Soma Healthcare (Central London)

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 were protected from the risk of abuse or harm. Risks related to people’s care were assessed and measures put in place to reduce them. Despite generally good principles we identified some people did not have moving and handling risk assessments in place. We raised this with the provider and they have taken prompt action to resolve this. The provider carried out safe recruitment and ensured staff completed induction training which included 5 days of shadowing with other staff. Despite this there were no formal records of staff shadowing. We raised this with the provider they have agreed to review this to ensure they record this part of the staff induction going forward. People received care visits on time from regular staff. However, the electronic call monitoring (ECM) data we reviewed showed there were issues with the logging of calls which meant records did not accurately reflect the times staff had attended calls. The provider had identified this as an issue and was working with the ECM provider to resolve issues. They were also monitoring timekeeping in other ways and taking appropriate action to address poor timekeeping.

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 were protected from the risk of abuse. People and their relatives told us they felt safe using the service. A person told us, “Yes, I feel safe, I am safe with them.” A relative told us, “Yes, [person] does feel safe.”

There were safeguarding, whistleblowing and duty of candour policies in place which helped protect people from the risk of harm or abuse. The provider investigated safeguarding concerns promptly and worked with the local safeguarding team and others to do so. Safeguarding action plans were put in place to protect people from immediate harm and follow-up actions agreed where necessary to enhance staff skills and knowledge and monitor for patterns or trends. The registered manager and provider understood their responsibility under the duty of candour and took responsibility when things went wrong. Notifications were also sent to the CQC as required. We checked whether the service was working within the principles of the MCA. The registered manager and staff had a good understanding of the principles of the MCA. There were policies and procedures in place and staff had received MCA training. The management team and staff monitored people's mental capacity to ensure that they were able to make appropriate decisions and where needed, supported them to do so. If a person lacked capacity to make specific decisions, they would ensure the best interests decision making process was followed, which would include involving relatives, healthcare professionals and a power of attorney when required. Despite this we found the provider had not always carried out mental capacity assessments when they had reason to suspect some people did not have capacity to consent to their care and treatment. We raised this with the provider and they took immediate action to resolve this, they have completed mental capacity assessments in line with the MCA.

Staff understood their responsibilities in relation to safeguarding. They completed safeguarding training and were aware of the different types of abuse and reporting procedures to follow if they had any concerns of abuse. A staff member told us, “I would document the incident and report it to the office. I can also report it to the local authority, police, CQC and emergency services. I am 100% confident management will act on the concerns and respond immediately.”

People and relatives told us staff were aware of their needs and provided them with the support they needed to keep them safe from harm. A person told us, “They know my condition. I have a frame for moving about in the bathroom. I have had a fall in the past that’s why I have a frame.” A relative told us, “Yes, [staff member] knows what to do because [person] has complex needs and [staff member] knows how to use the equipment.”

Staff understood where people required support to reduce the risk of avoidable harm. Staff had completed moving and handling training and were aware of actions they needed to take to maintain people’s safety. A staff member told us, “We have been trained to use safe manual handling techniques and it has to be done by two carers. We always make sure we communicate with each other when supporting the person. We also speak with the person to make sure they are comfortable, and they know what we are doing to keep them safe.”

Risks to people had been identified and assessed. Risk assessments were in place to help prevent or reduce the risk of people being harmed covering areas including falls, skin integrity, medication, nutrition, diabetes and neglect. Some people had specific devices which were accessible to them and ensured they were able to call for assistance whenever they needed in an emergency. The service also had an out-of-hours system in place for people if any support was needed outside of regular working hours. People’s care records contained some information about the support needed in areas such as transfers, however the moving and handling risks were not always fully assessed and information about how to minimise the risks of harm was not always sufficient. For example, 2 people were unable to weight bear and required the use of equipment when transferring. Although, there was some information in their care plans about moving and handling, there was no specific risk assessment in place for this. We raised this issue with the provider and they have put in place moving and handling risk assessments to ensure these risks are fully assessed and managed 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.

The provider followed safe recruitment practices and ensured appropriate pre-employment checks were completed satisfactorily before staff were employed. Staff completed induction training which included 5 days of shadowing with other staff. Despite this, there were no formal records of when staff had completed the shadowing. We raised this with the provider who told us they would ensure a formal record of this would be put in place to record staff shadowing dates. Staff received training relevant to their roles such as safeguarding, MCA/DoLS, infection control, moving and handling, first aid, tissue viability, medicine competency and end of life. Staff received regular supervision and appraisal to monitor and review staff performance and development. Staff competency was assessed by spot checks. This involved staff being observed and assessed how they carried out their duties. Records showed that if there were any areas of improvement, this was noted and followed up by the service. An electronic system was in place to monitor staffing levels and timekeeping, however there were multiple instances where call monitoring records did not accurately reflect the times staff had attended calls. We raised this with the provider who told us this was an ongoing issue with the ECM system which had been identified in the provider’s auditing processes and staff had also raised the issues with the service. The service were monitoring the system and working with the ECM software company to resolve issues and ensure the system is fit for purpose. The provider was also monitoring timekeeping through telephone feedback and spot checks. Records showed managers were taking appropriate action to address issues with timekeeping.

Staff spoke positively about working for the service and told us that they felt supported by their colleagues and management. A staff member told us, “They [management] are very good. They give us support when we need it, there are no problems. I can always call the office when I need to.” Staff were satisfied with the regular training and ongoing supervision and appraisal they received. A staff member told us, “Yes, we have regular training…The training does help me to do the job easier. We have supervision once every 3 months. They ask us questions on how we are getting on, how to improve what we do and what we want to achieve. Any problems, we can speak openly, and they support me.” Staff told us they received details about their shifts on time and they had regular people they supported and cared for. A staff member told us, “Yes, we get our rota on time. We have regular clients which makes it easier. We have enough travel time, and the visits are close to each other.”

People were supported by staff who knew their needs well. People and relatives told us they received care visits on time from regular staff which provided consistency and continuity of care. Where there were instances of lateness, people and relatives told us they were always informed of any delays. A person told us, “I have a lovely carer. They come several times a day. They are kind, they come on time, that is important to me. [Staff member] texts me if she is going to be late. They know me, and I am very happy.” A family member told us “I think staff are well trained, they do understand [person’s] health needs.”

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.