Caremark Southampton

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• 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

During this assessment we looked at 5 quality statements in the key question of safe. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. There were enough staff in place to meet people’s needs. Staff had received training appropriate to their role and the registered manager provided ongoing support to meet their training and development needs. There were effective systems in place to help ensure people received their medicines as prescribed. People had care plans and risk assessments in place, which were regularly updated to ensure they reflected people’s current needs. There were systems in place to help ensure people did not suffer abuse or come to avoidable harm. The provider ensured staff had appropriate supplies of personal protective equipment in place.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they were happy with the quality of the care and that they felt safe being supported by staff. Comments included, “The [care] visits are a positive experience, I have always looked after myself but the staff are very good” , “I am very happy with Caremark, brilliant firm 100%” and, “I do feel very safe in my home when they [staff] visit.”

Staff told us that they had received safeguarding training. They were able to describe different types of abuse and the signs that might indicate abuse. Staff knew how to report any concerns to senior staff or external bodies, such as safeguarding authorities or CQC. Staff told us they would feel comfortable raising any safeguarding concerns with the registered manager and were confident they would take appropriate action in response.

The provider had a safeguarding policy in place which had been developed in line with the local safeguarding boards policy. Staff had received training in safeguarding, which helped assure the provider that staff had a good understanding of their safeguarding responsibilities. The registered manager had thoroughly completed safeguarding investigations and involved the appropriate professional bodies where needed. This helped to keep people safe from suffering abuse or coming to avoidable harm.

People told us that staff effectively supported them to manage risks related to their care, including risks related to moving and handling. Comments included, “I have had no falls or accidents, any problems I speak to the office who are very helpful, no concerns around my safety” and, “I do feel very safe in my home. When they [staff] visit, I use a walker and have had no falls or accidents, the staff are very good.” People told us staff were knowledgeable about supporting them to manage equipment related to medical conditions, for example catheter care. Comments included, “Catheter care is good, staff are very good and know what needs doing.”

Staff had a good knowledge of risks related to people’s care and their role in helping people to manage them. They told us they had received training for the use of moving and handling equipment and they checked the condition of equipment before use to help ensure it was safe. Staff told us they promoted people’s independence through positive risk taking. They gave examples of how they encouraged people to maintain their independence by mobilising independently around their own home. The registered manager had systems in place to monitor and review risks that had been identified. This included reviews of care plans involving people, staff and professionals. This helped to ensure guidance for staff reflected people’s most current needs.

The provider had effective systems in place to identify, monitor and reduce risks related to the running of the service. For example, there was a business continuity plan in place. This detailed how the provider would ensure the continuity of people’s care in emergency situations, such as severe weather. The provider had a non entry policy in place. This provided appropriate guidance for staff to follow in the event of non-contact at a planned care call time. This helped to ensure people’s safety and welfare could be accounted for. Care plans and risk assessments were completed, which detailed how identified risk should be monitored and reduced. This included risk assessments around people’s medical conditions, mobility and medicines. Risk assessments were reviewed regularly or when people’s needs changed. This helped to ensure all current risks were identified.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they received consistent staff at planned times. Comments included, “Staff are on time, very good, same regular staff, I know them and they know me. [Staff are] very helpful [and] will do anything I ask.” People said that staff did not rush them with their care and stayed additional time when needed. Comments included, “Staff stay their allocated time and always offer any extra help.” People gave positive feedback about staff competence and training levels. Comments included, “Staff are well trained and understand me well."

Staff were positive about the training and ongoing support they received in their role. They told us they received a range of training, which was updated regularly to help ensure they were following current best practice. They told us that they had regular individual and group supervision where feedback and good practice were shared. Staff told us they were given consistent schedules of work, which included sufficient travel time between care calls. This promoted consistency in how people’s care was planned and delivered.

We reviewed 3 staff recruitment files and initially found some incomplete recruitment documentation, including missing references and work history. During the assessment, the registered manager located the missing information to ensure files were compliant with requirements. The registered manager had systems in place to monitor staff’s ongoing training needs to ensure they had up to date training. The registered manager had also obtained a qualification to enable them to train staff in key areas of their role such as moving and handling. They had put in place a system to ensure staff’s competency was regularly assessed through observations of their working practices. The registered manager had effective systems in place to schedule care visits, monitor care call times and review whether care tasks had been completed as planned. This helped to promote consistency and quality for people’s care.

People told us that staff wore appropriate personal protective equipment (PPE) whilst supporting them with their personal care. They reported no concerns about infection prevention and control. Comments included, “Staff [are] aware of hygiene, wear gloves, on the whole very hygienic, aware of infection control and well trained 100%.” People told us staff were conscious of hygiene by ensuring PPE was appropriately disposed of. They told us staff were respectful of their homes and helped them to keep them clean and hygienic. Comments included, “Staff are aware of hygiene when in the kitchen, wear gloves and keep it clean."

Staff told us they had adequate supplies of personal protective equipment in place, such as gloves and aprons. They were able to explain how they would appropriately use this equipment to reduce the risks of infections spreading when providing care.

The provider had an infection control policy in place, which had been developed and reviewed in line with best practice guidelines. Staff had received infection prevention and control training to help ensure they were following guidance set out in the provider’s policy. There were appropriate supplies of PPE in place to ensure staff would have sufficient equipment to carry out their role.

People were happy with the support they received in managing their medicines. They told us staff were competent in their role and this helped ensure people received their medicines as prescribed. Comments included, “The staff give me my tablets and put cream on my legs and feet, I have no concerns with this” and, “They [staff] were applying cream to a bad leg but with their help it has cleared up, they are well trained."

Staff had received training in medicines administration and were confident in explaining how they would administer people’s medicines in line with best practice guidance. Staff told us how they were mindful that if they made/identified a medicines administration error they should seek medical advice and report the incident to senior staff. This demonstrated an open approach to reporting concerns which helped ensure any errors were quickly identified and addressed.

People had medicines care plans in place which documented the support they required around their medicines management. This helped to ensure it was clear the level of support and independence they wished to have. Staff recorded people’s medicines administration using the provider’s electronic care planning system. The registered manager monitored the system for alerts of missed medication administration. This enabled them to quickly identify when planned medicines administration was not recorded by staff and take action in response. The provider had a medicines policy which had been developed in line with best practice guidance. This helped to ensure that staff were following correct procedures and prompting safe medicines management. The registered manager carried out audits of people’s medicines records. This helped them to identify any issues or trends related to people’s medicines administration or management.