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Archived: 6 Russell Gardens

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Inspection report

Date of Inspection: 26 September 2013
Date of Publication: 26 October 2013
Inspection Report published 26 October 2013 PDF

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Meeting this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 26 September 2013, talked with people who use the service and talked with staff. We reviewed information given to us by the provider.

We also looked at recent satisfaction survey results.

Our judgement

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

Reasons for our judgement

We looked at the provider’s most recent satisfaction survey results in the last 12 months to which 11 people responded. Overall the respondents expressed good satisfaction levels with the service they had received. Free text comments included: ''staff are always a pleasure to see'' and ''great clinical, patient and friendly staff.'' No improvements had been identified from the results. This demonstrated that the quality of the provider’s service was monitored and that the views of people were sought to identify areas for improvement.

Informal staff meetings were held weekly and were used as an opportunity to discuss the operational and clinical areas of the practice. Staff told us that although these were not noted formally in minutes, they set actions to follow up on them.

The provider had systems to identify, assess and manage risks to the health, safety and welfare of people and staff using the service. A risk assessment had been completed on the environment to identify and manage the risks to staff and people using the service. There was a log to record accidents or incidents and complaints. We saw a documented example of an accident. All details and actions taken by staff were recorded. We were told that no formal complaints had been raised at the time of the inspection. The provider had completed a patient record keeping audit in May 2013. 15 records had been chosen at random. Overall the audit yielded positive results in meeting the key requirements of record keeping. However where gaps had been identified we were informed that these gaps were not always followed up on.