Royal Mencap Society - Central Hampshire

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.

At our last assessment the service was in breach of the legal regulation in relation to safe care and treatment. At this assessment the service had improved sufficiently and is no longer in breach of this regulation.

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.

Relatives and staff felt confident in raising safety issues and told us senior staff would address their concerns about people. The registered manager or service managers reviewed incidents individually and the provider checked correct processes were followed. The provider had undertaken a thorough analysis of incidents and had plans in place to address trends and reduce recurrence. Staff were informed of any learning from incidents through supervisions and team meetings.

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.

The provider assessed people prior to starting their package of care. Care was organised flexibly, with adjustments made to meet people’s changing needs. This included when people attended appointments, when their health needs changed or when they were admitted to or discharged from hospital. Staff told us they had the information they needed in people’s care and support plans. The provider had supported people to move to a new property and was also supporting people moving to a new provider. This involved sharing support plans with the new provider and ensuring families had the relevant contact details. Where people and relatives may become anxious over the move, the registered manager had acknowledged this and was working with relatives to reduce their concerns. There was also a robust handover procedure covering people’s finances and medicines. Shadowing for the new provider’s staff was also considered. This helped to ensure a safe transition and coordinated care for people.

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 with external agencies.

The provider had effective safeguarding policies and procedures in place. Senior staff demonstrated a thorough approach to investigating safeguarding concerns, to help reduce the risk of people suffering abuse or coming to avoidable harm.

Staff were trained in safeguarding which was refreshed on an annual basis. Staff we spoke with knew what signs to look out for and who to report this to. Staff told us it was important to make sure no abuse, or neglect was experienced and they would call the manager if they had any questions. Staff understood the importance of ensuring care was as least restrictive as possible.

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 provider considered risks to people as part of their assessment, when the person started with the service.

Risk assessments included relevant information and guidance for staff to keep people safe and how to mitigate the risk. Staff we spoke with were aware of risks to people and told us they are continually updated if people’s needs and abilities change. They also understood the importance of positive risk taking with an appropriate risk assessment to allow a person to live their life to the fullest. This promoted positive outcomes for people around their safety. Staff told us there was enough information for them to follow in people’s care and support plans and any new risks would be reported to management.

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 provider carried out assessments of people’s home environments to identify and reduce any risks related to the delivery of care. Staff had completed fire safety training and were aware of the procedure to follow if there was a fire. The provider ensured regular fire drills were taking place. One staff member told us, “We do fire drills, practice ones 3 monthly.”

When people’s needs changed and they required equipment to support them, the provider worked with occupational therapists to obtain suitable equipment. The provider monitored equipment including inspection frequency to maintain safety. Staff were aware of the need to check equipment prior to use.

The provider made sure there were enough qualified, skilled and experienced staff. Relatives told us consistent staff supported people. Rotas and staff teams were in line with commissioned hours, and the registered manager confirmed staff retention was good.

However, staff recruitment records did not always show all the required checks and how decisions had been made, when information was not available, to ensure only appropriate staff were recruited. The provider reviewed their recruitment policies during the assessment to better achieve this, but this still needed to be embedded in practice.

Staff we spoke with were knowledgeable and knew people they supported well. However, records showed staff had not always received training in line with the provider’s policy. During the inspection, the provider began reviewing their training policy and frequency to ensure staff remained up to date with current practice.

The provider was aware of the staff training requirements when supporting people with a learning disability and/or autism and was providing additional training as required.

New staff received an induction and worked alongside experienced staff to develop their skills and confidence. Staff received regular supervision and attended team meetings.

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.

People or relatives did not raise any concerns about infection prevention and control (IPC). Staff were knowledgeable about keeping people’s homes clean and reducing the risk of infection. Staff knew when to use PPE and how to dispose of it correctly. They were also clear on the benefit of good hand hygiene. There was a suitable IPC policy in place.

The provider made sure that people received their medicines as prescribed and medicines management met people’s needs, capacities and preferences.

The provider had policies and procedures developed in line with national guidance, to help ensure staff were following best practice when supporting people with their medicines. People’s care plans detailed the support people needed to manage their medicines, and levels of independence people wished to maintain. Staff competency to administer medicines was checked on an annual basis where staff were observed and their knowledge reviewed. Staff were also aware of the need to check for harm if a person missed their medicines.

Staff completed an electronic medicine administration record when they administered people’s medicine. This was monitored by the provider and medicine records were promptly updated when people’s prescriptions changed. The provider used the alert system or medicines audit to follow up any potential missed medicines with staff.

Staff guidance on when people needed “as required” medicines was in place, and staff knew when to administer these. People’s medicines detail sheets were good and gave contraindications and side effects for staff to be aware of.