Russell Green Care Home

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 home care service. This key question has been rated 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.

Good systems were in place to promote a culture of safety, openness and learning. There had not been many incidents at the service for staff to learn from. However, records showed the management team considered information from incidents and gave feedback to identify where practice could be improved. This supported staff to develop their knowledge and helped drive improvement across the service.

Staff understood their responsibility to report concerns. Staff told us they felt able to raise issues and discuss mistakes openly. They said the management team was approachable and supported them to reflect on events and learn from them.

The management team reviewed information about the service and shared learning with staff through meetings, supervision and day to day discussions. One person told us, “[Staff] are always updating their training and they always put us first.”

Safe systems were in place to support continuity of care and ensure people received coordinated support when their needs changed or when other services were involved.

Care records contained information staff needed to support people safely. Information about people's needs, risks and preferences was recorded and available to staff and a copy in people’s homes available to emergency services and relatives if required.

The provider worked with healthcare professionals on occasion to help ensure people's needs were met, however, people and their relatives mainly took the lead on liaising with their health care providers. One person told us how supportive the staff were following a hospital admission due to a health condition. They said, “After [my hospital stay], I suffered from tiredness so they made sure there were no hazards between the living room and bathroom that would cause me to fall, nothing I could slip over. They made sure I had safe passage around the house.”

Records showed information was shared appropriately when people's health needs changed and when advice was received from external professionals.

Staff had access to up-to-date information and were able to describe how they worked with other professionals such as the occupational therapist or GP to support people's wellbeing.

People and relatives told us staff knew them well and understood the support they needed. They told us how staff had given them advice about equipment and services they might wish to use to ensure people were safe and able to maintain their independence.

The management team maintained oversight of care records and reviewed information to ensure people continued to receive safe and consistent care. Where improvements were identified, action was taken to strengthen guidance for staff.

People were protected from the risk of abuse because effective safeguarding systems were in place and staff understood their responsibilities to keep people safe.

The provider had processes for identifying and monitoring safeguarding concerns. Staff received safeguarding training and were able to describe different types of abuse and the action they would take if they had concerns about a person's safety. Staff understood how to raise concerns and were confident these would be taken seriously. Records showed safeguarding matters were reviewed appropriately and concerns were shared with relevant agencies when required. The management team maintained oversight of safeguarding issues and took action to help reduce the risk of harm.

People told us staff made them feel safe for a variety of reasons, including being well trained, reliable, trustworthy and kind. One person who was prone to injuries due to a health condition, told us, “[Staff] have attention to detail. Any scratches, lumps or bumps on me, they are all over it.” People described staff as reassuring and told us they had confidence in the care they received. A relative said, “It is an incredible peace of mind really to know someone is there so readily.” Another relative said, “Oh yes, absolutely safe. At first [my family member] was a nervous wreck but [staff] gave them confidence and made them feel safe.”

The provider had systems in place to assess people's mental capacity when needed. Care records reflected the principles of the Mental Capacity Act 2005. At the time of the inspection, people using the service were able to make their own decisions and no one required a Deprivation of Liberty Safeguards authorisation. One person told us they made their own decisions and said, “We have very forthright discussions and some fun conversations as well. There is a friendship rapport and there is always a friendly atmosphere.”

Good risk management systems were in place, and people were supported to make decisions about their care while remaining as independent as possible.

Risk assessments reflected people's individual needs and circumstances. Information was available for staff about how identified risks should be managed and the support people required to remain safe. Risks relating to people's health and wellbeing had been considered and guidance was reviewed when people's needs changed.

People told us they were involved in discussions about their care. The provider took a person-centred approach to managing risks and considered what was important to people alongside any risks associated with their care. One person told us, “It is always a two-way conversation. We discuss everything and my care plan is reviewed at least 4 times a year.” A relative said, “Absolutely (risk is managed), we have a talk every week and decide what we need and what I don’t think they can do any more. “Another relative told us, “[Staff] make sure [my family member] always has their walker with them at all times and they check that nothing that could harm them or is in their way.” This helped people maintain their preferences and independence.

