R-H-P Outreach Services - South Norwood Hill

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 requires improvement and there was a breach of regulation in relation to safe care and treatment. At this assessment, the provider had met the breach, and the rating has changed to 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.

Care workers completed daily progress notes which included recording any incidents and accidents that had occurred when supporting people.

The managers reviewed these which helped to ensure appropriate action had been taken.

Staff were supported with training to improve their skills and knowledge. Mandatory training was refreshed every year which meant they were continuously updating their knowledge and skills.

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 using the service had lived at the home for a number of years. This demonstrated that the provider had ensured a safe transition of people into the service by working with health and social care professionals and commissioners to ensure people’s needs could be met.

Pre-admission assessments were sent to the provider who carried out assessments for people to see if they were able to meet people’s needs and preferences.
 

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 safeguarded from abuse and improper treatment. People told us they were safe living at the service.

The provider had a current safeguarding policy in place. Training records showed that staff undertook safeguarding training to identify types and signs of abuse which was refreshed annually.

Staff understood what safeguarding meant and the steps they would take if they suspected people were at risk of harm. One care worker said, “Safeguarding is protecting people from harm and abuse. There are different types of abuse, physical, emotional, neglect, financial.”

Staff were also clear on safeguarding reporting procedures and there were safeguarding posters on display to remind them of their responsibilities under safeguarding.

None of the people using the service were under restrictions under (DoLS) Deprivation of Liberty Safeguards. Training records showed that staff had received training in Mental Capacity Act 2005. This is designed to protect people who lack the mental capacity to consent to their own care. These safeguards ensure that any restriction of a person's liberty in a care home or hospital is only carried out when it is in their best interest, is the least restrictive option, and is necessary for their safety.
 

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.

People’s risks were identified, assessed and mitigated. Staff had guidance in care records to keep people safe.
Staff were aware of the risks to people, including their behaviours and how to support them when out in the community.
Risk assessments were reviewed when people’s needs changed, which meant that people were kept as safe as possible.
Systems were in place to ensure risks people might face were continually assessed, monitored and reviewed. Staff told us they regularly discussed risk during daily staff catch up and shift handover meetings.
 

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 environment was clean, well maintained and free from hazards.

Staff carried out a number of checks to ensure the environment, including any equipment, was fit for purpose. This included regular checks in relation to fire safety, such as fire alarm, emergency light testing and regular fire drills.

We also saw up to date certificates for gas, electrical and legionella safety.

A health and safety checklist was also completed every month which helped to assure the provider that the environment continued to remain safe for people and protect them from avoidable harm.

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 told us there were enough staff to support them.

The provider followed robust recruitment processes to ensure staff were safe. These checks included references, identity, right to work and criminal records checks.

Staff received on-going training, giving them the necessary skills and knowledge to provide care and support safely and effectively. This included supporting people with mental health needs.

The registered manager ensured that staff received regular individual supervision. These meetings were opportunities to discuss work performance, future work targets and training needs.

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.

People were protected from the risk and spread of infection. Staff followed safe hygiene practices when supporting people.
There were handwashing guidelines on display and alcohol hand gel available in the home for staff to use.
The provider ensured infection control risk in the kitchen were minimised through the use of separate preparing boards for different foods, guidelines in place for safe cooking temperatures and labelling perishable foods in the fridge with the date of opening.
Staff completed records which showed that regular cleaning took place. Staff received training in infection prevention and control and food hygiene.
 

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.

At our last inspection, we found the provider lacked systems to sufficiently monitor stocks of medicines kept in their original packaging. Stocks carried over each month were not always clearly recorded.

At this inspection we found enough improvements had been made to the way the provider now managed medicines which meant they were no longer in breach of this regulation.

People told us they received their medicines on time. Staff confirmed, and records showed, they received medicines training and competency checks on the safe administration of medicines.

People had medication support plans in place which were up to date. Staff completed Medicine Administration Records (MAR) charts when they administered medicines. These were completed in line with peoples support plans.

Stocks of medicines were recorded and were tallied with the amount of medicines we counted on the day.