Seraphim Home Care

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

People’s mental capacity had been considered. Risks had been identified for people and guidance provided for staff to follow. Staff knew what constituted abuse and how to report this. Staff had an induction when they started. Equipment was monitored to ensure it was safe to use. However, we found 2 breaches of the legal regulations in relation to Regulation 18 (Staffing) and Regulation 19 (Fit and proper persons employed.) People were not protected from harm due to safe recruitment procedures not being followed. Staff had not been trained sufficiently to meet people’s individual needs. An on call system was in place. However, we received mixed feedback as to its effectiveness. We assessed a limited number of quality statements in the safe key question and found areas of concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which were good. Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good.

This service scored 62 (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 experiences varied. With some people feeling happy and safe with the care provided and others highlighting a decline in the quality of care. A person said, “I am safe with the carers.” Another person said, “I used to be very safe but that changed last October. The office has communication problems, they don’t talk to each other."

Staff we spoke with knew how to identify and report safeguarding concerns. Some staff told us they had received training in safeguarding and the Mental Capacity Act (MCA). Other staff told us they had not. Some staff said how concerns had been reported and actions not always documented or taken. For example, around medicines or staff practice..

Safeguarding concerns, accidents and incidents were logged. Actions had been taken in response. However, where additional training or supervision of staff was identified this had not always occurred. Where some safeguarding concerns had been raised with the local authority these had not always been notified to the Care Quality Commission (CQC). The provider did not conduct any audits of safeguarding concerns. People’s mental capacity had been considered in their care plan. No one receiving a service was under a community Deprivation of Liberty Safeguards (DoLS).

People's experience of risk management was not always positive. For example, one person told us care quality was compromised by manual handling equipment not being used correctly. A relative described a negative experience for someone in the community. However, another relative said, “The quality of care is very good. The hospital have praised the condition of [Name of person’s] skin.” People told us they experienced difficulties communicating with some staff which led to risks developing. For example, by instructions not being followed or understood.

Staff knew where to find information about risks to people and how to report incident and accidents. We received some comments about care plans not always being updated promptly.

Risk assessments were in place to guide staff how to mitigate individual risks. These had been regularly reviewed. Some risk assessments reviewed had clear and detailed guidance around safe environments and manual handling procedures. However, for some people this was lacking. An on call system was in place to support staff out of hours. However, people, relatives and staff told us the system was not always effective in keeping people safe, as calls were not always answered.

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 did not always experience safe and effective staffing. People told us they had not experienced any missed care calls/visits and staff were generally on time. Some people received consistent staff whilst others did not. A person said, “I usually have the same staff, I prefer that.” Another person said, “I receive a calendar with [staff] names, but anyone can arrive.” People said staff experience and training varied which impacted on the support provided. Examples given were in areas such as food preparation, manual handling and catheter care. A person said, “We feel confident with the majority of carers. There have been a lot of new ones, the experienced ones are good.” Another person said, “I spend half the time telling them [staff] how to do things.” People told us their preferences of care and support were not always listened to. For example, around particular staff supporting them. People said the manager was approachable and tried to resolve any concerns raised.

Staff highlighted training provided was not in depth and did not cover all areas. A staff member said, “It was basic training of first aid, hoisting and manual handling. Another staff member said, “They [the provider] send staff who don’t have any training.” Some staff told us they had received supervision and others were waiting for this to take place. Staff were not always supported. A staff member said, “Oh yes I feel supported.” Another staff member when asked if they felt supported in their role said, “No, not really.” Staff told us they received an induction and shadowing when they started.

Safe recruitment procedures were not followed. Staff had started working before recruitment checks were fully completed. This included Disclosure and Barring Service (DBS) checks, obtaining a full education and employment history and satisfactory references. The provider had not audited or checked staff recruitment files. This put people at risk of being supported by staff unsuitable for the role. Staff had not received training to ensure they were skilled and knowledgeable in their role. Whilst staff had received training in first aid and manual handling, other areas such a dementia, catheter care, safeguarding and food hygiene had not been completed. This put people at risk of receiving unsafe care and support. Staff received an induction when they started in their role. Supervision and spot checks were completed with staff. However, record keeping of supervision and staff competencies did not enable the provider to have effective oversight. This meant where additional checks or support of staff was identified, it had not always been completed. The manager was making changes to feedback forms and supervision proformas to make improvements to the information gathered. A condition of the providers registration for the service is that a manager is registered with the CQC. A manager had not been registered for 8 months. The provider said this would be addressed.

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

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