Royal Mencap Society - Essex Domiciliary Care

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 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.

The provider had reporting processes in place for accidents and incidents and completed quality assurance audits and used a quality and compliance monitoring framework tool to identify any improvements that may be required. The provider ensured that any lessons learned from accidents and incidents as well as from concerns and complaints was shared with the wider staffing team to help drive improvement. The provider completed statutory notifications in line with their legal requirements and regulation. Staff received regular supervisions and training.

Staff had good knowledge about how to identify and escalate concerns and report these appropriately.

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 worked in partnership with other professionals such as GPs, occupational therapists, dietitians and speech and language therapists (SALT) to support people to access healthcare when they needed it. People’s care plans and risk assessments were updated with information from external healthcare professionals to ensure that people received the appropriate support required. When people moved between services, information was shared to ensure people’s needs could continue to be met safely, and people had hospital passports in place.

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.

Safeguarding and whistleblowing policies were in place and accessible to staff. Staff had received training in how to safeguard people from abuse and understood how to report concerns. One staff member told us, “I would notify the managers and we have had training.”

The provider submitted statutory notifications accordingly and safeguarding’s were raised with the local authority. Lessons were learned from any incidents and shared with the wider teams for ongoing learning and improvement of the service. Staff told us they felt confident with raising any concerns with management.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found the provider had applied to the local authority for DoLS authorisations where appropriate. The provider had a record of all DoLS applications that had been made, including details of any conditions to the authorisations.

We received positive feedback from people and their relatives around feeling safe and supported. Comments we received included, “Yes, [relative] is safe. Because we visit [relative] quite a bit and can see the carers are very, very good” and “[Relative] is safe and gets good care.”

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

We reviewed care plans and risk assessments during our assessment of Royal Mencap Society – Essex Domiciliary Care Home. Care plans and risk assessments contained information relating to risks such as choking, mobility and individual health needs and were well detailed. We saw evidence that care plans and risk assessments were being reviewed and updated regularly and that people and their relatives (where appropriate) were involved in their reviews. Feedback supported this. Comments we received included, “Yes, I’m involved” and “Yes, I’m always asked to attend things because they’re really proactive getting things sorted for [relative].” People were supported to take positive risks, such as attending swimming sessions and staff told us they felt they had sufficient information to support people safely and staff we spoke with had good knowledge of people’s individual needs and how to maintain people’s safety.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service was clean and well maintained, however there was some signs of wear and tear in some areas of the service. The provider had a maintenance schedule in place for refurbishment or repairs, and this was actively being worked through. People’s rooms were clean and personalised. People had individual Personal Emergency Evacuation Procedures (PEEP’s) in place to guide staff with how to support people to evacuate the building in the event of an emergency.

Necessary safety certificates were in place to support safe environments in areas including gas safety, legionella and electricity checks. Checks relating to fire safety were up to date for example, emergency lighting and fire doors. Regular in-house checks of equipment were being carried out and the provider ensured that equipment was serviced regularly and well maintained.

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.

People had support from a consistent staff team. Feedback from people and their relatives supported this. Comments included, “With consistent staff, yes they do know what’s important to [relative]” and “They’ve got consistent staff. [Relatives] got lots of continuity and they have ‘in jokes’ with [relative] and speak to [relative] appropriately and have had proper relationships with [relative] from the get-go.”

Feedback was mostly positive around staffing levels. Some comments we received related to wanting more staff so people could go out more frequently. For example, one relative told us, “Going out, [relative] is reliant on being taken by a carer in a wheelchair and that depends on staffing levels so that’s my biggest thing. But they sometimes go together with another resident. And for instance, if other residents have not gone to the Day Centre, they really don’t have enough staff to take her out.” However, another relative told us, “There are always enough staff to assist.” We fed this back to the provider who told us they would be updating their family information packs to better explain how their core and 1:1 support hours are allocated so relatives have a clearer understanding of the delivery of care and support.

We observed that people were being supported by staff who knew them well and had built trusting relationships. The provider also involved people within the recruitment process. Staff had received appropriate training and supervisions and felt supported by the management team within their roles.

The provider had recruitment procedures in place to ensure the required checks were carried out prior to staff commencing their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

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.

We observed the environment was clean and tidy and no malodours. Staff had received the appropriate infection prevention and control (IPC) training. Staff had access to personal protective equipment (PPE), and the provider had an up-to-date policy and procedures in place for infection prevention and control, and regular audits and cleaning schedules were being completed.

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.

The provider had the appropriate processes in place to ensure safe administration of medication. People received their prescribed medications in line with their needs and during our onsite visits, we observed safe practice during medication administration. Medication was stored appropriately and we found no concerns around stock controls.

Staff had received the appropriate training, including competencies being reviewed, to safely support people to receive their medicines. We reviewed PRN – ‘as required’ protocols and found these contained the required information and were being reviewed regularly.