Support Solutions (West Sussex)

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

At the last inspection undertaken on 27 July 2022, we found shortfalls in the providers mitigation of risks associated with assessing people’s health conditions. Staff were not always recruited safely and in accordance with the providers policy. At this assessment, the provider had ensured that risks associated with people’s health had been assessed and considered in their care planning. The registered manager had improved recruitment processes that ensured employment references and criminal record checks were completed in line with the providers recruitment policies. There were sufficient staff numbers to provide people with continuity of carers, and at the times people requested. Staff continued to receive relevant training that allowed them to support people safely and effectively. Medicines were safely managed and administered. People’s concerns were listened to and acted upon. Staff were trained in safeguarding and understood how to protect people from the risk of abuse. Environmental assessments of people’s homes had been undertaken to protect them and to allow staff to undertake their role safely.

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.

Incidents and accidents were consistently recorded, and staff understood their responsibilities to report any concerns. There was oversight of recorded incidents from the registered manager to determine whether changes to people support needed to be made. Incidents were monitored daily, and actions were recorded. A complaints process was in place, although the registered manager confirmed that there had been no formal complaints submitted. Quality Assurance Reviews were completed for each service user monthly. These allowed regular discussion with people and their relatives about the standard of care where issues could be discussed and resolved without the need for formal issues being raised.

The registered manager was confident that staff reported incidents correctly. The registered manager said, "We use Atlas (system) to record incidents. A report of medicines missing this morning was an incident. If a client falls when a carer is present, they report through the phone. They are encouraged to call me." Staff were knowledgeable on how to report incidents and accidents to the management team, whether verbally or through the electronic care application. Most carers confirmed that they receive feedback about the incidents they raised. One care worker said, “I would report anything to my supervisor and use the phone app to record. It's user friendly and quicker than writing." Another care worker said, "I would follow company policies and procedures. Phone call first and follow it up in writing."

People told us they felt safe and supported to understand any risks. One person said, “They get in touch regularly to see how the care is going.” Another person said, “They have their checklist and make sure they tick off everything. They don’t make any mistakes. If they do, they correct them very quickly.”

Feedback from professionals and partners was positive on how staff and management worked together with them to provide consistent, effective care. One mental health professional said about the care for the person they supported, “The care agency adopts a proactive and personalized approach to care provision. They have exhibited creativity in tailoring their support to meet the unique needs of my customer, which I believe is essential for promoting individualized care and enhancing overall well-being." The professional added, "I have observed that they have allocated the most suitable worker to customers such as the one I am involved with, which is quite complex. They worked closely and gained confidence with my customer which has been very effective in this specific case. This person-centered approach fosters a sense of trust and familiarity, which has been invaluable in promoting positive outcomes." The local authority reported that it had no issues in relation to quality of care following its recent review of the service.

The Registered Manager spoke about the collaborative joined up approach with health colleagues and the local authority. The registered manager stated, "We did occupational therapy referrals for (named people)." The registered manager described the challenges in communication and notification when people had been admitted to hospital and subsequently discharged home. The registered Manager said, "It's not always known. We will contact them and notify them that we are involved and have a care package with the client. We tell them we need to be notified before they come home." Staff spoke of the coordination in place when people needed two carers on a call to support them with any mobility needs. One staff member said "I do double up calls. We join up at a client’s home. I use the phone if there's any problems. With regards to the communication of new information, "It's done usually through the app or if it's an urgent appointment they will give us a call."

People told us that staff were proactive in seeking additional support for any health needs should they need to. Most people arranged and attended health visits independently, but some people told us that staff would often arrange and coordinate appointments on their behalf if needed. One person said, “They are very efficient.”

There were systems in place to facilitate safe pathways and transfers for people. Before people started to receive care from the agency, assessments of need and risk assessments were completed to ensure safe, effective support. People's care plans were detailed about people's health conditions and provided the guidance staff needed to seek additional professional health support and when to make appropriate referrals to partners. For example, one person had a condition that impacted their diabetes and received regular specialist eye checks. Guidance for staff was in place for them to identify early signs of potential Glaucoma so that they could alert and make arrangements with the optician on their behalf.

People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. People told us that they felt that staff understood their needs well and felt they were protected from forms of abuse.

The registered manager had recognised when incidents had put people at potential risk of abuse and made the appropriate referrals and notifications. Records of referrals made since the last inspection demonstrated this. Staff had the training and knowledge to ensure they could recognise when people may be unsafe and to identify potential signs of abuse. Staff had a clear understanding of the different types of abuse. People were protected when issues around capacity had been identified. Mental capacity assessments had been conducted and recorded to determine whether they had capacity to make specific decisions about their care. Information about people’s care was safeguarded by adherence to data protection policies and consent processes.

The registered manager spoke about communication with the local authority to discuss and inform them of potential safeguardings. Staff were clear about reporting responsibilities and understood what signs to look for that may indicate any safeguarding concerns with the people they supported. One staff member said, "Yes, I've completed training. We learnt about protecting the person from abuse. The person may change behaviour. For example, they used to be talkative. The person might be withdrawn."

People told us that staff supported them safely. They told us they had the equipment they needed to move around their home and sometimes used it with the help of staff. One person said, “They use the bath lift when I have a bath. They are safe using that.” Another person said, “They do like six monthly checks. Face to face and by phone. Any issues, they would sort out quickly. It's managed quite well.” Another person said, “They know what to do as they’ve been here a long time.”

