Respectful Care Nottingham South

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 remained good. This meant people were safe and protected from avoidable harm.

This service scored 84 (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 demonstrated an exceptional, well‑embedded and proactive learning culture where safety, openness and continuous improvement were clear priorities. A strong and positive culture of safety was evident throughout the service, underpinned by transparency, honesty and accountability. Staff consistently demonstrated a willingness to listen to concerns, with all safety issues thoroughly investigated, clearly reported and used as key learning opportunities. Lessons learned were not only identified but effectively embedded into practice to drive sustainable improvements.

People who used the service, their relatives and staff were actively involved in learning and service development. The provider ensured people’s voices contributed meaningfully to shape improvements and included them in the review of incidents and the learning process. This inclusive approach strengthened outcomes and promoted a shared responsibility for safety and quality.

Where things went wrong, the provider consistently upheld the duty of candour. There was clear evidence of sincere apologies, transparent explanations and timely communication. Importantly, these were accompanied by robust actions to reduce the risk of reoccurrence, which demonstrated integrity and a commitment to continuous learning.

The service fostered a strong culture of psychological safety, where staff and people felt confident and empowered to raise concerns, report incidents and share feedback without fear of blame. Views were actively welcomed, respected and acted upon. One staff member told us, “I feel comfortable discussing concerns openly because management listens and takes concerns seriously.” This culture enabled proactive identification of risks and supported ongoing improvement.

Robust electronic systems were in place, which enabled effective monitoring and analysis of incidents, complaints, safeguarding concerns and care records. The management team used these systems to identify themes, patterns, trends and potential risks, to ensure strong oversight across the service. Records clearly evidenced that learning from incidents was meaningful, thoroughly analysed and consistently translated into improvements in practice.

The provider worked proactively with people and healthcare partners to establish and maintain safe, coordinated systems of care where risks were effectively managed and monitored. There was a strong focus on ensuring continuity of care, particularly when people moved between services. For example, the provider maintained clear and up-to-date records that could be shared promptly with emergency services, detailing people’s care and support needs to ensure safe and consistent care in urgent situations.

Comprehensive initial assessments were completed before people started using the service. These captured detailed information about people’s needs, preferences and the involvement of other health and social care professionals. This ensured care was well planned, joined-up and responsive from the start. The provider maintained effective communication with external professionals and enabled coordinated care delivery and timely interventions. This meant people experienced seamless transitions between services, reduced risks during periods of change and always ensured consistently safe, person-centred care met their needs.

The provider worked in partnership with people and healthcare professionals to understand what feeling safe meant to them and how best this could be achieved. There was a strong focus on promoting people’s rights while ensuring they were protected from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Concerns were shared promptly and appropriately, ensuring timely action to safeguard people.

People told us they felt safe. One person told us, “Yes safe. Very much so. No concerns about safety. No worries.” Staff received comprehensive safeguarding training and followed a robust, clearly structured policy. They demonstrated strong knowledge of safeguarding responsibilities and how to respond to concerns. One staff member told us, “I understand different types of abuse such as physical, emotional, financial, sexual, neglect, discriminatory abuse and self-neglect. Signs may include unexplained injuries, sudden changes in behaviour, poor hygiene or fearfulness. If I suspect abuse, I ensure the person is safe, report immediately to my manager, complete an incident report, record facts accurately and follow safeguarding procedures. If urgent, I contact emergency services.” Records related to incidents and safeguarding concerns were detailed, accurate and completed promptly. Where required, concerns were appropriately escalated and shared with external professionals, including the local authority safeguarding team. This meant people were protected from the risk of harm, abuse or neglect.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

People were at the centre of their risk management plans. These were comprehensive, personalised and clearly reflected how people chose to manage their risks. Care plans demonstrated a strong, balanced approach. They outlined how people wished to be supported on a ‘good day’, enabled positive risk-taking, and provided clear guidance for staff when people required additional support. This flexible and empowering approach promoted choice, control and flexibility, and ensured risks were managed safely and respectfully. Staff had access to clear, consistent and accurate information, which enabled them to respond appropriately to changing needs.

The provider demonstrated a proactive approach to support people with complex needs. For example, people who live with dementia had declined aspects of personal care and were at increased risk, additional guidance and specialist training was provided to staff. This ensured staff used appropriate communication techniques and tailored approaches to engage people more effectively. We saw this was meaningful and resulted in improved outcomes, with care delivered in a more person-centred way and it reduced the risk of neglect.

The service further promoted people’s autonomy and provided training and accessible information to people and their relatives. This included information about moving and handling, dementia awareness and resuscitation training for relatives to support their loved ones to ensure people received consistently safe care. Easy-read resources, such as falls prevention guidance, were also available. These resources empowered people and their families to better understand risks and make informed decisions, supported greater confidence and independence in managing safety within their own homes.

This meant, the service demonstrated an exceptional approach to involve people in managing risks, where safety and independence were equally prioritised, and lead to improved outcomes and enhanced quality of life.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider demonstrated strong and robust systems to maintain safety within people’s homes. Comprehensive environmental risk assessments were completed prior to care commencing and were clearly incorporated into people’s care plans. These provided detailed and practical guidance for staff to support people to maintain a safe living environment.

