Royalcare- Thanet

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were recorded and immediate action was taken to keep people safe. Analysis was completed to look for any patterns and trends and action taken if any were identified, such as when someone was falling more often they were referred to their GP for review. Staff confirmed the outcomes of incident investigations were shared with them along with any changes to people’s care.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People had a ‘client passport’ which contained basic information about their health, care needs and things which were important to them, such as advanced decisions. These were kept in people’s homes and staff supported people to take them with them if they went to hospital for any reason. This helped healthcare staff understand people’s needs if they were unable to advocate for themselves and did not have anyone to advocate for them.

Leaders worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Leaders shared concerns quickly and appropriately.

Staff had completed training and knew how to recognise the signs of abuse. They were confident to raise any concerns they had. A staff member told us, “I feel comfortable raising concerns. If I saw something concerning, I would raise it formally through the system, but I would always tell the manager as well”. Staff had raised concerns when they felt people may be at risk, including self-neglect and domestic abuse. The provider had followed their policies to protect people from the risk of abuse from staff. This included stopping staff from working with people while concerns were investigated and referring them to the Discolsure and Barring Service where concerns about their practice were confirmed.

Staff were required to wear identification badges and a uniform displaying the service name while providing people’s care. Processes were in operation to get these items back when staff no longer worked for the service.

Leaders worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff confirmed leaders acted promptly if they raised concerns about people’s safety. Their comments included, “My manager is really understanding and deals with safety concerns quickly”.

Risks to people had been assessed and action had been planned to keep people safe whilst being as independent as possible. Staff followed detailed guidance around risk management, this included any support people needed to move around their home or remain as healthy as possible. For example, information was available to staff about people’s individual health needs and how to identify if people had an infection and the action to take. Staff confirmed they were aware of any risks related to people’s care and followed guidance about how to keep people safe.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff had assessed and planned with people how to mitigate risks in their homes to keep everyone safe. They had worked with other professionals, including safeguarding and housing to support people to move when their needs could not be safely met in their current homes. Equipment was monitored to make sure it was safe. A staff member told us, “There are service dates on equipment and we take photographs when carrying out checks. I always make sure equipment is in good working order”.

Some people used key safes to keep their door keys secure and enable staff to get into their properties. Staff were reminded to ensure the safes were locked when they left to keep the keys safe. People and their families were requested to change the code to key safes when staff changed to prevent staff entering without prior authority.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Action had been taken since our last inspection to ensure staff were recruited safely. A full employment history, with gaps was obtained and staff’s conduct in previous care roles was checked and verified.

Staff deployment was planned to ensure continuity in care. People received support from a small team of staff, the size of the team depended on people’s needs and the number of times staff cared for them each day.

Staff had the support and training they needed to perform their roles. New staff completed an induction which included working alongside experienced staff and completing the care certificate. The care certificate is a recommended tool to support minimum training for staff new to care. Staff confirmed they completed an induction which had prepared them for their role. Staff comments included, “The induction was good. It taught me about care, moving and handling, and other important aspects of the role. I completed two days of shadowing” and “The induction was good and detailed. It prepared me well for the role”.

Staff completed further training to develop their skills and keep them up to date, this included training to meet people’s individual needs such as the use of percutaneous endoscopic gastrostomy tubes to support people to eat and drink. A staff member told us, “I completed training at the head office before starting work, as well as online training, which is refreshed annually”. Staff who wished were supported to complete further recognised qualifications in social care.

Leaders assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff had completed infection control training and their competence was checked to ensure hygiene standards were maintained. A stock of personal protective equipment (PPE), including disposable gloves, aprons and hand sanitiser were held and easily accessible to staff. Staff described how they correctly used PPE.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff completed training around medicines and their competence to manage medicines safely was regularly assessed.

Medication administration records were maintained to demonstrate when people had taken their medicines. If planned medicines were not recorded as taken by a particular time, the provider and registered manager were alerted so they could check the person had received their medicines.

Some people were prescribed ‘when required’ medicines and staff followed guidelines to make sure these were given as prescribed. If people took the medicines regularly they were supported to have the medicine reviewed by their GP to see if it should be prescribed regularly. A similar process was followed when people did not take the medicine to check if it still needed to be prescribed.