Servoca Complex Care - Chelmsford

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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

Risks to people was included within their care records with guidance in place for staff to follow. There were enough suitably qualified staff to meet people’s needs. Safeguarding processes were followed and medicines were managed safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were processes in place to review incidents and accidents and learn lessons from them. There were regular meetings with staff to share lessons learned.

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.

People and relatives told us they were confident to raise any concerns about their care and support and they were listened to. A relative told us, “They do listen to us, I have regular communication with the office staff.”

Staff were encouraged and supported to raise concerns, they felt confident the management team would listen to any concerns raised. A staff member told us, “When I have reported things they have been very supportive and I think my clients feel the same.”

The registered manager kept a detailed log of all complaints, accidents, incidents and safeguarding concerns. Action taken was clearly recorded and lessons learned comments were included as part of the log. The registered manager told us a clinical Governance meeting was held every 3 months with other registered managers within the provider group and all concerns were discussed openly and shared as part of their learning.

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 and relatives told us they or their family members felt safe with the staff supporting them. A person told us, “The staff are very reliable and I feel very safe when they are here.” A relative said, “My [family member] is definitely safe with the staff, we have regular carers and we have built a good rapport with them.”

Staff had training on how to recognise and report abuse and they knew how to apply it. Staff told us they would not hesitate to raise any concerns. A staff member told us,” I would feel very comfortable reporting to the office but would go to CQC or adult care services if I was still concerned.”

Policies and procedures were in place to safeguard people from the risk of abuse. The registered manager understood their legal responsibilities to protect people and share important information with the local authority and CQC. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA. The provider had considered people’s capacity to consent as part of the assessment of their needs.

People told us they were fully involved in their care and support and included in any decisions related to risks to their care. A person told us, “They [staff] absolutely understand my care needs. They understand my critical needs and care. They always follow what I want and they know what I want and what I need.”

Staff told us they had access to people’s care plans and risk assessments. A staff member told us, “My client has a care plan which I read during the interview, all risks were included.” Another staff member said, “The risk assessments are being kept in a folder in the clients house for all staff to assess and it's also in the Servoca pass [electronic system], so when a person is being allocated to you, you can assess the risk assessments in plenty of time before you get to the person.”

The provider had processes in place to assess people’s needs and associated risks. The registered manager told us they took a balanced and proportionate approach to risk that supported people and respected the choices they made about their care. They gave us an example of this approach and how they worked with partner agencies to support people’s choices. Accidents and incidents were recorded on an electronic system to ensure any actions or outcomes could be monitored.

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

We received positive feedback about people’s current staff teams. People told us they received care and support from a consistent staff team. A person told us, “I have a regular team of staff who look after me very well. They understand my needs well and they are very helpful.” A relative said, “They are 100% reliable and they are able to cover shifts when needed.” Whilst most people and relative feedback was positive about their current staff teams, we did receive feedback about previous incidents where staff were not always consistent. One person commented that initially they experienced lots of changes but told us this had now been resolved and they were now happy with what was in place. We discussed this with the registered manager who told us they now had contingency plans in place.

Staff told us there were enough staff available to meet people’s needs and they received appropriate training before working with people. A staff member told us, “I think we have a good number of staff available and I am happy to cover when needed.” Another staff member said, “They do provide me with specific training, I have just completed bowel training. They give us the training we need for each individual client.”

The service recruited staff specifically for each package of care so staff knew who they would be supporting. On assessment of a new care package, the provider determined how many staff members would be needed to ensure safe numbers of staff were recruited. Staff completed mandatory training and then any specific training to meet the person needs. Recruitment procedures were in place which included obtaining references, identification and Disclosure and Barring Services (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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.

People and relatives we spoke with did not raise any issues about how their medicines were administered. A person said, “They do administer my medicines. There is a roster so I get my medicines at the right times.”

Staff had received appropriate training and their competency to administer medicines was assessed. One member of staff told us, “I had all the medicine training and they checked my competency.”

The service used an electronic system which alerted them immediately if medicines had not been administered within the required time. This meant management were able to contact staff immediately to investigate the reasons why. Medicine administration information was audited regularly to identify any trends or themes.