Risks to people’s health needs had been assessed and were being managed safely. There was sufficient guidance in place for staff to safely support people with these needs. Risks were recorded effectively and relate to the specific needs of that person. For example, one person was assessed as being at risk of developing pressure sores and there was guidance for staff to monitor and identify any potential changes in skin integrity while completing personal care. The person had health conditions that heightened this risk and staff were given guidance on how to respond to any potential impact.

The registered manager was clear on the systems in place to manage risk. The registered manager said, "It's all down in initial assessment." Staff understood the people they supported and the risks to their health and support. Staff spoke of where to find information about people's risks and when to make other professionals aware when people's needs changed. One staff member described supporting one person with their blood pressure and blood sugar level readings so they could present this information to their doctor.

People told us they felt safe and secure when staff supported them in their homes. One person said about staff practice in their homes, “Oh yes, I do I feel safe. We have a protocol for that, they do check the doors. They lock it on the last thing at night." One person said, “(The registered manager) has rung the bath lift people for me as I had a problem.”

Environmental risk assessments were completed to ensure that staff could undertake care and support safely in their homes, and that the persons environment supported this. Detailed assessments of the interior and exterior of people’s homes highlighted any risks or factors that could impact carer's access to the home and their ability to undertake safe and effective care. Severe weather Conditions Risk assessments were also completed to identify and prioritise which people were more vulnerable when severe weather conditions impacted staff in travelling to, and accessing, people's homes.

Management and staff understood that ensuring safe environments of people’s home was important for both the person and for them to provide effective support. The registered manager said, "(Environmental assessments) are done at the initial assessment and reviewed annually. Any changes will be reviewed and updated." One care worker said about maintaining a clear and clean environment, "One lady we support has COPD, so we need to be careful with cleaning." Another staff member said, "So far with our clients we are very safe in their homes."

The registered manager was confident that the service had sufficient staff to cover people’s care calls effectively. The registered manager was happy to maintain the current staffing levels as it provided consistency of times that people preferred. Staff spoke positively about their schedules and confirmed that they received travelling time in between calls. They confirmed they regularly had the same clients which benefited continuity. Regarding the benefits of good continuity, one care staff said, "That way you can notice any changes." Speaking about the induction they received, one member of staff said, "It was perfect. (The registered manager) was very accommodating and I learned a lot. It made it very easy for me." Another care worker said, "Training was good. It's all pretty good. Medicines are all in house, as is the manual handling. I mentioned to (Registered Manager) about diabetes and it came onto the programme."

Reviews of weekly work schedules showed that staff were provided with sufficient travelling time to move between care calls, and that people generally received weekly support from the same care workers. Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. New staff completed an induction and probationary period. Staff completed shadowing shifts with established staff members prior to lone working. Training had been identified and provided to staff according to the needs of the people the service supported. These included training in areas such as safeguarding, Mental Capacity Act (MCA), medication, and moving and handling.

There were enough staff in place to ensure people remained safe and meet their needs. People told us that staffing was generally consistent, regular carers were provided as much as possible and stayed for their allotted time. One person said, “They are always on time.” Another person said, “They fit around what I have to do.”

People were protected from the prevention and control of infection. Staff were trained in infection control and there was a policy and procedure in place which staff could access. Staff demonstrated a good understanding of how to prevent the spread of infection. Environmental risk assessments supported care workers with information and guidance on personal hygiene and infection control, detailing the cleanliness of the environment, whether carer has access to hand washing facilities, supplies of cleaning equipment, whether disposable protective clothing is used. Care plans provided person centred guidance for when infection control procedures needed to be increased or presented higher risk. For example, one person living with high-risk health conditions, staff were guided on what additional infection measures and personal protective equipment was required.

People were supported by staff who followed appropriate infection control processes when supporting them with care. People told us that their carers ensured they used the appropriate personal protective equipment protective aprons and gloves when supporting them. One person said, “Oh yes always wear gloves and aprons.”

The registered manager advised that staff had access to personal protective equipment (PPE). The registered manager was clear on the level of PPE required for each home visit, and what additional measures were needed in the event of a person having an infection. Staff were knowledgeable about the measures they needed to take to maintain a clean environment in people's homes and what personal protective equipment was needed. This helped to maintain the prevention of infections, and ensure proper meal preparation and storage avoids cross contamination.

There were systems in place to ensure that medicines were administered safely. Staff had received training in administration of medicines. Systems had improved that ensured any changes in medicines were updated efficiently and correctly on people’s Medicine Administration Records (MAR). Information about the specific medicines people took, and their potential side effects, were available for staff. The registered manager monitored medicine administration daily and received electronic alerts if medicines had not been administered.

The registered manager was confident in the oversight of medicine administration. They confirmed that they support some people with the re-ordering of their medicines. The registered manager said, "I will put in a notification for when people’s medicines are due to be reordered. I do it online and get a confirmation.” Staff confirmed they'd received medicines training. They confirmed that information about people's medicines was in their home and detailed on the electronic application they used. One care worker said, "It's on the task list on the app. If there's an urgent issue, we call. We put a message through if it's not urgent."

Some people we spoke with needed support to manage and administer their medicines. Where staff supported, people confirmed that this was done safely and as they wished. One person said, “They remind me to take my medication.”