Ranmore House

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 the same. 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.

The provider understood their role to record accidents and incidents, and how to reduce the risk of them happening again. Due to the small number of recent accidents and incidents, the provider had not completed a detailed analysis. However, we saw there were systems in place to do so if this changed, including an accident and incident reporting policy and procedure.

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.

There were procedures in place to ensure people’s transition to and from services was managed. This included involving people, relatives and relevant professionals in the process. We saw staff followed guidance provided by professionals to ensure continuity of care. There was a business continuity plan in place which included information on what to do in the event of an emergency, such as what to do in case of an electrical failure.

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.

Relatives told us people felt safe living at the service and that staff treated them with respect. They described how staff treated people with compassion and respected their choices.

Staff had completed training for safeguarding and whistleblowing, and there was a safeguarding policy in place. They told us they knew how to recognise potential signs of abuse and how to report these internally and externally. One member of staff told us, “There could be marks on the body. Their behaviour may be changed and it’s different. [I would] tell the management or the Care Quality Commission.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. The provider understood their responsibility in relation to safeguarding people’s rights and what would constitute a restrictive practice. Applications were submitted to the local authority, and we saw that applications had considered the restrictions in place and involved relevant parties.

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.

Relatives told us risks in relation to people’s care were managed well by staff. One relative told us, “They really support people. They are really good.”

Care records included information on how to reduce risks in relation to people’s care. For example, these outlined how staff could ensure certain triggers could be removed prior to undertaking a journey so that a person felt less anxious. We saw that relevant healthcare professionals had provided instructions and we observed these were followed by staff. Where a person was at risk of seizures, there were plans in place for staff to follow which included when to escalate these and how to reassure the person.

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

Relatives told us people lived in a safe environment. We saw there were systems in place to ensure the environment and equipment, such as the lift, were checked regularly.

The provider undertook regular checks of the environment and worked with external partners, such as the fire and rescue service, to make the service safer. People had individual evacuation plans in place which were person-centred and provided important information in the event of an emergency. Staff understood how to evacuate people from the service, and we saw fire safety equipment had been checked by qualified persons to ensure it was effective if it needed to be deployed.

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.

Relatives and staff told us there were sufficient staff to meet people’s needs. We observed there were sufficient staff throughout the assessment and staff were knowledgeable about people’s needs. Staff had completed training relevant for their role and had received supervisions. Rosters showed there had been a core staff team who supported people. One member of staff told us, “There’s enough staff. It’s calm. We don’t need to rush.”

Staff were recruited safely to the service. This included requesting and receiving references from previous employers, right-to-work documentation and Disclosure and Barring Service (DBS) checks. DBS checks are carried out to confirm whether prospective new staff had a criminal record or were barred from working with people at the time.

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.

Relatives told us the environment was clean and staff took steps to reduce the risk of infection. Staff cleaned the environment regularly and told us they had sufficient personal protective equipment to undertake these tasks. We observed staff following infection prevention and control (IPC) procedures and they encouraged people to take part where they wished to be involved.

The provider had an IPC policy in place, undertook regular IPC checks of the environment and equipment, and they understood their responsibilities to report infection outbreaks to the relevant authorities. Staff regularly completed temperature checks of the food provided to people in order to ensure it was safe to serve.

The provider generally made sure that medicines and treatments were safe and met people’s needs, capacities and preferences, however, there were some areas for improvement. Staff involved people in planning, including when changes happened.

People received their medicines as prescribed, however, we identified some shortfalls in safety such as ensuring handwritten entries on the medicines administration records (MAR) were always signed in line with national guidance to ensure an audit trail for accuracy. The temperature monitoring of storage facilities was not always carried out which could affect a medicine’s effectiveness. The provider addressed this prior to the end of the assessment and put systems in place to ensure this was monitored. However, these areas were not identified by the provider until we highlighted them.

Relatives told us people received their medicines in a safe way. MAR included information about people’s medicines, the times they took them and records showed people had received their medicines as prescribed.

The provider understood their responsibilities in relation to managing medicines alerts and ensuring the use of specific medicines was in line with national guidelines. Staff had received training and competency checks prior to administering medicines, and there was a medicines policy in place.