Richmoe Healthcare

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 service. This key question has been rated 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 provider had a proactive and positive culture of safety, based on openness and honesty. Lessons were learnt to continually identify and embed good practice.

People did not raise any issues in relation to safety incidents. They told us they felt safe when staff were providing support. Staff had a good awareness of the importance of promptly identifying, reporting, and recording of incidents. They told us they received debriefs from senior staff post incidents, which helped them reflect on their practice to reduce the risk of reoccurrence.

Senior staff followed up with people and relevant stakeholders, ensuring care plans were reviewed and updated in response to incidents. For example, when one person experienced 3 falls within 2 weeks, senior staff visited their home, identified environmental risks, and took action to reduce these. They worked with the person and made a referral to occupational therapy for further assessment, which helped keep the person safe.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. People told us there was continuity of care, including when they moved between different services.

The registered manager explained how they were addressing ongoing challenges in supporting safe discharges from hospital and the timely reinstatement of care packages. They highlighted that coordinating the restart of care packages, along with obtaining updated care plans, could sometimes be difficult when people were discharged from healthcare settings.

To ensure people’s needs were met safely, the provider carried out additional checks before care resumed. This included consulting with relevant professionals, such as pharmacies, when necessary, to confirm up-to-date medicines information at the point of discharge. They also reviewed up to date assessments and discharge summaries, so they were assured staff could meet people’s needs. These actions demonstrated a proactive approach to managing potential risks and supported safe, well-coordinated transitions between services.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately with professionals.

People told us they felt safe receiving care from staff. They said staff were trustworthy and they felt comfortable allowing them into their homes. There were safeguarding policies and procedures in place, which had been developed in line with statutory guidance and local best practice. The registered manager and staff demonstrated a good understanding of their responsibilities in recognising and reporting safeguarding concerns to the local authority. Electronic records of safeguarding enquiries were maintained to show how concerns had been appropriately escalated and addressed.

Staff demonstrated a good knowledge of how to safeguard people from known or common risks. For example, they described how they supported people to remain safe in their own homes, including helping to reduce risks relating to home security and potential exploitation by members of the public. Policies were also in place to guide staff when supporting people with their finances and maintaining professional boundaries. This shared understanding helped ensure that relationships between people and staff remained appropriate, respectful, and safe.

Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. People told us they felt safe receiving care from staff.

There were non-entry procedures in place, which documented actions to follow in the event people were not contactable at planned care call times. People’s individual circumstances had been risk assessed, and appropriate escalation protocols were agreed if people were reluctant to engage with support. For example, 1 person had a protocol in place, where professionals were to be contacted in the event of an agreed number of declined care visits. This helped to balance the person’s right to privacy with the need to minimise risks associated with not receiving care. People’s needs had been assessed and prioritised in the event of an emergency. This information was recorded in care plans and was accessible to senior staff through a critical client priority list. This promoted effective oversight and coordination of care in the event of an emergency.

People told us staff had a good understanding of risks related to their care. For example, one person had a diagnosis of epilepsy. Their care plan included background information about their condition, how it affected their daily life and clear guidance for staff to follow in the event of a seizure. Staff had received training in these protocols and demonstrated a good understanding of the actions to take, which helped to keep the person safe.

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

The provider conducted assessments of people’s home environments, including risks relating to falls, home safety and security, smoking, and the use of care equipment. People told us they had appropriate equipment in place and that staff were competent in its safe use. The provider took appropriate action to report concerns regarding equipment and sought professional advice when developing guidance for staff. Care plans included clear instructions for the use of equipment, and staff demonstrated a good understanding of how to use items such as hoists and mobility aids safely. This helped to ensure equipment was used appropriately and people remained safe.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

People told us staff were competent in their role, and they were happy with their staffing arrangements

Staff received training relevant to their role and in line with requirements for working in health and social care. Training covered specialist areas such as catheter care, stoma care, and ventilator support. The registered manager, who held relevant qualifications, provided additional training and worked alongside staff to build their confidence and competence in supporting people with complex health needs.

New staff were subject to a structured probationary period where their working performance was assessed and reviewed. Staff told us they felt supported in their role, receiving regular input and feedback from senior staff, which gave them confidence in their working practices. Senior staff used supervision meetings, spot checks, and competency assessments as an opportunity to support learning and embed good practice. This helped give the provider assurance staff were upholding the standards and behaviour expected.

The provider had systems in place to oversee the safety of staff recruitment. Where full recruitment information was not immediately available, risk assessments were completed to assess the suitability of candidates and arrange for adapted levels of supervision and support. This supported the provider to make safe recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

People told us staff followed good infection prevention and control practices. They said staff used personal protective equipment (PPE), such as gloves and aprons, when providing support with personal care.

Staff told us they had received training in infection prevention and control and demonstrated a good understanding of safe hygiene practices and how to reduce the risk of the spread of infection.

The provider had policies in place relating to infection prevention and control. These included measures to minimise the risk of infections spreading, particularly as staff supported multiple people in separate locations during their care rounds. These measures supported staff to follow effective infection prevention and control practices.

The provider made sure that medicines were safe and met people’s needs, capacities, and preferences.

People told us they received support to take their medicines as prescribed. They told us care visits were scheduled to help ensure they received their medicines at the right times.

Staff demonstrated a good understanding of safe medicines management in a community setting. Care plans detailed people’s levels of independence and the support they required with their medicines. People participated in care planning to help ensure that arrangements for the administration and storage of medicines were not restrictive. Risk assessments were in place to reduce risks related to individuals’ needs and circumstances. For example, one person received time-specific care visits to support them to take their medicines safely. This helped reduce the risk of the person getting up and continuing with their daily routine without taking their medicines, which could pose a risk to their safety. We saw evidence that care visits were completed as planned, helping to keep the person safe.