Seren Healthcare 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. This is the service’s first assessment. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 registered manager had an overview of all accidents, incidents and complaints which had been responded to or investigated where required. People and relatives felt supported to raise concerns and were assured action would be taken to improve care.

The provider recognised the risks associated with closed cultures and worked with staff to ensure any concerns were raised. Managers encouraged staff to raise concerns when things went wrong. Staff felt confident to report any concerns and had opportunities to discuss and learn from incidents and complaints. One staff member said, “We are encouraged to keep reporting.”

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 to ensure people were transitioned into their care packages safely when they were referred to them. Initial assessments were completed for people before a package of care commenced. Some people had been supported to transition from children to adult services. Transitions for people between services were planned and involved staff working closely with families and alongside the person’s existing staff team to learn how to support them safely. People and relatives told us they were regularly supported by the same staff, who were able to get to know them well.

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 had not had any instances of needing to raise safeguarding concerns for people they supported, however they had a good oversight of safeguarding and completed regular audits.

Staff received regular safeguarding training and understood their responsibilities in keeping people safe. One staff member said, “As soon as I notice something I am to report it immediately, call the manager and report everything to them.” People and relatives told us they felt safe care was provided to people. One relative said, “Absolutely they stick to my relative’s routine, any issues or anything they see they are not sure of, they come and ask.”

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.

Risk assessments were in place for people. Where people required support to manage complex health needs, risk assessments were specific and detailed.

Staff understood risks to people and people and their relatives told us their risks were well managed.

Risk assessments were updated when any changes were needed, for example to ensure proper posture management for one person, photos were taken and added to the risk assessment for staff to follow, this reduced the risk of the person feeling discomfort or pain.

However, some risk assessments we looked at had completion and review dates missing, we fed this back to the registered manager to address.

The provider detected and controlled potential risks in the care environment. The provider had worked with people to ensure the environments they lived in were safe, this included supporting people with referrals to health partners where specialist equipment was needed for people. People had individual premises, and personal evacuation plans and risk assessments, these contained clear information on how to support people to remain safe in their environment and in the event of a fire.

Where people used moving and handling equipment, staff were trained to use the equipment, and relatives told us people were safe. One relative said, “Yes [person] needs hoisting the staff are really good at that, they know what they're doing.”

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.

Recruitment checks were being completed, we found some gaps in staff’s employment history which had not been explored. However, a new application form was now in use, which ensured reasons for gaps were recorded.

Staff felt supported in their roles and had regular supervisions, appraisals and spot checks to observe their practice. Specific training and competency checks were in place where people had complex care needs, and a clinical lead oversaw people’s care and support in this area.

Staff had received the training they needed to support people well. Staff felt they had good support from the clinical team who always made sure they were comfortable in how they support people. One staff member told us, “It is good to learn, there is a lot of training so I feel confident. If there are any issues, I can call a senior person or clinical nurse for help to assess the person I am supporting.”

People and their relatives felt staff were well trained. Comments included “Oh yes definitely 100%” and “I would certainly say they are proficient or better, there are not any staff that leave me with any concerns or worries.”

The provider assessed and managed the risk of infection, they detected and controlled the risk of it spreading. People had individualised infection prevention and control risk assessments, they covered the use of personal protective equipment (PPE), outbreak management and cleaning of equipment.

Quality spot checks which covered infection prevention and control, and the use of PPE were completed regularly. Staff had access to PPE and knew when to use it. Relatives said, “They do a lot of cleaning, they've got all the PPE they need for personal care, it's all in place” and “Oh yes they use gloves and aprons they are meticulous in that way.”

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.

Protocols were in place for as required and emergency medicines. Where a person required emergency medicines staff were competent in their administration. A relative told us, “It takes a long time to get to know my relative and at what stage to give the medication, staff know now when it's the right time.”

Staff received regular medicines training and competency checks. Where people had specific needs for their medicines administration, medicines training was tailored to their needs. Staff told us they had received a whole day of separate training just tailored for a person who had specific medicine requirements. People’s relatives had been involved in medicines training at times which staff found beneficial and supported consistency and continuity in medicine management.

An electronic medicines administration record (EMAR) system was used. The person’s EMAR contained clear information about medicines, including any specific instruction, such as to take with food. However, we found times of medicines administration were not always recorded correctly. This was important as some people were on time specific medicines or medicines it is important to take at regular intervals, for example for epilepsy. The registered manager told us this was a recording error, and medicines had been administered at the correct time. We did not find any evidence anyone had come to harm. The provider’s medicines audits had identified these issues. These had been addressed within a recent staff meeting and there was a plan in place to address them, this included further training for staff and the introduction of an alternative EMAR system.

We also found more clarity was needed in people’s care plans for when people or their relatives administered their own medicines to ensure a consistent approach was followed. We fed this back to the registered manager.