Seremed Healthcare

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 changed to good. This meant people were safe and protected from avoidable harm.
The provider was previously in breach of the legal regulation in relation to safe care and treatment. Improvements were found at this assessment and the provider was no longer in breach of this regulation.
 

This service scored 66 (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.
Where there was an incident, the registered manager had investigated thoroughly and there was evidence of lessons learnt being fed back to staff. The registered manager was aware of possible trends for future trend analysis.
 

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 partners to ensure smooth transitions, especially when people had to go into hospital for short periods. There was evidence of communications by the provider with various organisations and professionals including hospitals, speech and language therapists (SaLT), social workers, district nurses and GPs to enable this. This helped to ensure people experienced coordinated and planned discharges from hospital and had the care in place which they needed.
 

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 and relatives we spoke with told us they felt safe receiving care from the service and were able to raise any issues if there were any. The provider had obtained consent from people for the care provided, as well as ensuring they obtained evidence of power of attorney, for when people lacked the capacity to make this decision. Safeguarding and whistleblowing policies were in place and staff knew where to find these. Safeguarding and Mental Capacity Act 2005 (MCA) training for staff was up to date. Staff had a good knowledge of what to report and to whom.
 

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.
Improvements had been made following the previous inspection. The provider completed risk assessments when people started with the service. These were regularly reviewed to ensure up to date risk management guidance was available for staff. Staff identified when people’s risks changed and took appropriate action to ensure people remained safe. For example, staff had worked with the SaLT team to reassess a person when they were concerned they could not eat safely. They also followed this up with the GP for their medicines where swallowing tablets was difficult. However, information in the person’s care plan did not always reflect the SaLT guidance to ensure staff would always provide appropriate support.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The provider completed environmental risk assessments at the start of care packages. Staff were aware of risks relating to people’s homes and how to mitigate these. The registered manager was working on ensuring all staff were confident in responding to a fire or flood if people needed to be supported to evacuate their home urgently. The provided logged equipment during initial assessment. Staff knew the need to check equipment prior to use including inspection date and condition. This helped to ensure all care related equipment was safe to use.
 

The provider made sure there were enough qualified, skilled and experienced staff. However, they did not always make sure staff received effective support, supervision and development.
We reviewed 3 recruitment records during the inspection. These included Disclosure and Barring Service (DBS) checks as well as police checks from countries where the staff member had resided, which was good practice. However, recruitment records did not always record all the required pre-employment checks. The provider made efforts during the inspection to obtain this information as well as updating their recruitment policy.
Records showed evidence of induction including training and shadowing. The registered manager had recognised the training needed to be more comprehensive and was arranging for a new training provider prior to the inspection.
Training for staff across all mandatory subjects was up to date and exceeded Skills for Care guidance. The registered manager told us all new staff completed the care certificate with a different training provider.
Staff received supervisions but some staff told us they were infrequent, and they had also not attended any staff meetings. The registered manager planned to hold more team meetings including virtually to enable more staff to attend.
 

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.
There were no issues raised about infection prevention and control (IPC) by people or relatives.
Staff told us the registered manager provided personal protective equipment (PPE), or they went to the office to collect some. There was a suitable IPC policy in place.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences, although care planning and documentation related to medicines errors needed to be clearer and more detailed. Staff involved people in planning, including when changes happened.
A process was in place when people missed their medicines to ensure staff would take action to keep people safe. However, this was not recorded when a person missed their medicines. Action was taken to follow up where a person was struggling to swallow tablets. As required (PRN) medicines protocols were in place and generally well detailed. There was evidence of staff’s medicines administration competency being carried out and spot checks were in place. Consent to medicines administration was also in place.