, people told us they received their medicines as prescribed and this was confirmed by medicine records completed by staff.

Staff responsible for medicines management had completed training and their competency to administer medicines safely was assessed.

Where protocols in place for medicines prescribed as PRN included guidance in terms of medicine to be administered, reason for administration, and the maximum dose to be taken in 24 hours.

Clear guidance and body maps were in place to inform staff where to apply prescribed creams on the person’s skin. Risk assessments were also in place for those creams which contained flammable ingredients to inform staff of the measures they should take to reduce the risk.