Sihara 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

The rating has improved from requires improvement to good during this assessment. Effective systems were in place to safely recruit staff. Staff were trained and supported appropriately. The majority of risks to people's safety had been assessed. However, some risk assessments lacked detail around how to mitigate risks. Systems were in place to investigate accidents, incidents, complaints, and safeguarding incidents. People’s medicines were managed safely. An electronic system was in place to monitor staff timekeeping and punctuality. Systems were in place to help prevent and control infections. Staff and management communicated and worked with other agencies to help keep people safe.

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 majority of people we spoke with told us they felt able to speak to staff and the manager openly. A person told us, “If there were any problems, I would let the office know. Sometimes the manager will come and see me and see how I am getting on.” Relatives told us they knew how to make a complaint and felt they would be listened to. People and relatives were encouraged to provide feedback.

Lessons learnt were discussed in staff meetings and supervision sessions. This provided an opportunity for staff to openly share information, discuss and learn from one another. Management investigated adverse events to reduce the likelihood of these reoccurring and improve the quality of care and safety.

Policies and procedures were in place for investigating and responding to accidents, incidents, complaints, and safeguarding alerts. Staff were encouraged to report incidents promptly.

. We did not receive feedback from staff regarding this aspect of the service.

We did not receive feedback from external partners regarding this aspect of the service.

There was a referral and admission process in place so that people received joined up care.

The majority of people we spoke with told us they felt safe in the presence of care staff. This was confirmed by relatives we spoke with. A person told us, “[Care staff] are perfect, they are 100%. [My family member] is very satisfied with them. They are caring and gentle.”

Staff told us they felt confident reporting concerns and wouldn’t hesitate to do so. Care staff described the action they would take if they witnessed any abusive or neglectful practice. This involved reporting concerns immediately to management. Some staff we spoke with were unaware of other relevant agencies safeguarding concerns could be reported to. We raised this with management who advised that they would carry out further training with staff focusing on ensuring they were familiar with other professionals they could contact. Care staff were confident management would take appropriate action when required. The manager was aware of their responsibilities on how to help protect people from abuse and the actions they would take where there was an allegation of abuse.

Safeguarding procedures were in place. These provided guidance about the action to take if staff had concerns about the welfare of people. Training records showed staff had completed safeguarding training.

People told us they felt staff provided safe care which met their needs.

Staff we spoke with told us they wouldn’t hesitate to raise concerns with management and had confidence that appropriate action would be taken. Staff were able to tell us how they supported people safely to help protect them.

The majority of risks to people were identified and managed to help keep people safe. Risk assessments covered various areas such as the environment, falls and transfers. They included detail about the level of risk and information about control measures in place. However, we found examples where there was not sufficient detail in some risk assessments in respect of some specific health issues. For example, 1 person was diabetic but did not have a personalised risk assessment in place for this. Another person was at risk of self-neglect and did not have a personalised risk assessment detailing the signs to look out for and how to mitigate this. We raised this with management who were receptive to our feedback and took things on board. Following the site visit, management immediately reviewed and updated risk assessments accordingly. They also advised that they were in the process of migrating to a different care management system and would ensure that detailed risk assessments were in place on the new system. Staff completed training in areas of potential risk such as first aid, moving and handling and health and safety.

The CQC does not assess people’s home environments for this type of service. However, we were able to see that the service had carried out an assessment of people’s home environment to help identify risks.

Management explained that during the assessment of people’ needs, they looked out for hazards and if these were identified, measures were put in place to reduce the risks of harm to people.

Processes were in place to help identify risks within the environment and monitor these.

People and relatives spoke positively about care staff and said staff were mostly punctual. A person told us, “If they are late, they will let me know, we have one regular carer but if [they] are off sick we will get another carer.” A relative said, “Most of the time they [care staff] turn up on time. If they are late they will let me know.” However, a person did raise concerns about care staff punctuality. We raised these concerns with the manager who advised that they would investigate this further. Care and support was provided by a mostly stable and regular workforce that people and relatives were familiar with.

Staff told us there were enough care staff to safely meet people’s needs and no concerns were raised about this. Staff spoke positively about communication within the service and said they were kept informed of changes and developments. A member of staff said, “Communication is good here. There have been no issues about this for me.”

Policies and procedures were in place to help recruit staff safely. Thorough checks on the suitability of potential staff were completed. This included obtaining references and checks with the Disclosure and Barring Service (DBS). The DBS helps employers make safer recruitment decisions and help prevent unsuitable people from working in care services. Records showed that staff had received training in areas relevant to their roles. Staff received supervision sessions which provided an opportunity for them to discuss their performance and professional development. An electronic homecare monitoring system was in place. This monitored care worker’s timekeeping and punctuality in real time. The system would flag up if care staff had not logged a call to indicate they had arrived at the person's home and were running late. If this was the case, staff in the office would receive an automatic notification and the office would call care staff to ascertain why a call had not been logged and take necessary action there and then if needed.

People and relatives told us care staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE).

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

Infection prevention and control policies were in place. Staff were given the information and guidance they needed.

The majority of people and relatives told us that medicines were administered appropriately. A concern was raised by a relative regarding medicines administration. We raised this with the manager who advised that they would look into this concern and action appropriately.

Staff had their competency to administer people’s medicines safely assessed to check they had the appropriate skills and knowledge to do so.

A medicines policy and procedure was in place. People’s medicines support needs were documented in their care plan. Care staff recorded medicines administration electronically so that the office could monitor this in real time. We looked at a sample of Medicines Administration Records (MARs) and found that these were completed with no unexplained gaps. We noted there were some instances where medicines had not been administered and staff had documented this with the appropriate key but had failed to record specific detail and context as to why the medicines had not been administered. We raised this with the manager who advised they would look into this.