Staff had access to clear, essential information, including the location of fuse boxes and water stopcocks, which ensured they could respond promptly and effectively in emergencies. A wide range of environmental risks, such as fire safety had been thoroughly assessed, with robust mitigation plans in place to outline the actions staff should take. Staff demonstrated a clear understanding of their responsibilities to maintain safety. The registered manager told us, “During our initial assessment and reviews we always risk assess the environment to ensure its safe, and if people have had a fall we review their environment to identify any risks that can be removed or if adaptations are needed to make their environment safer such as grab rails.”

The provider adopted a highly proactive and preventative approach to risk management, and worked in partnership with external services where needed. For example, people were referred to the fire service for ‘safe and well’ assessment when risks were identified, which supported early intervention and reduced potential harm.

The provider went above and beyond to further promote safety. They maintained oversight of people’s equipment servicing schedules. Records evidenced household risks were identified as part of the dynamic risk assessment process, which included considerations of people and staff safety. They kept clear records of when mobility and other essential equipment required routine checks and worked proactively with external agencies to ensure these were completed on time. Where delays occurred, the provider followed these up on behalf of people, ensuring equipment remained safe and fit for purpose.

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.

Robust and safe recruitment processes were in place to ensure staff were suitable, knowledgeable and values driven. This included thorough pre-employment checks and a strong focus on recruiting staff who shared the provider’s commitment to delivering high-quality care.

Staff completed a comprehensive and personalised induction, which provided them with the additional skills and knowledge required to provide outstanding care. The provider told us, “Our values are important and how our clients are treated by our staff is important to us. We give staff in house induction and include extra weeks shadowing if we feel they are not up to the standards we expect. We do not rush the process because its important everyone we support gets quality care. We spend time with staff during their induction to ensure they are fully aware of their responsibilities and how we expect care to be delivered to people who are cared by us in a kind, respectful, safe and person-centred way.”

The provider placed a strong emphasis on staff training, development and competency checks. There was a blend of external specialist training and in-house, face-to-face learning that ensured staff developed a deeper understanding across all areas of care. Competency assessments were completed and closely monitored, and where required, additional training and extended shadowing were provided to maintain consistently high standards. Staff were expected and supported to remain for the full duration of care visits to ensure people received safe and dignified support. The provider told us, “I expect all staff to stay the required time or longer to ensure people are cared for properly.” This demonstrated a clear commitment to quality over task-focused care.

The provider demonstrated a highly inclusive approach to recruitment and workforce development. International staff from a range of cultural backgrounds were effectively supported to succeed through tailored and accessible approaches, including support to understand policies, training, and expectations in their preferred language. This included management support to ensure communication was accessible and staff were confident to deliver care in line with the provider’s values and standards.

Simple, easy-read guidance with photographs were available to support all staff with a range of health tasks, such as administering eye drops, nasal sprays and ear drops. This enhanced their formal training and ensured staff who required information in a more accessible format could fully understand and carry out their roles safely and effectively.

There were strong systems in place to support and engage staff. Regular supervisions, appraisals, team meetings and an open-door culture ensured staff felt listened to, valued and supported. Records showed these were meaningful and led to tangible actions, which included additional support, development opportunities and improvements in practice.

People told us they received care from a safe effective staff team. Comments were, “Carers respond quickly if I’m unwell. They are sufficiently trained and understand my needs. Activity is logged on their phones.” “It’s going very well. I’m very satisfied. They [staff] get me up, showered, breakfast and anything else I want doing. They’re always on time and stay for the time they should. No safety concerns. All staff are fine.”

This meant the service had an exceptional approach to safe and effective staffing, that were highly skilled, supported and motivated that consistently delivered outstanding, safe, effective and person-centred care.

The provider assessed and effectively managed the risk of infection. They took prompt action to identify and control risks, and shared concerns with appropriate agencies in a timely way.

Staff completed infection, prevention and control training, and clear policies were in place, which included procedures to follow in the event of an outbreak. People told us staff consistently followed best practice guidance. One person told us, “Carers wear protective clothing. They wash their hands and wear gloves.” This meant people were protected from the risk of infection, with staff who applied their training effectively to maintain safe and hygienic care practices.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff had received training in medicine administration and had frequent checks to ensure they remained competent. Staff told us,” I follow the medication policy carefully by checking the right person, right medication, right dose, right time, and right route. I check medicine administration record (MAR) charts, confirm consent, observe the person taking medication, record immediately after administration, and report any errors or concerns promptly.” People’s care plans provided clear and detailed guidance on the level of support required with their medicines. MAR’s were consistently completed accurately and reviewed regularly by staff and the registered manager. These checks ensured any gaps or discrepancies were identified promptly, and enabled swift action to reduce the risk of errors recurring. People told us they were supported safely with their medicines, which reflected effective and reliable practice. One person said, “Carers make sure I’m taking my medication. It’s done safely. Staff check I’ve had my tablets in the morning.” This meant people received their medicine safely.