Archived: UK Sports Institute – Bath

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 as Requires improvement. At this assessment, the rating has changed to Good.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a strong proactive and positive culture of safety, based on openness and complete honesty. They actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Staff were encouraged to raise concerns when things went wrong. They told us incidents, complaints and examples of feedback were shared and discussed during regular governance meetings. Guidance was available on responding to various types of incidents including the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR). Leaders provided examples of how incidents were investigated and resolved.

There were policies and processes in place to record, investigate and take action from incidents and complaints. There was a system to record and investigate complaints and staff were able to clearly describe the service’s process for supporting people and sharing outcomes openly in line with the duty of candour. Incidents we reviewed showed investigations were risk assessment rated which detailed expected outcomes, response timeframes and identified learning, coded by incident type. There was effective oversight of trends of incidents across the organisation with detailed analysis of how the learning minimised the risk of reoccurrence. For example, the service worked with the clinical records system to integrate additional safety netting for sensitive patient data to enhance digital security.

Ongoing risks were identified with control measures and mitigating actions recorded on the wider organisation’s risk register. This also incorporated business continuity planning and recognised bespoke arrangements with the local UK Sports Institute premises. Service health and safety updates were cascaded to all UK Sports Institute site teams to ensure provider-wide learning was in place.

The provider was proactive in embedding new evidence-based guidelines such as specific incidents requiring reasonable adjustments to their care and treatment, such as applying sports concussion assessment tools. Care records we reviewed showed how the service adapted care and treatment plans based on safe return-to-play criteria.

The service 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. There were systems in place for processing information relating to new people as well as care and treatment records shared with the person’s registered GP practice with consent. Referrals and test results were managed in a timely way. During our on-site visit, we saw radiological images and results had been appropriately managed and reviewed to provide safe care and treatment.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

There were designated safeguarding children and adult leads at the service. There were monthly multi-disciplinary meetings where safeguarding issues were discussed and these were attended by clinical governance leads. Systems were in place to appropriately refer people to the local authorities where required. Safeguarding and chaperoning policies were in place and accessible to staff.

A mixture of clinical and non-clinical staff members had chaperone responsibilities as part of their role. Those staff members had completed Disclosure and Barring Service (DBS) checks to ensure they would be appropriate to undertake this role.

Staff were trained to the appropriate safeguarding level relevant to their role and were confident in applying mental capacity assessments. There were safe systems and processes in place to ensure children had been appropriately followed up with when they failed to attend scheduled clinics and consultations. The service had ensured there were appropriate measures in place for parents, next of kin or advocates accompanied children to consultations.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Emergency equipment was available and maintained. Staff could recognise a deteriorating individual and knew of action to take. Clinical staff were trained in advanced trauma care applicable to specific sports national governing bodies and were equipped to deal with pre-hospital immediate care.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken and risks identified had been addressed and complied with standards of safety legislation. The service had effective oversight of actions taken when identified within fire safety and legionnaires risk assessments. The service ensured there were schedules for the calibration of relevant medical equipment and portable appliance testing had been carried out across the premises. There were suitable arrangements for the storage and replacement of oxygen with correct safety signage.

The service 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.

There were effective staffing arrangements to prevent lone working through scheduled rotas.

Staff told us there were opportunities to ask for support, raise concerns and appraisals were carried out annually. Staff could discuss clinical queries in relation to their medicine prescribing or care and treatment planning with leaders who they said had an ‘open door’ policy. Line managers and clinical technical leads held regular support sessions to discuss performance and care and treatment. On review of a random sample of supervision records, we noted there was a focus on mentorship, continuous professional development and evaluation of records to ensure care was in line with evidence-based practice.

All recruitment and Human Resource (HR) records were kept in-line with practice policy and Schedule 3 requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We carried out a review of the provider’s recruitment checks in relation to 3 members of staff and all required information was available and up to date. However, during the on-site visit, we identified the service’s recruitment policy had not included guidance for records to contain successful candidate job interview summaries and technical assessments and therefore these records were not always available for the staff we sampled. After the assessment, we were provided with evidence to demonstrate the recruitment policy had been reviewed and systems to record these summaries to demonstrate decision making of recruitment had been implemented.

Staff received a formal induction relevant to their role and responsibilities and were supported through ongoing appraisals, personal development reviews and supervisions, including prescribing checks for relevant clinical staff.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. We found improvements had been made to the oversight of infection control processes since our last inspection. The service had a designated infection prevention and control lead, and all staff had completed relevant training. Cleaning schedules were now in place and followed and risk assessments and audits were now completed, with any identified actions taken to mitigate risks. During the on-site visit, we observed suitable arrangements for the storage and the disposal of clinical waste and hand hygiene signage was on display. Personal protective equipment (PPE) was available for staff. The service had retained Control of Substances Hazardous to Health (COSSH) risk assessments for all of the infection control products stocked.

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

Since our inspection, the service had improved its systems and processes to manage and respond to safety alerts and medicine recalls, including completing audit logs of safety alerts that directly affected the service.

Staff received regular training, were competency assessed on medicines management, and felt confident managing the storage, administration and recording of medicines. Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received reviews and monitoring. Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and travel bags. Prescriptions were authorised electronically and sent directly to community pharmacy organisations.

There was a programme of regular clinical audits of prescribing that focused on improving care and treatment, such as regular cross-checks of prescriptions against records and their treatment outcomes. We saw audits of antibiotic and non-steroidal anti-inflammatory drugs (NSAIDs) to ensure people were monitored to prevent over-prescribing and evaluate care and treatment plans to determine effectiveness.

The service held appropriate emergency equipment and emergency medicines and these were stored securely. The service maintained appropriate fridge temperature records where vaccines were being stored. Temperature fluctuations outside of the service’s cold-chain policy ranges had been addressed and logged with remedial actions.