Cera - Essex and Havering

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

We did not look at all quality statements for Safe at this assessment. The service was safe. This rating uses some scores from the previous inspection. The service followed robust recruitment procedures and enough staff were employed. Care staff completed appropriate training and their competency was regularly checked. There were safe medicines processes and regular audits of medicines were completed.

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.

The registered manager demonstrated good knowledge of the service and systems in place to monitor safety. The registered manager showed us incident records and audits that looked for lessons learnt. Staff used technology to help monitor people's health care needs and set actions to help mitigate risks. The registered manager demonstrated falls had been significantly reduced by staff being more aware of people's changing needs and to take action to reduce those risks, such as removing trip hazards or advising people of environmental concerns.

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 felt safe and knew how to raise a complaint. One person said, “The care is fine, I love it, carers are lovely, and I feel very safe with them.” A relative said, “I think the general standards of care are good. My relative feels safe with the carers being there” and “I would know what to do and who to contact if there were any safety issues.”

Staff received training about safeguarding people from harm however, there were a lot of staff due a refresher. The registered manager told us safeguarding training was scheduled and staff confirmed they can access their online training. Staff demonstrated their knowledge with identifying and reporting concerns. Staff knew how to raise concerns; however, their knowledge was limited to reporting internally. More than one staff member said, "I would report any concerns to the office."

Processes were in place and effective to ensure people were protected from harm and abuse. The registered manager shared concerns with the local authority and CQC in line with their requirements of registration. The registered manager oversees all safeguarding investigations.

One person told us, “My [relative] can’t walk, but the carers mobilise [relative] around very carefully and safely to the shower and stand by them” and, “I think the carers are skilled and have the right training equipment.” Another person said, “The carers put my [relative] on a special chair to lift them up” and “The carers are trained professionally to mobilise people safely.”

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

Feedback from people and their relatives about staff was positive. A service user said, “I’m quite content with the quality of care I get from this company. They keep me safe; the standards are brilliant. I get the same carers and they are mostly on time and very reliable.” A relative told us, “As a family we could not have wished for better.” People told us they felt happy with the care provided and staff had the skills needed.

Staff told us they felt supported by the registered manager and felt they received the training they needed to support people safely. One staff member told us, “I got all my training before I started.” “I can refresh my training when it’s time and have no problems about it.”

Safe and effective recruitment practices were followed to make sure that all staff were of good character and suitable for the roles they performed. All the necessary pre-employment and identity checks were completed to ensure best practice.

There were processes in place to ensure staff had access to personal protective equipment when needed. People told us staff had good hygiene standards, used gloves and aprons, and washed their hands.

One person said, “The carers give me my medicine very successfully, so I never forget. The carers make sure I take the right dose.”

The registered manager showed us the online medicines system and explained how the records were audited. A system error had been identified by the provider that allowed two staff to sign medicines as given, when only one signature was needed by the person administering. This was identified as cause for concern by the provider because it may indicate people had been over medicated or mask medicine errors. The provider was working to resolve this issue and had processes in place for a lead staff member to be the one who signs medicine as given. The provider assured us people had not been overmedicated or impacted by this system error.

Staff received training for safe administration of medicines. Staff member’s ability to administer medicines was checked to ensure they were competent. People were appropriately involved in decisions about their medicines. Documentation relating to medicines were checked 3 monthly and systems were in place to ensure best practices were followed, this included an alert system for late or missed medicines.