Routes Healthcare Preston

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. Accidents and incidents were analysed, and trends and patterns were identified to mitigate future risks. The provider showed commitment to understanding root causes. Lessons were learned to improve the service.

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. Systems were in place to ensure people transitioned to the service safely and all relevant up to date paperwork had been completed. The management team visited people prior to them commencing the service and checked everything was in place to safely begin their support. One relative said, “When we first started requiring care for my loved one the company discussed what my loved one’s needs were and we agreed timings and what support was required the carers listen to me and do their job, if I was unhappy, I would ring the office I have a book with all the numbers in.”

 

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. Staff were knowledgeable about safeguarding and told us they would be able to recognise and report concerns. Staff were confident the management team would take appropriate actions to protect people from harm. A safeguarding policy and flow chart were in place and guided staff in taking the appropriate actions when they suspected abuse. Safeguarding concerns were recorded and appropriate actions taken to keep people safe. An annual analysis was also completed by the registered manager. People and relatives felt the staff provided safe care. One relative said, “Excellent care, the carers are so vigilant nothing gets pass them. They [staff] check to see if there are any pressure sores and if any concerns the district nurse is contacted.” Another relative said, “The carers work well together and are vigilant and raise any concerns, they work well together and with the district nurses when needed.”

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 associated with people's care and support had been identified and managed to keep people safe. Risk assessments were in place for things such as emollient, environmental, equipment, falls, medicine, and moving and handling. The level of risk was assessed and kept under review and care plans were completed giving details of how to manage the risk and controls that were in place to do so. Staff had accessed current best practice guidance such as RESTORE2. RESTORE2 (Recognising Early Soft signs, Take Observations, Respond and Escalate) was used to identify any signs of deterioration. People and relatives were confident staff would identify any risks and take appropriate actions. One relative said, “I feel my loved one is very safe with the carers, they call 4 times a day 7 times a week, the carers support my loved one with their walking ensuring the walker is close by and they are steady when using it.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Assessments of the care environment were carried out to ensure risks were mitigated. Environmental risk assessments were reviewed annually unless anything changed. Any equipment used was checked for safety and regularly serviced. Staff told us they checked equipment for safety prior to use.

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. Staff received training and support to carry out their role effectively. Staff felt supported and said the registered manager was approachable. The provider had a safe recruitment process in place to ensure suitable staff were employed. New staff commenced an induction programme and shadowed experienced staff prior to carrying out support alone. A dependency tool was completed to ensure the correct number of staff were available to meet people's needs. This was kept under review and any changes to support required for people were requested from the local authority. A staff training and development policy was in place; this showed a commitment to train and support staff. People and relatives told us staff were competent and knowledgeable about their needs. One relative said, “The carers are very good, and the quality of care is exemplary and takes a lot of pressure of me to know [family member] is in safe hands and receives the care from people who care.” One person said, “The carers turn up on, time always come in 2’s and have never let me down. Time keeping is good if they are ever delayed it is usually down to traffic.”

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. An infection prevention and control (IPC) policy was in place and guided staff in reducing cross infections. Personal protective equipment (PPE) was readily available to staff. Managers ensured staff were working in line with IPC procedures such as washing hands and wearing the correct PPE.

 

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. People received their medicines as prescribed by staff who were trained and competent in medicine administration. People had a medication profile which informed carers where medicines were stored, whether there were any time critical medicines, and any particular foods and drinks to avoid. For example, one person needed to avoid high potassium and caffeine food and drinks. Informative protocols were in place which stated how people should receive medicines prescribed on an ‘as and when’ required basis. Body maps were in place for things such as topical creams. People and relatives told us staff were competent in ensuring they received their medicines. One relative said, “We know most of the staff the carers are very tactful and prompt with medication and allow [family member] to be independent.”