Riseup Healthcare Ltd

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 changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation in relation to safe care and treatment.

This service scored 59 (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, accident and incident forms lacked detail, meaning a robust analysis to identify any trends and take action to prevent reoccurrence was not always possible. For example, where people had experienced falls, the service had failed to adhere to its own policy which stated the risks associated with falls must be reassessed after each fall. In addition, not everyone who used the service had been assessed for falls risk. This shortfall did not meet best practice nor the provider’s policy in relation to falls management.

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. However, the provider had not consistently sought information from professionals to ensure people received the care they had been assessed as requiring. For example, for one person who required a modified diet, the service had failed to seek confirmation of this from the professional involved in assessing the person’s needs and making recommendations. This had placed this person at risk of receiving inappropriate care.

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. However, the provider had not always shared concerns quickly and appropriately. We found a few examples where the service had failed to report safeguarding concerns to other professionals as required. Whilst we found no harm had occurred to the people who used the service, it had placed them at risk.

Whilst staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them, records did not reflect this. We saw that whilst risks were managed in practice, they had not consistently been identified, recorded, mitigated, and/or reviewed. This meant we could not be assured people remained safe from the risk of harm. For example, for people at risk of pressure sores, risk assessments were not always in place to address this risk, and staff had not received training in this topic. Furthermore, staff were supporting people living with health conditions, including diabetes and dementia, without care plans and/or risk assessments in place for these health needs. Where risk assessments and/or care plans were in place to manage risks, we saw these often contained contradictory and/or missing information and had not always been regularly reviewed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Records demonstrated this and people confirmed that. For example, the provider had risk assessed people’s home environments to help keep people, and staff, safe including in relation to fire. However, we noted the provider did not record utility shut off points in people’s homes and this is something they should consider.

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 staff had the skills and abilities to care for them effectively and meet their needs. We saw that staff had been robustly recruited, inducted, trained, and supported to provide care to the people who used the service. One person who used the service said, “Staff know what they are doing, they are very good at their job” whilst a relative said, “I have absolute confidence in all the staff.” However, we did find one incident where the provider had failed to effectively risk assess a concern in relation to a staff member.

Whilst the provider could not consistently evidence they assessed, recorded, and reviewed risks associated with infections, people’s feedback demonstrated staff adhered to best practice guidance in relation to this. We also saw they had received training in this topic. For example, people told us staff washed their hands regularly and as required and used personal protective equipment (PPE) as required which they disposed of safely. One relative said, “Staff are fastidious about that (infection prevention and control). They put on clean gloves when they arrive and dispose of them before they leave. They wear shoe covers.”

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 told us this and records confirmed that. One relative said, “Staff do all [family member’s] medicines and we’ve never had any issues at all.” Another relative told us how vigilant staff were in ensuring their family member took their medicines particularly as their sight was poor. Records confirmed medicines were administered as prescribed and followed good practice guidance. Staff has received training in managing and administering medicines and had their competency to do so assessed.