The Royal

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 people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were reviewed and analysed by the management team. Learning was identified following reviews and feedback provided to members of staff through team meetings.

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. The provider ensured information was shared appropriately with health and care professionals to support continuity of care and support for people.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way for this to be achieved. 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 told us they felt safe living at The Royal. The registered managed had good oversight of safeguarding referrals made to the Local Authority and lessons learned from incidents and notifications submitted to CQC. One person told us, “I feel safe, [the staff] look after me and make sure I am alright.” A relative said, “[The staff] are doing everything to make [family member] safe here.”

We saw evidence the provider followed the principles of the Mental Capacity Act 2005 (MCA) to review people’s capacity and understanding around receiving care and support. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs which was safe, supportive and enabled people to do the things which mattered to them. People’s care plans were detailed and contain information about their care needs and how these should be met. People’s care was delivered in line with their care plans and care was delivered safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Maintenance records and schedules of servicing and safety were well organised. There was a proactive approach to redecoration throughout the care home which ensured the environment was modern and fresh.

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 which met people’s individual needs. There were sufficient members of staff available to meet people’s needs throughout the care home. The provider had safe recruitment practices and ensured pre-employment checks were completed prior to new members of staff delivering care and support. Members of staff received appraisals and supervision sessions to support their professional and personal development. People told us there were sufficient members of staff to support them. One person said, “There are always staff around. There are lots of different staff, they rotate them.”

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. The care home was clean throughout, odour-free, and regular cleaning schedules were in place. Personal protective equipment (PPE) was available throughout the home and members of staff used it appropriately.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Administration of medicines was managed safely. Members of staff were knowledgeable about safe administration of medicines. The management team regularly reviewed and audited medication administration records (MARs) to ensure information was recorded appropriately by members of staff. A relative told us, “[Staff] give [family member] their medication. I have seen them with the medication, I don’t think there are any problems.”