Rialto Care & Support

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 62 (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. Incidents and accidents were recorded, and any learning was communicated to teams via handovers and care plan updates. Spot checks were carried out to check learning was being embedded. Staff were trained in health and safety and understood how to report any concerns. One professional partner told us, “The provider puts additional measures in to safeguard people. This has included equipment, risk and falls assessment reviews and providing additional staff if required.”

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. People were assessed prior to starting to receive support from the service to ensure their needs could be fully met. A mix of healthcare professionals, relatives and staff were involved to ensure a smooth transition. The transition was tailored to each person. For example, one person was visited 4 times during their assessment with different staff also in attendance to ensure they got to know the person well, and for the person to become familiar with staff. Relatives were also involved. One relative told us, “Rialto met my family member a few times but not myself, however, I was verbally involved, and the transition went remarkably well.” Staff were made aware of new admissions via the provider’s electronic care planning systems, face to face meetings and message facilities.

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 their family members were safe. Safeguarding incidents and concerns were reported to the local authority and safeguarding policies were in place. Staff were aware of the signs and symptoms of abuse and had received safeguarding training.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe. Some information in care plans was conflicting or inaccurate. For example, one care plan gave incorrect guidance regarding falls management. The provider admitted this was an oversight and immediately rectified this. Some people had positive behaviour support plans in place. They contained detailed information to help staff understand people's individual needs, and promoted positive outcomes. We observed staff following these plans by demonstrating successfully de-escalating a situation. Staff were supportive and enabled people to do the things that mattered to them. There were examples of positive risk taking, for example, going on holiday and daily outings.

The provider did not always detect and control potential risks in the care environment. Some risks were not always identified and mitigated. For example, despite staff completing regular environmental checks, one person had exposed carpet strips along their landing. This put them at risk of cutting their feet especially walking around bare foot in their own home. When we fed this back to the provider these were immediately removed. The provider made sure equipment, facilities and technology supported the delivery of safe care. Environmental risk assessments were in place and staff were trained in health and safety. Staff had access to 24 hour on call support and access to emergency contact details for maintenance concerns.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Some mandatory training was not in place to reflect people's current needs. When we fed this back the provider booked this in immediately. However, staff received training to effectively support people’s individual needs. The provider made sure staff received effective support and supervision and staff worked together well to provide safe care that met people’s individual needs. Inductions for new staff consisted of full support from managers and peers on site until the staff member felt confident. Staff were recruited safely and there were sufficient staffing levels. Agency staff were booked under a permanent contract meaning this consistency gave continuity of care and support to people.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading. There were good supplies of personal protective equipment (PPE) and this was easily accessible to staff. Staff were trained in infection prevention and control. Staff told us they cleaned every day, and cleaning charts were evident in people’s homes. People were included and supported with cleaning tasks, promoting independence. Spot checks were undertaken to ensure standards were maintained. One relative said, “The washing machine is always on when I visit.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medication was not always managed safely. For example, one person had their medication dispensed into a dosset box by staff for future administration. This had not been risk assessed by the provider. When we pointed this out, this practice was immediately stopped. Medication was not always disposed of safely. For example, one person’s medication was thrown away into the bin rather than being returned to the pharmacy. Another person’s medication was a year out of date, however, it was not currently being administered to them. When we fed this back a new process was put in place straight away by the provider to prevent these issues occurring again. Staff were trained in medication administration and involved people in planning. Protocols for ‘as required’ medication were detailed, and medications were listed in both people’s care plans and hospital passports.