Sambhana Care 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 Inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager 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.
At the last inspection, the service did not demonstrate a proactive or positive safety culture. Concerns were not consistently listened to, safety incidents were not always investigated or reported, and lessons were not learned to promote continuous improvement.
Since then, improvements had been made. The registered manager, who was not in post at the time of the previous inspection, told us they accepted the findings and implemented a clear plan to improve the service on taking up the role. There was now a more open culture within the management team, who were clear about the improvements required and demonstrated a commitment to strengthening safety practices across the service.
 

The registered manager 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.
Systems to support people’s safety had been strengthened. Assessments were carried out prior to care commencing, and information was shared with staff to support safe delivery of care. In response to the concerns found at the last inspection, the registered manager had overhauled several key processes, including those relating to hospital discharges and communication between teams, to ensure safe and well-managed transitions were in place.
 

The registered manager 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 registered manager shared concerns quickly and appropriately.
There had been improvements in safeguarding practices since the last inspection. The registered manager worked collaboratively with people and partner agencies to understand what feeling safe meant to each individual and how best to support this. Staff focused on improving people’s lives while protecting their right to live free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The management team shared concerns promptly and appropriately.
People told us they felt safe with staff and were confident any concerns they raised would be addressed. Staff had received safeguarding training, understood the signs of possible abuse and knew the steps to take should they have concerns. Staff also had access to the service’s updated safeguarding and whistle blowing policies.
 

The registered manager 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.
Processes for assessing risks had improved, but further work was required to ensure consistency. Risks to people’s health, safety and welfare were generally assessed, monitored and managed. Care plans and risk assessments were being reviewed and updated when needed. Plans were also in place to provide staff with additional mentoring to support their understanding of risk assessing.
During the inspection, we identified that risks relating to the use of flammable creams had not been fully assessed for some people. We raised this with the management team, who took immediate action. They confirmed these assessments would be rolled out to all relevant individuals, and the registered manager agreed to provide evidence once this had been completed.

The registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
The registered manager had improved how environmental risks were identified and controlled. Since the last inspection, trained staff had begun assessing the safety of the home environments where care was provided and documenting these in environmental risk assessments. This helped ensure care was delivered safely for people and for staff supporting them.
Staff told us they ensured people’s homes were left tidy and secure after visits, including locking doors and key safes and ensuring people wore their personal alarms where required.
 

The registered manager 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.
At the last inspection, the provider had not ensured there were enough suitably skilled and experienced staff, nor had staff received effective support or supervision. Improvements had since been made.
The registered manager had implemented strengthened recruitment checks to ensure new and existing staff were safe and suitable to work in people’s homes.There had been significant staff changes since the previous inspection, which people and staff told us had been positive.
Training and induction processes had been redeveloped, with evidence of mandatory training and shadowing shifts being completed. Staff said the training they received equipped them well to meet people’s needs. Staff were also receiving regular supervision, and a clear schedule of spot checks, supervisions and appraisals was now in place.

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.
The registered manager had improved how infection risks were assessed and managed. Risks were identified, controlled and shared with appropriate agencies when necessary. Staff understood their responsibilities regarding the use of personal protective equipment (PPE) and told us PPE was accessible when needed.
 

The registered manager did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.
At the last inspection, the provider had failed to ensure the safe management of medicines. While improvements had been made, these required further embedding into day-to-day practice. We found occasions where there were gaps in people’s medicines administration records. We queried this with the management team, who explained the reasons and agreed to add additional checks to medicines audits to ensure they could assure themselves that medicines were administered as prescribed.
Staff responsible for administering medicines had received training and competency assessments.