Apex Healthcare Service Ltd

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 harm and abuse. People were supported to understand and manage risks both to themselves and in their environment. Care plans were clear and provided sufficient guidance to staff to keep people safe. There were sufficient numbers of appropriately trained staff to support people.

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 their relatives felt safety concerns were appropriately investigated and acted upon straight away. People gave us examples of how staff responded to their changing health needs to keep them safe. One person said, "Every one is in the loop to make sure that all safety procedures are addressed without delay". Another relative told us, "the carers are really good at engaging and communicating with him to make sure every safety issue is addressed very well".

Staff maintained a culture of openness and transparency. Staff shared learning and updates through regular team meetings to protect people from harm. People’s liberty and human rights were protected and upheld by staff. The registered manager and nominated individual told us they maintained an openness within weekly team meetings to share concerns and specific feedback from people and their family members with staff.

The provider had clear processes which facilitated staff reflection and continuous learning. This included learning from errors, accidents and incidents. Records showed staff maintained detailed records of incidents and accidents, with evidence of actions taken to prevent recurrences.

People told us staff communicated effectively with professionals from health and social care to meet their needs. Staff communicated changes in people's health needs and promptly referred any concerns to the appropriate practitioners. People and their relatives gave several examples of how staff had liaised with healthcare professionals to meet their needs and support their wellbeing. One family member said, "[Staff member] immediately lets the GP and office know any concerns which need their attention whilst also informing me. I was aware that this has recently occurred and antibiotics and some cream have been prescribed".

Staff maintained effective communication with GPs, nurses and occupational therapists to identify and escalate risks to people’s health and wellbeing to help them stay safe. Staff maintained a detailed oversight of people's care and support needs and ensured all records were accurate and up to date. The registered manager told us one person had been given a DNACPR status on their care records to indicate they did not wish to be resuscitated in an emergency. They liaised with the person and followed up with their GP to ensure this was removed from their records as this was not accurate information.

External professionals made positive comments about how staff were proactive in escalating concerns, and referring changes in people's health and wellbeing to them. Comments included, "All referrals to [service] from Apex are appropriate and they always work with us to mitigate the risks before we can see them" and "they...follow up with proportionate updates and actions as necessary and required promptly".

Staff maintained detailed, records of interactions with external professionals and of follow up actions after referrals were made. Staff maintained clear records of communications with people's healthcare professionals. Instructions from healthcare professionals were incorporated into people's care plans and carried out by staff. Policies and procedures were reviewed regularly by the senior team to ensure they were up to date and fit for purpose. Audits were used effectively to review people's care and support needs and interventions from healthcare professionals.

People and their relatives told us they felt safe with staff. One person said, "I am very safe in the carers hands but if I had any issues I would ring the office". One relative told us, "My relative has been with the service for about 2 years and is very happy. I know she feels safe and if I had concerns I would ring the office". Another relative said, "I am pleased to say my wife feels very safe with this care service".

Staff told us they had completed safeguarding training and knew how to raise concerns should they arise. There was a safeguarding policy in place and safeguarding concerns were reported appropriately to the local authority and to CQC. Staff understood their responsibilities to keep people safe. One staff member said, 'I would always raise any concerns and speak up if I had a problem".

Staff maintained robust and effective systems for monitoring safety. Staff maintained detailed records of safeguarding concerns and actions taken to mitigate risks. The registered manager completed monthly audits detailing any concerns raised and actions taken by staff to prevent recurrences and keep people safe from harm.

People were supported by staff to understand and manage risks to enable them to live fulfilling lives. Relatives made positive comments about staff's abilities in this area. One relative said, "My husband’s care needs are complex and they are sensitive to demand and flexible". Another relative told us, "the carers are really good at engaging and communicating with him to make sure every safety issue is addressed very well".

Staff were aware of and knew where to find information about people's risks. Staff told us they felt they had the training and skills to manage risks for people. The senior team used a detailed assessment process in partnership with people and their relatives to tailor people's care and support and help them manage risks effectively. They told us they incorporated discussions about people's care plans into weekly team meetings to ensure all staff were aware of how to support people to be involved in risk management.

During this assessment we found the provider was now recording all actions taken to mitigate risks to people. The provider ensured they followed best practice guidance to record accurate information in people’s risk assessments. Care plans contained detailed assessments to identify risks and keep people safe, for example, moving and handling assessments. These had been completed in partnership with people and their relatives and were reviewed at regular intervals to ensure they remained accurate.

People were kept safe by staff who helped them maintain a safe environment. People's care plans contained detailed assessments of their environments which identified hazards such as trip hazards and ways to mitigate risks in people's environments.

Staff showed us records of environmental checks they used to maintain people's safety.

Care plans contained detailed environmental safety risk assessments which were regularly reviewed as part of the provider's audits. Audits were then used to analyse any trends and identify and address risks within people's environments which could lead to an increased risk of falls for example.

People's relatives made positive comments about the skill of staff and the consistency of support delivered. One relative said, "their quality of care is 100%. They take him out for a walk around the block. They do food and medication. There is a regular team of 4". Another relative told us, "Not only is the care brilliant but the management is exceptional, above great...I have the same team all the time to care for my husband". People said staff attended calls on time, but if there was a delay staff contacted them to explain this. People told us they felt the staff had the skills to support them safely.

Staff told us they were well supported by the management team and felt confident to raise any concerns. People and staff told us there were enough staff to meet people’s needs. Staff received regular supervision and appraisals. Staff told us they felt well supported by the management team.

The provider had made improvements in information recorded in staff's recruitment files. The provider completed appropriate police and criminal records checks, right to work checks were in place and references were obtained and verified. Staff received the training they needed to carry out their roles; the training matrix confirmed this.

People were kept safe from the spread of infection by staff who used the correct personal protective equipment (PPE) and had completed training. People's relatives confirmed this. One relative said, "They wear [PPE] and observe a strict hygiene regime". Another relative told us, "They always wear [PPE]."

The provider completed regular audits of personal protective equipment such as gloves and aprons, to ensure there was always a supply available to staff. The provider also reviewed policies regularly in infection prevention and control to ensure they remained up to date and fit for purpose. The staff training matrix showed all staff had completed infection prevention and control training.

People's relatives told us staff supported their loved ones to take their medicines at the correct times.

Medicines were managed safely by staff. Staff analysed errors and omissions using the provider’s regular audits. Staff ensured medicines and treatments were safe and met people’s needs, capacities and preferences by enabling them to be involved in planning, including when changes happened. Staff worked with GPs and pharmacies to ensure people received their medicines on time.