Raby Hall

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 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. Systems were in place to record and monitor accidents and incidents. Staff understood the process for reporting and recording events which occurred. Events were reviewed on a regular basis by the registered manager and the provider. This enabled them to analyse trends, identify any lessons learnt and work with people and staff to identify why events had happened, and how to avoid situations in the future. Family members told us these systems were effective. One family member described some recent events and commented, “They have learnt from the investigations. The manager is good and investigates and sorts things out straight away.”

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. Family members told us they were kept informed if a person’s needs changed. One family member told us, “I am notified if anything’s going on.”

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. Staff received training and understood the actions they must take if they felt someone was being harmed or abused. The provider shared concerns quickly and appropriately. Referrals had been made to the local authority safeguarding team when abuse had been suspected, and investigations had been completed. Information was available explaining how people could raise concerns if they felt someone was being abused. Family members told us they felt their loved ones were protected from the risk of abuse. One commented, “The staff are always polite. [Name] seems very happy.”

Some people were unable to consent to the care they received and were being deprived of their liberty through the deprivation of liberty safeguards (DoLS) framework. One family member described some restrictions which were in place for their loved one and explained the reasons these actions had been introduced. We reviewed the systems in place to ensure such restrictions were lawfully authorised and found all authorised restrictions were appropriately assessed and accurately reflected in peoples care plans.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments had been completed, and personalised care plans had been developed to minimise any risk to people’s health and wellbeing. Staff told us these plans were clear to follow.

Equipment was in place to keep people safe when accessing their local community as well as to prompt staff to medical emergencies, such as a person experiencing an epileptic seizure.

People told us they felt safe. One person commented, “I’m happy at Raby Hall. I like the staff and I feel safe.” A family member also told us, “I have no issues with safety. [Name] is safe and secure.”

Some people experienced occasions of distress. Detailed care plans had been developed to help staff understand the person’s emotional and communication needs and offered detailed guidance how best to support the person during such occasions. Staff received training which included specific instruction how to physically assist a person safely as a last resort. One staff said, “We do physical intervention training, but we see have seen a lot of reduction as we focus a lot on prevention.”

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. Some communal hallways were dark and at times, cold. We were assured heating was appropriate within people’s living areas. Overall, a full scheme of redecoration was needed and some bathrooms needed to be replaced. At the time of our assessment, only part of the service was occupied. The other part was undergoing extensive refurbishment. We viewed this area, which was being refurbished to a high standard and had been designed around people’s bespoke needs. We were told some people were due to move to the new area within the timeframe of this assessment. We were further assured there was a detailed plan to then refurbish the remainder of Raby Hall to the same standard.

Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this. There were ample communal spaces for people to choose to spend time with others or have their own space. Some of these areas had also already been refurbished and contained facilities which where appropriate to people’s sensory needs.

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 inducted; appropriate checks had been made before applicants were offered employment. Staff received training to effectively support people with a learning disability and autistic people. A staff member told us, “The training is fine. A lot of the work is also on the job.”

Staffing levels were safe, and there were enough staff on duty to support people to access a variety of activities both within the service and out within their local community. Family members and staff both told us there had been several staff changes at Raby Hall however, staffing had now become more consistent. One family member confirmed, “[Name] has regular staff that understand them.”

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. Some furniture needed recovering or replacing. We raised this and the management team told us an upholsterer was in the process of completing this upgrade. During our assessment visits we saw this person collecting and delivering furniture to the service. The remainder of the service was generally clean and tidy, however until the full refurbishment was completed, staff were unable to fully clean high-risk areas including some bathrooms. Staff had access to adequate supplies of the personal protective equipment (PPE) they needed when assisting people with care.

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. Records of administration were maintained and in line with best practice. Guidance was in place 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. The effective use of ‘as required’ medicines was monitored and reviewed by the management team and professionals who worked with people. This ensured people were not at risk of being over medicated. Medicines were stored securely and only administered by staff who were suitably trained.