Rance Healthcare Services 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

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

This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Where concerns had arisen, the registered manager and nominated individual had worked with people, relatives and professionals to resolve concerns and make any improvements. Staff told us learning was shared with them during 1 to 1 meetings and through staff communication channels. One staff member said, “We let the management know if anything goes wrong, they ask if there’s anything they can improve.”

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’s needs were assessed prior to them receiving care. Staff told us they had access to guidance about people’s needs when they first started supporting them. The registered manager told us care plans were developed and more detail was added as staff got to know people and understand their needs. People’s care plans were regularly reviewed and updated where their needs had changed to ensure care met their current needs.

The person in receipt of support had moved from another service. Records about their transition showed staff had visited them in their previous home to support a smooth transition to their current home. Staff told us they were able to learn about the person’s needs from staff in the previous placement and this enabled them to adapt their approach, so the person felt reassured when they moved into their new home.

The provider 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. The provider shared concerns quickly and appropriately.

There were systems in place to ensure any concerns for people’s safety or well-being were recorded and escalated as required. Staff were trained in safeguarding and knew how to identify concerns for people’s safety and how to report any concerns. One staff member told us, “I know who I would speak to, there’s [registered manager] or the field care supervisor. Or I could contact the local authority or CQC if I felt I needed to.”

The provider 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.

The registered manager completed risk assessments which staff used to provide safe care. Staff we spoke with were aware of the person’s risks and could describe how they were supported safely. Risk assessments were in place for areas such as eating and drinking and support for distressed behaviours.

The person’s care plan contained clear guidance for staff to follow about how to safely support the person to reduce the risk of harm. Staff were trained in the management of distressed behaviours and used techniques in de-escalation to reduce the need for physical interventions.

Records showed the person’s risks had been reviewed where there had been any changes, which ensured they received care that met their current needs.

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

The registered manager and field care supervisors carried out assessments of the person’s home to ensure the environment and any equipment used was safe. An environmental risk assessment was in place which considered how risks posed by the home environment, fixtures and fittings and equipment should be managed. An evacuation plan was also in place to ensure staff knew the action they should take to support the person in an emergency.

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.

The person was supported by a staff team in line with their assessed needs. There were enough staff to meet the person’s needs and to ensure they could frequently spend time both at home and in their local community or visiting places they enjoyed.

Staff understood how the person’s knowledge of who was supporting them was important to them. One staff member said, “[Person] likes consistency. Any change upsets them, they ask you who is coming? During staff changeover they are checking who are their staff for the night and the day. [Person] wants to know they are accepted.”

Staff had received training relevant to their role and told us they felt well equipped to support people safely. The registered manager told us they matched people with staff to support the development of a strong working relationship between people in receipt of care and the staff team. The provider had carried out relevant pre-employment checks to ensure staff were safe to work with people.

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.

Staff had received training in infection control. Staff told us they had access to PPE and contacted the management team if they were running low. There were systems in place, which staff followed, to reduce the risk of cross infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

Medicines records did not always reflect the difference between daily medicines and those prescribed for use 'as required'. We discussed this with the registered manger and nominated individual who took immediate action to address the concerns. Following the inspection, they shared with us the actions they had taken and explained how changes would be monitored to ensure they were effective.

Despite this concern the person received their medicines as prescribed. Staff were trained in the administration of medicines and shared how through a consistent approach they had reduced the amount of medicines the person required in relation to their anxiety. One staff member told us, “We have improved in terms of medicines, we can now give them to [person], whereas previously medicines had to be left in their room. [Person’s] health has improved and their medicines are reduced.”