Saxon Care Solutions Limited was rated overall Good at its December 2016 inspection, with a Requires Improvement rating for Safe due to incomplete 'as required' medication guidance in care plans and two wrong-medicine incidents in the preceding month. All other key questions were rated Good, reflecting strong person-centred care, effective leadership, robust quality assurance, and a well-supported and trained workforce.
Concerns (4)
critical
Medication management
: “There had been two incidents in the previous month in which staff had supported people to take the wrong medicine.”
moderateMedication management: “It was not always recorded what action was needed to support people with medicines that were prescribed to be taken 'as required'.”
moderateCare planning: “The care plan was not clear at what point the medicine should be administered or that the medicine should be taken with them if they went out of their home.”
minorRecord keeping: “There was one occasion when additional calls had been scheduled for a person which were not provided due to a communication error.”
Strengths
· People felt safe and praised the quality and capability of care staff
· Staff received thorough induction and ongoing relevant training, including medication administration observations
· Robust safeguarding awareness with staff confident to report concerns internally and externally
· Effective risk assessments developed with people and their representatives
· Strong complaints handling with thorough investigation, trend analysis, and prompt resolution
Quality-Statement breakdown (14)
safe: Medicines managementRequires improvement
safe: SafeguardingGood
safe: Risk assessmentGood
safe: Staffing and recruitmentGood
effective: Staff training and supervisionGood
effective: Mental Capacity Act complianceGood
effective: Health needs and professional liaisonGood
caring: Dignity, respect and person-centred careGood
Saxon Care Solutions Limited achieved a Good rating across all five key questions at this August 2019 inspection, demonstrating notable improvements to medicines management since the previous inspection. Minor gaps were identified in MCA documentation practices and the initial absence of children's safeguarding training for relevant staff, both of which were being promptly addressed.
Concerns (3)
moderateSafeguarding: “Whilst staff had completed safeguarding training, this did not include information about children. This was despite some staff working with two people under the age of 18 years.”
minorConsent / capacity: “Documentation showed people's capacity to make decisions had been considered but the information did not clearly show the principles of the MCA had been followed.”
minorRecord keeping: “Records did not always support this practice. We recommended that any decisions made on behalf of a person was done so, and documented, in line with the Mental Capacity Act 2005.”
Strengths
· Significant improvements to medication administration systems since last inspection, including new records, one-to-one training, and introduction of medicine auditor posts.
· Electronic monitoring system used to identify and address potential missed visits before any impact to the person.
· People received personalised, comprehensive support plans tailored to their needs, preferences and risks.
· Strong, positive and inclusive culture led by director and manager who were highly valued by both staff and people using the service.
· High volume of compliments received, including external recognition via Wiltshire Council 'Proud to Care Awards'.
Quality-Statement breakdown (23)
safe: Using medicines safelyGood
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies and healthcare servicesGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Meeting people's communication needsGood
responsive: End of life care and supportGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood