Ruby 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 newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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. The service recognised that its previous accident and incident recording system was not effective. A new process was introduced to strengthen oversight, enabling trends and patterns to be identified and used to reduce future risks. The organisation had strengthened how it recorded and reviewed learning from incidents, including through debriefs with staff and people using 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.

Preadmission assessments and transition planning ensured people experienced a safe and well-coordinated move into the service. The registered manager completed thorough assessments before people were admitted, enabling the service to fully understand people's needs in advance.

Hospital passports were available. These documents contained essential information about people’s health needs, current care requirements and key contacts. This supported effective communication and continuity of care should someone need to attend hospital.

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.

Systems to safeguard people from abuse were effective and understood by staff. A safeguarding adult’s policy was in place to guide practice, and staff had completed safeguarding training. They demonstrated clear knowledge of their responsibility to report any signs of potential abuse. A health professional said, “Ruby House has demonstrated a proactive approach to risk management and safeguarding. The service has appropriately recognised and escalated concerns to a person they support.”

The service was working in line with the Mental Capacity Act (MCA). People were only deprived of their liberty when this was in their best interests and legally authorised through the Deprivation of Liberty Safeguards (DoLS). People assessed as lacking capacity had appropriate DoLS authorisations in place.

The provider worked with people to understand and manage risks by thinking holistically. Risks to people's health, safety and wellbeing were identified, assessed and appropriately managed to help keep people safe. Care plans provided clear guidance for staff to ensure people received safe, effective and responsive care and support. Detailed strategies were included to help guide staff to provide support safely and consistently. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider had effective systems in place to identify and manage environmental risks, helping to ensure people received safe care. Equipment, facilities and technology were monitored and maintained to support safety. Regular checks were carried out across the service to ensure the environment remained safe. Records showed routine monitoring of electrical systems, legionella, water temperatures and fire safety equipment. Personal Emergency Evacuation Plans (PEEPs) were readily available in an emergency grab bag to support safe evacuation.

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.

The provider operated robust recruitment procedures to help ensure suitable staff were employed. Pre-employment checks were completed before staff commenced work, including enhanced Disclosure and Barring Service (DBS) checks, references and verification of employment history. Rotas showed planned staffing levels were maintained. Staff received regular supervision, providing opportunities to discuss their practice, performance and development needs.

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 had access to infection prevention control training and to personal protective equipment (PPE). The provider also had an appropriate policy in place. A staff member told us, “I went through IPC on my induction. There is definitely enough PPE.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medication that was refused by a person did not always have records to show why the medicine was refused. As a result, the provider could not demonstrate why a person had refused their medicines or what action had been taken. However, they had identified this as an area for improvement and agreed to address it.

Systems were in place to ensure medicines were ordered, received, stored, administered and disposed of safely and in accordance with current guidance. Only staff who had completed medicines training and been assessed as competent were authorised to administer medicines.