Staff understood the risks associated with people's care and described the steps they took to support people safely. Guidance within care records helped staff provide consistent support and respond appropriately to people's individual needs.

Safe systems were in place to help identify and manage risks within people's home environments and ensure equipment was used safely. Environmental risk assessments were completed for people's homes and considered any risks that could affect the delivery of care. Information was available for staff about the home environment and any actions needed to reduce risks to people and staff.

Staff understood their responsibilities for providing safe care within people's homes. They were able to describe how they identified hazards, reported concerns and followed guidance to help keep people safe. Where equipment was used to support people's care, this was checked before use to ensure it was safe and available for staff to use.

People spoke positively about the support they received from staff in their homes. One person told us, “[Staff] are always next to me when I am moving from a room to my chair or bathroom. They help to prevent me from losing my balance.” Another person said, “[Staff] even remember what day the bins are and do that for me.”

The management team monitored environmental risks and reviewed information when people's circumstances changed to help ensure guidance remained up to date and reflected people's current needs.

There were enough skilled and suitably recruited staff to provide safe and effective care that met people's individual needs. Recruitment processes helped ensure staff were suitable for their roles. Appropriate checks were completed before staff started work, helping to reduce the risk of unsuitable people being employed.

Staff received induction and ongoing support to help them carry out their roles effectively. Supervision records demonstrated meaningful discussions about people's care, staff wellbeing and professional development. Staff told us they felt supported by the management team and were able to seek advice when needed.

Staff were knowledgeable about the people they supported and understood how to meet their individual needs safely. Training was tailored to the needs of the service and helped staff develop the skills required for their role. One person told us, “When [staff] are new, they must learn, but they all seem to be very professional in what they do”. A relative said, “[Staff] are definitely trained. When I saw the way they got [my family member] into the shower, they were very experienced and I did not feel the need to watch their every move because they were fully trained and very kind.”

Care visits were organised in a way that supported effective care delivery. Rotas allowed sufficient travel time between visits and staff told us they had enough time to complete the support people required without feeling rushed. A relative told us, “[Staff] are very kind and caring and have a relaxed state of mind and take their time to talk to [my family member]. They are very respectful.”

The management team monitored call times and staffing arrangements to help ensure people received their care as planned. People were happy staff were not late and told us staff stayed for the full allocated time of the visit. One person said, “[Staff] are generally on time; if there is going to be a major hold up, they would contact me, but it is generally within minutes either side and seldom happens.” This planning reduced the risk of staff arriving late or missing calls.

At the time of the inspection, a new system was being introduced to improve oversight of late and missed calls, allowing the management team to identify and respond to any issues quickly.

Effective infection prevention and control arrangements were in place to help reduce the risk of infection and support people to receive safe care.

Staff received training in infection prevention and control and understood the importance of good hygiene practices. They were able to describe the steps they took to minimise the risk of infection when providing care in people's homes.

Personal protective equipment such as disposable aprons and gloves was available to staff so they could carry out their roles safely. Staff followed guidance on the use of personal protective equipment and safe working practices.

People were positive about the standards of cleanliness maintained during care visits. A person said, “[Staff] leave my house nice and clean.” Another person told us, “I get tired quickly and the staff will do some of the cleaning jobs that I can’t do so I don’t endanger myself. I can put the washing in, but they take it out and hang it out for me if the weather is good.”

The management team monitored infection prevention and control practices and ensured staff had access to current guidance and the resources needed to provide care safely.

Systems were in place to support the safe management of medicines and to ensure people received appropriate support when needed.

At the time of the inspection, people were able to manage their own medicines and did not require staff to administer them. However, the management team had arrangements in place to ensure staff were assessed as competent to provide this support if people's needs changed and still had detailed information about prescribed medicines which they regularly reviewed with people. A relative told us, “[My family member] does their own medication but every so often [staff] ring and discuss the medication.”

Staff received medicines training and completed competency assessments. Guidance and procedures were available to support the safe administration of medicines and help staff follow best practice. Care records included information about people's medicines and the level of support they required.

Regular audits were completed to monitor medicines management and identify people’s ability to manage their medicines independently. These arrangements meant the provider was well placed to support people safely with their medicines should this become necessary.