Rexshi Ltd

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 systems in place to learn from accidents, incidents, complaints and concerns. Incident records, accident records and complaint processes were reviewed and were supported by policies and procedures which provided guidance for staff. Staff described a positive culture where concerns could be raised openly, discussed and used as opportunities for learning and improvement.

Staff told us they felt supported when raising issues and received feedback regarding actions taken. This helps promote a culture where concerns are identified early and improvements can be implemented quickly.

One staff member said, "Concerns are taken seriously, feedback is provided promptly and staff are kept informed."

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.

People's needs were assessed before support commenced and information gathered was used to develop personalised care plans and risk assessments. The Registered Manager described a structured assessment process that considered risks, preferences, support requirements and desired outcomes before introducing care.

Reviews were completed routinely and whenever people's needs changed. Staffing arrangements were planned to ensure consistency and safe transitions into the service.

The Registered Manager said, "I complete an initial assessment, identify the needs and risks, formulate the care plan and ensure staff are aware of what is required before support begins."

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.

People were protected from the risk of abuse because safeguarding arrangements were embedded within the service. Safeguarding records, policies and training records were reviewed. Staff demonstrated a good understanding of safeguarding responsibilities and were confident describing how concerns would be escalated.

Training records confirmed staff had completed safeguarding training and systems were in place to assess ongoing staff knowledge through supervision. One staff member told us, "I look for bruises, injuries, behavioural changes and signs of neglect and report them to my manager." Another staff member said, "I follow safeguarding procedures, report concerns immediately and feel confident due to training."

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.

Risks to people's health, safety and wellbeing were assessed and managed in a way that promoted independence. Care plans and risk assessments reflected individual circumstances and provided staff with guidance on balancing safety with people's rights and preferences.

Staff understood the principles of positive risk-taking and described supporting people to remain independent whilst reducing avoidable risks. One staff member told us, "Care plans balance safety, independence and positive risk-taking."

The Registered Manager described supporting a person living with sensory loss who preferred not to use mobility equipment, explaining that staff worked with the person to understand risks rather than imposing restrictions.

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

People were supported in a safe environment because risks associated with the home environment and equipment were assessed and monitored. Environmental risk assessments formed part of care planning and staff understood their responsibilities to identify and report hazards. Staff described prompt action being taken when concerns regarding equipment or safety were identified.

One staff member told us, "Hazards are removed where possible and reported urgently." Another staff member said, "Faulty equipment is reported immediately and removed from use if required."

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.

The provider operated safe recruitment processes. Staff files reviewed contained all relevant checks including right to work documentation. Staffing rotas showed sufficient staff were available to meet people's needs.

People benefited from continuity of care provided by a consistent staff team. Relatives spoke positively about familiar carers supporting their family member. One relative said, "The continuity for [name] is fantastic. I don't imagine many other companies provide such an offering."

Documentation supported people had received appropriate supervisions and support. A staff member told us, "Regular supervision and reflection support development."

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.

Systems were in place to reduce the risk of infection and promote safe practice. Infection Prevention and Control records were reviewed alongside staff training information. Staff demonstrated a clear understanding of hand hygiene, use of Personal Protective Equipment (PPE) and safe disposal procedures.

People and relatives confirmed staff routinely used PPE whilst providing care. One person told us, "When I have a shower, I see their hands with gloves on."

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.

Medicines support reflected people's assessed needs and medication records reviewed were completed appropriately. Medication Administration Records (MAR) and medication risk assessments were available and linked to care planning documentation.

Staff had completed medicines training and competency assessments. The Registered Manager maintained oversight of medicines support arrangements.

One staff member told us, "I have completed medicines management training and competency checks."