The Raikes Residential Home

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 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

There were robust systems in place to support a positive learning culture. This highly positive approach ensured staff consistently reported concerns and learning was shared across the service in a safe learning space. Regular team meetings took place, and there was a comprehensive overview of incidents, enabling the service to identify patterns and trends. This was supported by precipitating factors included in people’s risk assessments, for example, people at risk of falls and post incident outcomes. Leaders responded to any concerns raised by staff regarding staffing levels. For example, staff had discussed in a team meeting and advised leaders additional staff were required to support those people who needed support with eating and drinking. Leaders immediately put additional staff in place to support with mealtimes. Staff told us they were well supported to discuss any areas of learning with leaders in the service and leaders were very responsive to implementing changes discussed in any team meetings. We observed the service had a positive approach towards learning during our assessment. Leaders were welcoming and responsive to any learning. We made suggestions regarding improvements in the service which were immediately put into place.

The service worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was continuity of care, including when people moved between different services.

The service fostered positive working relationships to ensure a smooth transition of care, such as, working with relevant health services. The service worked closely with other services to ensure care was safely managed, monitored and co-ordinated, for example, for people with mental health needs. The service worked closely with mental health professionals to establish risk assessments and care plans which were highly detailed, regarding the person’s mental health presentation and escalation required. This included signs and symptoms to signal any deterioration, and actions to take including how to contact the relevant mental health services. There was a consistent, seamless joint working approach which supported care to be safe, and personalised. Professionals we spoke with provided consistent positive feedback regarding the service’s ability to provide safe systems of care. One professional told us, “Leaders have sought professional advice to ensure all appropriate measures are in place to minimise the risk of malnutrition and prevent escalation.”

The service worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service always shared concerns quickly and appropriately.

There were robust systems and processes in place to protect people from risk of harm. There was a safeguarding policy in place and staff had completed relevant training relating to safeguarding and demonstrated a high level of knowledge. The service held a detailed record of any incidents, falls or safeguarding concerns, including any relevant actions taken, such as referral to the local authority or lessons learnt. Safeguarding contact information was displayed throughout the service, so people, relatives or staff could raise concerns independently.

There were robust systems in place regarding best interest decision making and Deprivations of liberty safeguards (DoLS). People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA, 2005). In care homes, and some hospitals, this is usually through MCA application for DoLS.

Professionals we spoke with told us the service worked well with them to keep people safe. One professional told us, “From a risk‑management perspective, [leaders] are proactive and timely in contacting me regarding residents identified as being at risk of malnutrition, consistently following the agreed pathway of implementing standard care plans initially and reviewing their effectiveness.” People consistently told us they felt safe in the service. One relative told us, "My [relative] is safe and happy.”

The service worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

There was evidence of involvement with appropriate services to monitor risk, for example, speech and language teams (SALT) to manage those people nutritionally at risk. There was evidence of significant involvement and review with relevant SALT teams to ensure dietary plans remained safe, updated and continually reviewed. The service appropriately escalated any changes in presenting need, swiftly to ensure people continued to have safe care.

Professionals provided consistent feedback regarding the service involving them appropriately to manage risk. One professional told us, "The service are very proactive, and, on the ball, they are quick to give me any updates." Another professional told us, “They [the service] are very good at managing risk.” From observations, staff knew risks relating to people well and demonstrated their ability to adapt and escalate concerns accordingly. People told us they were supported by the right professionals to manage risk. One relative told us, “My family are very happy that the home will contact the surgery if the staff have any concerns – they never leave anything to chance.”

The service was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The service completed regular and thorough maintenance checks to support the safety of the environment for people. For example, there was robust documentation in place regarding fire safety. There was evidence regular fire evacuations had taken place, staff had relevant training and there were appropriate personal emergency evacuation plans in place (PEEPs). The service completed regular checks on relevant equipment to ensure this was safe for people, including in kitchen areas. We observed the environment to be safe, clean and tidy. People told us the service's environment was safe. One person told us, "My room is cleaned daily, laundry collected every morning whilst I am at breakfast. The whole home is kept well."

The service 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.

There were robust recruitment processes in place to support safe staffing in the service. The service’s training documentation showed staff had completed relevant training to fulfil their role. We observed there to be a good deployment of staff in the service, evidenced by staff rotas and discussions with staff who advised they felt there was enough staff. Staffing was also increased following feedback from team meetings, for example, more support required with supporting people who were cared for in bed. People told us the service had staff who were well trained.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

There were IPC policies and cleaning documentation in place and staff had completed IPC training. There were regular cleaning schedules in place, which were thoroughly documented, and we observed regularly cleaning during our site visits. We observed there to be ample personal protective equipment (PPE) in place at the service. People told us staff used the correct PPE whilst supporting them. One person told us, “When I require assistance with personal cares, the staff always wear gloves and aprons.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

There were robust systems and processes in place to support safe medicines management in the service. Appropriate controlled drug protocols were in place to support safe administration, including second signatures. Medication audits and staff competencies were completed regularly by leaders in the service, to identify any medication errors or areas where staff required additional support or training. There were appropriate stock levels in place. The service had highly detailed protocols were in place for people with (PRN) and covert medication administration. Appropriate professionals had been consulted regarding specific medication needs, for example, pharmacy teams. There was relevant supporting consent, best interest decision and risk assessment documentation was in place to support safe decision making, for example, where people were at heightened risk due to blood thinning medication. Escalation plans were clear and well detailed, should a person experience a fall who used blood thinning medication.

The service had robust documentation in place which further supported safe medication management, for example, body maps were in place to support staff to know where appropriate medications would be administered on the body, with clear directions. Systems were particularly robust relating to management of patch medication, with a high level of audit documentation in place, so staff were aware of when and where patches were placed or removed. People told us their medicines were managed safely. One person told us, "I have regular medication and this is always on time."