Raven 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. 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 78 (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.

There was a proactive approach to learning lessons. If there was an adverse incident, leaders ensured staff had a thorough debrief and reflection opportunity to minimise the risk of the incident happening again. There was a strong learning culture where leaders reviewed each accident and incident to understand what had happened and identify any learning from it.

The provider always 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 always continuity of care, including when people moved between different services.

The service had an exceptionally close working relationship with involved professionals. Reviews, care plans and updates were completed with professionals fully involved and consulted. Leaders ensured there was continuity of care to ensure systems supported the delivery of safe person-centred care. Professionals had a very positive experience of working with the service. One visiting professional told us, “Raven House have been responsive to changes in need and have worked positively with commissioners.”

The provider 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 provider always shared concerns quickly and appropriately.

People were protected from the risk of abuse or neglect. Staff were trained in safeguarding adults and children and there was a clear understanding at all levels within the service on how to detect and report areas of concern. There was a zero tolerance approach to any form of safeguarding concern and leaders were proactive to ensure people were able to live their lives free from harassment and discrimination. One leader told us, “We work closely with the Council to report safeguarding concerns. We work in a transparent way,”

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.

People and their representatives were fully involved in managing their risks. Risk assessments and the ongoing management and minimisation of risk had a holistic person-centred approach. People were supported with positive risk taking and there was a culture to breakdown risk barriers which may prevent the person doing something they wanted. Staff supported people to live lives with reduced restrictions and be able to fully access the community. One person told us, “I feel very safe here. I like it here.” One member of staff told us, “There isn’t much we can’t do with people. We take people to the gym, swimming, climbing centres, bowling. Whatever the person wants to do, we will try and do this. I can’t think of a time we have had to say ‘no, we can’t do that’. We try and think what we need to do so we can do the activity.”

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

The environment was clean, tidy and hygienic. Leaders were proactive to ensure repairs and maintenance issues were resolved promptly to minimise any impact to people. The environment was homely and each person’s annex was personalised to meet their needs and decoration preferences. There was a clear and established cleaning schedule with monitoring systems in place to make sure the standard of hygiene was always a good standard. Leaders ensured the environment was maintained to a high standard and they did regular monitoring of the environment to make sure it did not fall below a good standard.

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.

There were enough staff to meet people’s care needs. Staff had the skills and confidence to provide person centred holistic care. Staff had been safely recruited and staff received support from leaders to ensure the care being provided was high quality. The staff teams worked well together to prioritise people’s wellbeing and safety. One member of staff told us, “There are enough staff. We are never short staffed and we don’t use agency [staff]. The managers are very good at making sure we have enough staff.”

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 and leaders worked to minimise the risk of infection transmission. Staff had access to personal protective equipment (PPE) and they had the skills to maintain good hand hygiene. We observed the environment to be clean throughout and staff using PPE.

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

Staff supported people to have medicines reviews both with their GP and where appropriate, specialists. Staff members had received training in the safe administration of medicines and were assessed as competent before supporting people. Records we checked showed people received their medicines as prescribed and that people’s medicines needs were considered when away from the home. Appropriate safeguards were in place should the covert (hidden) administration of medicines be used. Individual guidance supported the correct use of people’s ‘when required’ medicines. However, where a variable dose was prescribed, the actual dose given was only recorded on the home’s tally sheet and not the person’s medicine administration record.

People who were prescribed medicines for seizures had detailed care plans in place about how staff would support them. Advice had been sought where one person sometimes refused doses of medicine, but details of the action to be taken should this become more frequent had not been clearly recorded. Hospital passports were used to help support people should they be admitted to hospital.

Medicines were safely stored but only the actual refrigerator temperature was recorded. Staff took immediate action to ensure that the maximum and minimum temperatures could also be recorded. The service carried out medicines audits and should any shortfalls be identified these were promptly addressed.