Ralle Health Limited

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 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. However, it was not always apparent when lessons were learnt to continually identify and embed good practice.

Incident and safeguarding records were brief, which limited evidence of reflection and learning following incidents. This reduced the provider’s ability to clearly demonstrate how learning was used to improve safety over time. We raised this with the provider at the time of our inspection, who agreed to make some improvements to this. Policies supported staff to raise concerns, including a whistleblowing statement that promoted reporting and protection for staff.

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.

There were systems in place to support continuity of care. A business continuity plan outlined how care would be maintained during staff absence or disruption, including clear lines of communication and contingency arrangements. Rotas showed consistent care delivery, with planned visits covering key periods of the day.

The provider did work 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 had a comprehensive safeguarding policy that clearly outlined types of abuse, reporting processes and multi‑agency working. Staff received safeguarding training and understood that safeguarding was everyone’s responsibility. However, a safeguarding incident involving an allegation of physical abuse and police involvement was not notified to CQC as required. We raised this with the provider at the time of our inspection, who acknowledged this and has since completed this.

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 their care, and positive feedback indicated they felt safe and well supported. Risk assessments were basic in detail, however risks were identified, clearly linked to outcome for each of the people viewed, and mitigation was in place to prevent reoccurrence.

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

Environmental risks were assessed within people’s care plans. Where risks were identified, mitigation included safe flooring, clear access routes and appropriate equipment. This supported people to remain safe in their own homes.

The provider made sure there were enough qualified, skilled and experienced staff. Staff worked well together and received training and supervision. However, safer recruitment practices were not fully compliant with requirements and we observed some gaps.

These gaps meant staffing systems were not consistently robust. The turnover of staff was exceptionally low, and the last staff member to be recruited was a number of years ago. This indicated staff were well treated and enjoyed working for the provider. We discussed this with the registered manager who acknowledged our feedback and has since taken action to update their practices.

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.

Infection prevention and control training was in place for all staff, with refresher dates planned and recorded. Staff told us they were provided with personal protective equipment.

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.

Medication risk assessments were in place, and care records showed medicines were administered or assisted with as prescribed. Medication Administration Records [MAR] charts were completed and signed, and medication support levels were clearly defined. Feedback and records indicated medicines were monitored and people received appropriate support.