Rangeford Care - Wadswick Green

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 69 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

Leaders recognised the need to strengthen how they captured learning from incidents, feedback and day to day practice, particularly following a period of inconsistent leadership. We found concerns about the way staff used social media which created a risk confidential or sensitive information could be shared inappropriately, potentially impacting the privacy, safety and wellbeing of people receiving support. After this issue was raised with leaders they took steps to complete an investigation and to reinforce staff understanding of their social media policy.

Leaders told us they were using feedback from people and staff to set priorities, including improving communication, staff morale and consistency of practice. They described plans to better review incidents, audit outcomes and demonstrate improvements over time. However, these actions were at an early stage and it was too soon to show that learning was consistently captured, shared and used to improve safety and quality across 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.

People were supported through safe systems and routines that helped maintain continuity of care. Managers worked with others when people’s needs changed, so that care remained safe and responsive. Electronic care planning and medicines systems were used to support consistent recording and handover of important information.

Although information being stored on different systems made oversight less efficient, we did not find this had resulted in unsafe transitions or disrupted care for people receiving the service.

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.

People were protected from the risk of abuse by staff who understood their safeguarding responsibilities. Staff had completed safeguarding training and were able to describe different types of abuse and how they would raise concerns. People told us they felt safe with staff who supported them.

Records showed managers took action when issues were raised and used existing policies to guide decision making. Provider oversight of safeguarding was supported by electronic records and supervision.

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 were involved in decisions about risks and the support they wanted, which helped ensure care was delivered in a safe and person-centred way. Risk assessments reflected people’s individual needs, including moving and positioning and skin care, and considered how to support people to remain as independent as possible.

People told us they were included in assessing and reviewing risks and staff listened to how they wanted tasks completed. Staff understood people’s preferences and routines and described how they adjusted support when people’s needs changed or when they requested additional help. Leaders used these assessments to guide care planning and to review whether support remained appropriate.

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

People were living in their own homes and held responsibility for their own environment. We saw leaders completed environmental risk assessments and carried out regular environmental checks, ensuring equipment was serviced in line with requirements. Records showed routine checks were used to identify and address environmental risks.

People told us they felt safe in their homes and that staff supported them with domestic tasks where this formed part of their agreed care.

There were systems to report and act on maintenance issues within the retirement village, and managers worked with other staff in the village to coordinate environmental safety where responsibilities were shared.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

Staff told us training relating to moving and positioning was not robust enough. This training was delivered online and staff said they felt it should be face to face. General non-care staff from the setting were on occasion being called upon to assist with moving and positioning tasks but had not been safely trained.

We shared these issues with leaders who stated they were addressing this as a matter of urgency.

Supervisions had not always been completed with staff; however, the new manager told us they were focusing on ensuring staff received appropriate supervisions in the future.

Staffing arrangements helped to keep people safe, although leaders acknowledged they were working to strengthen consistency of practice A small number of people reported some staff did not always complete tasks as expected, and that practice could be inconsistent at times. Leaders were aware of this and were taking steps to ensure consistency for people. Most people received care at agreed times and said staff let them know if they were delayed.

Staff were recruited safely; pre-employment checks were made prior to them supporting 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.

People told us staff used personal protective equipment appropriately and supported them with domestic tasks to help maintain cleanliness where this was part of their package of care.

Staff had access to guidance about infection prevention and control; there were policies in place that reflected current requirements. Leaders carried out checks to make sure practice remained safe and took action when improvements were identified.

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.

People experienced safe medicines support that promoted their wellbeing and independence. People told us staff prompted or checked their medicines at the agreed times, which helped them take medicines as prescribed.

Staff understood their responsibilities in relation to medicines and described how they would report concerns or seek advice if they were unsure. Leaders used electronic systems to support safe administration and recording, including checks to identify any errors or omissions. Information from audits and electronic records were used to identify where further support or staff training was needed.