ABI Homes - Roman 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. 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.
 

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, 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. The provider had a process to report near misses, and lessons were learned from these events to drive improvement. However, whilst regular reviews of care plans were happening, where people’s needs were more complex or their circumstance had changed, the provider had missed opportunities to prompt reviews of their more detailed assessments, for example, functional assessments and full positive behaviour support plans, these enabled staff to gather a detailed understanding of a person and attempt to understand the reasons behind their actions to better anticipate their needs. In response to our feedback the provider took action and arranged full review of these records.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services. Records evidenced people had been supported to access external health professionals appropriately and when needed. Relatives confirmed this, one relative said, “I receive updates, they inform me about changes and appointments.”

Safeguarding means protecting people's health, wellbeing and human rights, and enabling them to live free from harm, abuse and neglect. It's fundamental to high-quality health and social care. We found evidence that people were not always proactively safeguarded from abuse and improper treatment due to concerns in relation to restrictive practice. However, the provider had safeguarding policies and procedures in place and there were systems to enable staff, people and visitors to raise concerns. When concerns were raised to the management, they acted quickly and promptly. A relative said, “They are always transparent and keep me informed of any issues.” During our assessment, the provider was already developing and reviewing existing processes to strengthen their safeguarding processes and review training for restrictive practice.

At the time of our assessment, not all people's care plans contained up-to-date information about managing the risks people could experience. For example, in relation to restrictive practice. When people lived with other health needs, some care plans provided only generic information about the condition and were not always clear how the condition could impact the person. The provider was responsive to our feedback and reviewed these plans during the inspection. Relatives told us they believed their loved ones were safe. One relative said, “Yes my loved one is kept safe, the staff are brilliant any they know how to deal with [Person].”

The provider did not always detect and control potential risks in the care environment. They did not always make sure facilities supported the delivery of safe care. For example, we identified some fire doors had gaps above the recommended standards, there was a large outdoor area that was accessible by a ramp and level doorway, however we saw that the equipment outside had not been used in some time and could do with some refurbishment/replacement. There was a swing set and an outdoor table and chairs setting that were in some disrepair. The provider was responsive to our feedback and developed an action plan to address these areas. The provider met requirements in relation to other fire, electrical, and water safety requirements.

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 needs. Staff were recruited safely. Staff received a comprehensive induction when they joined the service. Staff told us they received regular supervision.
 

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading.

Some areas of the service were not always cleaned effectively and due to a level of disrepair it was difficult to clean some areas. For example, one person’s bathroom had a rusty radiator and dirt engrained around floor seals and another person’s wall was stained and their protective bed rail coverings were damaged and no longer able to be effectively cleaned. The provider was responsive to our feedback and arranged deep cleaning of these areas and presented us with plans to fully replace one of the bathroom areas.
 

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found medicines were not always stored safely and securely. When people had medicines to be given ‘when required’, we found guidance for staff was not always in place or up to date. However, relatives told us they were involved in regular medicine reviews. One relative said, “I am made aware of any changes to [Person’s] medicines and am able to attend any reviews.” Medicines were reviewed regularly. Staff received regular medicine competency checks and training to enable them to administer medicines safely. The provider was responsive to our feedback during the inspection and immediately ensured medicines were stored safely and records were updated.