Supreme Care Services Limited

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 assessed 4 quality statements in the safe key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Our rating for the key question remains good. We found that the service was delivering safe care. This was a result of thorough and personalised risk assessments with evidence of positive risk taking. Staff confidence and competence meant that concerns were raised with the appropriate people promptly and recorded accurately. Changes were made to care delivery where needed in order for risks to be mitigated and enhance peoples quality of care. People were involved in how the risks associated with their care were managed and they told us they felt care was delivered 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.

People told us that they felt safe with their carers. One person told us “I can take my medication myself, but to keep me safe so I don’t make mistakes they are arranging for me to get a dosette box off my chemist.” Another person said “My carer knows exactly how to lift me without hurting me or me being scared, I can tell they feel confident when they are doing it.” People told us that staff were good at recognising when changes needed to be made to care plans and would contact the office straight away. Staff managed risks well and knew how to use equipment properly and safely. One relative told us that they contacted the manager if they thought anything needed to be changed in the care plan and the service implemented or suggested changes themselves.

Staff and leaders’ feedback demonstrated concerns about safety were being listened to. Staff told us that they confidently knew when to report a concern for safety to the office. One staff member gave us an example of their response to a concern for a physical injury as “I would record it and contact the office, they will then contact the GP or nurse for them to call out to the clients house.” Staff gave us some good examples of when they would carry out a risk assessment. One staff member told us “I would do an assessment as soon as I realise that it needs to be done. I look at the risk and advise office of how it can be managed.” The registered manager encouraged staff to communicate anything which seemed unusual with the office team. They told us “We encourage staff and reassure that there is no comeback from anything that they share.” They gave us examples of where staff communicating concerns had resulted in improvements for people.

We saw that Field Care Supervisors had increased the frequency of contact with people to ensure concerns about safety are identified promptly. Improvements had included the availability of staff via phone, which we saw evidenced in telephone monitoring reports. We saw evidence on the analysis of incidents and accidents that the outcome of investigations had been responded to, lessons had been learnt and implemented in the ongoing care provision for people.

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.

Staff had received training to safeguard people effectively and we saw records which demonstrated changes were made to improve the response to safeguarding concerns. The safeguarding policy had been updated in October 2023 which demonstrated an up-to-date approach to the oversight of safeguarding management. The policy clearly detailed principles, pathways and responsibilities of the service in keeping people safe. Safeguarding concerns were seen to be raised with the local authority and notified to the CQC. Records showed that appropriate action had been taken to protect people from actual or potential abuse and the outcomes had been shared with people and professionals.

Staff told us that training was ongoing with frequent refresher training. One staff member told us, “The best thing is all the training and the support that I get. My training makes me feel very confident.” Staff also said the office keep them up to date with changes to guidance. The registered manager described the recruitment and induction process including a test to ensure new staff were competent to begin working for the service. They told us, “Our pass rate is very high, so it is not easy to become employed with us”. Staff who pass then shadow other members of the team before being signed off to work independently. The registered manager told us that although the service does not currently support anyone with a learning disability, they had proactively arranged training for all staff in delivering care to people with learning disabilities since someone with a learning disability had recently been referred.

We did not receive feedback which told us that people or relatives had concerns around neglect or abuse. People and relatives felt confident that staff would raise a concern if they felt they were experiencing or at risk of abuse.

Staff were conscious about leaving people in a safe environment to support their independence to mobilise safely once they had left. One staff member told us, “I make sure that all pathways and floor areas are clear before I leave so there is no trip hazards.” Another staff member told us, “[Person] loves to do her own skincare as it is very important to her, so I encourage her to do this and make sure that she completes this correctly just by little things like telling her if she has missed a bit.” The registered manager gave us an example of supporting someone to take positive risks to develop their independence. They said “A very experienced, competent carer was assigned to [person] to help them gain confidence in accessing the community. That person is now in a relationship and accesses the community independently.” The registered manager emphasised that risk assessments are unique to individuals and they told us, where possible “we sit with them and tailor their risk assessment.”

People and relatives told us that they were supported to manage risks by staff and relevant personal protective equipment is always used. One person told us “I am encouraged to drink lots of water to keep hydrated by my carer and they always get me a drink and leave one with me when they leave.” A relative told us “If the carer thinks my relative is in pain they will come through and advise me and ask if it is okay to give pain killers.”

People were supported to be involved in the assessment process with clear preferences stated in risk management guidelines. Risk assessments included a section for peoples comments on the risk assessment which showed a collaborative approach. There were clear protocols in place for staff to follow in emergency situations which had been identified as likely such as people falling. Incidents and accidents had resulted in peoples choices being respected with ongoing risks managed in the least restrictive way.

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

Staff told us that training was ongoing with frequent refresher training. One staff member told us, “The best thing is all the training and the support that I get. My training makes me feel very confident.” Staff also said the office kept them up to date with changes to guidance. The registered manager described the recruitment and induction process including a test to ensure new staff were competent to begin working for the service. They told us, “Our pass rate is very high, so it is not easy to become employed with us”. Staff who pass then shadow other members of the team before being signed off to work independently. The registered manager told us that although the service does not currently support anyone with a learning disability, they had proactively arranged training for all staff in delivering care to people with learning disabilities since someone with a learning disability had recently been referred.

People told us that they believed staff were well trained and very experienced and they have positive relationships with them as they have the same carers consistently and know them well. One relative told us “The staff must receive excellent training because my relative feels so safe with them and trusts them completely.”

Staff recruitment records confirmed that the service had ensured staff had the necessary checks from the Disclosure and Barring Service (DBS) and that two employment references had been sought. Staff were recruited with relevant experience and skills to do the job safely. We saw a record which showed completed training, identified training needs and planned training where it was needed. We saw staff supervision records which showed collaborative and reflective discussions had taken place with regards to staff development needs and updating staff on changes to guidance. We saw records of frequent competency checks of staff performance along with recommendations of how improvements could be supported.

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.