Rosehill Care

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, although the way risks were assessed, managed and monitored needed to be improved. At this assessment, the provider had made improvements in relation to how risk was managed as previously discussed with the manager [registered]. The services rating remains 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People received safe care from the registered manager and staff who had developed a positive learning culture within this home care service. They understood the importance of reporting safety concerns and learning lessons when things went wrong. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and any lessons learnt were shared with staff and used to continually improve the service.

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.

The registered manager gathered information about people’s individual needs and wishes, and risks to their safety, prior to them receiving a home care service. This information was used to develop person-centred care and risk management plans which were shared with staff to help them provide safe and appropriate care to people from the moment they started using the service. The registered manager and staff worked closely with the relevant external health and social care professionals and bodies to make sure care plans and risk assessments reflected people’s current needs and wishes.

The provider worked with people 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.

People told us they felt safe receiving a home care service from this provider and with the staff who regularly visited them at home. A relative said, “Yes, I absolutely do feel my [family member] is safe using Rosehill Care.”The registered manager and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I alwaysfollowsafeguarding policies and make sure I report any concerns immediately to either my manager [registered] or the organisations safeguarding lead.” Another member of staff added, “I attend safeguarding training organised by my employer and stay updated on procedures for reporting abuse to the local authority if needed.” The registered manager made timely safeguarding referrals when required and worked with the relevant partners to ensure people were safeguarded from further risk.

The service was working within the principles of the Mental Capacity Act (MCA) 2005. People were supported to understand the care and support staff provided them. People’s care plans made it clear what decisions people could make for themselves. Staff understood people’s capacity to make decisions about the care and support they received. The registered manager and staff confirmed they had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DOLS) training.

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.

The provider had made improvements since our last inspection in relation to how they managed identified risk as we had discussed with the registered manager at the time. People’s risk assessment and management plans were now being reviewed at more frequent intervals and updated accordingly to reflect any changes in people’s needs. People’s care records contained current and sufficiently detailed information about potential risks to their safety and how these risks should be prevented or appropriately managed. For example, peoples risk assessment and management plans were now being reviewed at more frequent intervals and updated according to reflect any changes in people’s needs. The registered manager and staff were fully aware of the potential risks people might face and the steps they needed to take to prevent or safely manage them. A member of staff told us, “I always make sure I read each client's risk assessments and management plans on the electronic care planning system we use beforeI start working with them and we also receive daily updates from [name of registered manager] before the start of my call visits.”

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

There were effective arrangements in place to maintain and monitor the health and safety of people’s home environment. Health and safety risk assessments, including those relating to fire safety had all been conducted before a person could start receiving a home care service from this provider. The registered manager and staff regularly visited people at home. This ensured they were able to identify and mitigate any potential environmental health and safety risks people being supported might face in their own home, as well as staff who worked there.

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.

People told us they received continuity of care from the same group of care staff who were usually punctual and were familiar with their personal care needs, wishes and daily routines. A relative said, “We consistently have the same small group of staff.” Another added, “Generally there are no issues at all with staff time keeping. They [staff] will always stay and complete all they need to do. When an emergency arose, as it did last year, the carers went above and beyond and even stayed overnight.” Staff were equally complimentary about how their call visits were coordinated. A member of staff told us, “My call visits are well coordinated by [name of registered manager]. This means I have reasonable travel times between my visits and can therefore always reach my clients punctually.”

Staff were well-trained to meet people’s individual needs and encouraged to continually improve in their role. Staff received a mixture of e-learning and in-person practical and theoretical training, which was routinely refreshed and included, ongoing competency-based assessments. A member of staff told us, “My manager [registered] ensures my training record is up to date and also reminds us of when our next training updates are due.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff attended regular meetings with the registered manager and fellow co-workers, and their working practices during a call visit were routinely observed by the registered manager. A member of staff told us, “I have formal supervision every 3 months with [name of registered manager] and I am allowedto request extra if needed. We also have annual appraisals with her to help us identify our strengths and areas for development.”

Staff recruitment practices at the service remained safe. Managers undertook the necessary checks required on staff that applied to work at the service, to make sure they were suitable to support people.

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.

Staff had received relevant infection control and food hygiene training and had access to resources and equipment to help them reduce the risk of infections spreading. Staff used personal protective equipment [PPE] when meeting the intimate personal care needs of people they supported.A member of staff told us, “PPE, such as gloves, aprons, and masks are always available in the client’s homes, and when needed replacement are made promptly by the office.” Staffs working practices in relation to infection control and their safe use of PPE were routinely checked and observed by the registered manager as part of their routine quality monitoring home visits.

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

At the time of this assessment no one currently using the service required any support from staff to manage their prescribed medicines. Staff received medicines training and their competency to continue managing medicines safely was routinely reassessed. The provider had policies in place relating to the safe storage and administration of medicines.