Roby House Care Centre

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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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. There was a system in place to record, report and monitor accidents and incidents. Accidents and incidents were reviewed on a regular basis by the registered manager and the provider. The management team discussed accidents and incidents which occurred with the wider staff team through regular meetings. We were assured appropriate action was taken to prevent the recurrence of incidents and consider how potential risks could be mitigated for other people living in Roby House Care Centre.

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. For example, one person was being supported with a planned move back home following a short stay at the service. By the second day of our assessment however the person had gone home but returned as they were not yet able to manage independently. The registered manager had been proactive in welcoming them back to Roby House Care Centre and ensuring all relevant professionals were made aware of the persons change of circumstance.

When people moved into the service, detailed assessments of their needs were undertaken and care plans quickly developed to guide staff on how to support people safely. One person described this experience as, “Very good.” Their family member added, “Its clean. We are happy and [Name] is happy. We visit every day. We appreciate the assurance of having [staff] here.” Another family member also described a positive experience and confirmed they were able to choose their bedroom and had been involved in the development of their loved one’s initial care plan.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Systems were in place to protect people from the risk of abuse. Information explaining how people could raise concerns was clearly displayed on notice boards. Staff received training and understood the actions they must take if they felt someone was being harmed or abused. Referrals had been made to the local authority safeguarding team when abuse had been suspected. People who lived in Roby House Care Centre told us they felt safe. Comments included, “I feel safe, I like it here I feel cared for”, “I feel safe, [staff are] wonderful, very friendly” and “The care is marvellous, and it’s all done for you.” One family member told us they had recently raised concerns with the provider and the local authority regarding aspects of their loved one’s care. We discussed the detail of this with the provider and confirmed the concerns had been reported to the local authority and to the CQC. Records were maintained of the investigation which provided assurance the concerns had been taken seriously and appropriate follow up action taken to ensure the person’s safety.

When a person was assessed as lacking the capacity to agree to the support they received, important decisions were made in their best interests in line with the Mental Capacity Act 2005. The local authority had been informed of any restrictions which had been put into place to keep people safe, and the appropriate legal authorisation had been obtained through the deprivation of liberty safeguards (DoLS) framework. All authorised restrictions were accurately reflected in peoples care plans.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. We identified some shortfalls in the accuracy of record keeping. For example, a person had been receiving assistance to shower in line with their preferences and care plan, however their care records indicated they had only had a body wash in bed. We raised this with the registered manager. The management team told us they were aware this was an area that needed improvement and had recently addressed this issue with staff. Other records, such as recording people’s correct dietary intake was accurate.

Detailed information was available to guide staff to support people safely. Risk assessments were completed and detailed care plans were in place to guide staff on how to care for people safely. Staff we spoke with knew people well and their individual care needs, including areas of risk. Throughout our assessment, we observed safe working practices, such as moving and handling of people being carried out. People also had the equipment they needed to be supported safely.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Recent changes in staffing meant some of the routine checks on the environment were not all up to date. We raised this and the provider quickly arranged for an experienced staff member from another service to attend Roby House Care Centre to bring the records up to date and to support the induction of a new team member. Servicing records of the fire system, electrical system, gas boilers and routine checks on equipment such as hoists, modified baths and the lift were up to date, and certificates were in place to demonstrate this.

We observed some people were not always using the designated outdoor smoking area and discarded cigarette ends were observed outside the ground floor lounge door. One bedroom ceiling also had some staining from a previous water leak. Both issues were raised and the registered manager gave assurance they would take the appropriate action.

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. Staff were safely recruited, and recruitment was ongoing to fill any vacant staffing posts. The provider was utilising some agency workers to ensure safe staffing levels were always maintained. We observed the same agency workers on different days of our assessment. This helped to ensure people received consistent care.

There were enough staff on duty. We observed call bells were answered promptly and people told us staff responded to any requests for care as quicky as possible. Comments included, “If I need anything [Staff] come straight up. I don’t have to wait long” and “Yes, I use my call bell. [Staff] they do their best to respond. If you use it at busy times, they are slower.”

New staff, including agency workers were inducted to the service and all staff received the training they needed to safely support people. People told us staff were well trained. Comments included, “The staff appear to be trained well” and “Yes, [Staff] seem trained to do what they need to do.” A family member told us, “Staff are knowledgeable about [Name’s] condition and will make an effort to find out [anything they are unsure of].”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home was clean, tidy and well maintained. There were plenty of supplies of personal protective equipment (PPE) such as gloves and aprons available for staff to use throughout the service when assisting people.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. One person told us, “Yes, I have medication every morning they bring it round the same time each morning.” Records of administration were well maintained and in line with best practice. This included when people were prescribed creams. Guidance was available to staff for all prescribed medicines administered on an ‘as required’ basis. This helped staff to understand why certain medicines were prescribed; and under what circumstances they should be offered to a person. Medicines were stored securely and only administered by staff who were suitably trained. This included the safe storage of thickening products which were to be added to some people’s drinks.