Rutland Road Care Home

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 84 (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. There were many ways where a learning culture was promoted such as staff handovers, staff meetings and individual supervision sessions. The management team met weekly to review incidents and accidents and these were shared at monthly forum meetings where themes and patterns were discussed across the whole provider group. We saw the home manager was proactive at identifying incidents and took action to review the circumstances and address any actions required in a timely way.

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. Staff worked closely with other professionals involved in peoples care such as GPs, social workers, case managers, community teams and mental health professionals. Information from professionals was communicated to the team and acted on. Each person had a ‘hospital passport’ to take with them to appointments to ensure other professionals involved in their care understood essential information about their needs, preferences and how they communicated. Staff frequently attended appointments with people, particularly if they needed reassurance or support to understand information provided.

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People consistently experienced safe, respectful and rights based care because safeguarding and the protection of people’s rights were firmly embedded throughout the service. People said they felt safe. 1 person said, “The staff are always here if I am worried.” Staff showed a consistently caring approach and the management team maintained high quality oversight of safeguarding issues and learning from them. Staff had strong knowledge of safeguarding and peoples’ rights and applied these confidently in day to day practice, ensuring they were supported to make their own choices and decisions wherever possible. People were encouraged to understand what keeping safe meant to them, and staff worked sensitively and proactively to help them recognise risks without limiting their independence. They provided people with clear, easy read information on keeping safe and spoke with them often in relation to matters of personal safety. Conversations and outcomes were clearly documented in one to one records. Concerns were identified early and shared quickly with partner agencies, and safeguarding investigations were managed thoroughly with clear, timely communication.

The provider always worked with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People were supported to understand risks in a way that helped them stay safe and confident. Risk assessments were person centred, proportionate and reviewed often with people. Staff balanced safety with choice and promoted independence while respecting each person’s decisions. When people became anxious or distressed, staff used calm, positive approaches that protected their rights. Incidents were reviewed so staff could learn and adjust support to reduce future distress. The provider encouraged positive risk taking to help people build skills and enjoy fulfilling lives safely. For example, staff had worked with one person to reduce their anxiety about money by encouraging them to carry small amounts with them and keeping it safe. This involved ongoing reassurance and we saw staff approach this with patience and kindness. Staff were trained to recognise risks in relation to health and wellbeing as well as environmental risks and responded quickly to concerns. When restrictions were needed, these were lawful, least restrictive and clearly documented to guide staff practice. Staff also supported people to understand unwise decisions without limiting their autonomy. For example, people who smoked were given information about support to stop smoking and made aware of the risks of continuing to smoke, but their decision to continue was fully respected.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff supported people to keep their home tidy and free from risks, and reported any repairs required in a timely manner. There were plans to refurbish the property to address areas of the premises that were showing some signs of wear and new carpets had recently been laid throughout. Staff completed checks to maintain the safety of the environment, including regular checks of fire safety equipment and carrying out evacuation drills to ensure people and staff knew what to do in the event of a fire.

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and strong development opportunities. They worked together well to provide safe care that met people’s individual needs.

People and relatives told us there were enough staff who were well trained. The provider’s approach to staffing the service was flexible and focused entirely on the needs of the people using the service. Additional staff were deployed to support people with appointments or events they wanted to participate in, making it possible for them to take part in more than they may otherwise have done. When required to support the needs of one person, the provider recently changed night staffing to waking nights to keep the person safe.

The provider ensured staff received training relevant to the needs of people using the service. The home manager told us they had built a bespoke package of mandatory training to ensure all staff had skills in relation to people’s specific needs. This included training in relation to people with a learning disability and autistic people beyond the statutory minimum requirement, and training in relation to specific mental health needs and substance misuse. The home manager maintained strong oversight of training within the service and all staff were up to date with all training. The provider encouraged staff professional development through well-structured supervision and appraisal processes and a pathway to support them to undertake recognised qualifications. The provider recruited staff safely to help ensure they were suitable for their job roles including carrying out all required pre-employment checks.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and knew to share concerns with appropriate agencies promptly. Staff were trained in Infection Prevention and Control (IPC) and knew how to use Personal Protective Equipment (PPE) to reduce the spread of infection. They supported the people who used the service to maintain a clean environment to live in. The service was visibly clean, and checks were in place to monitor the cleanliness of the home and the IPC measures in place.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences. Staff were trained to administer medicines safely and had their competency checked regularly using a comprehensive workbook to test their understanding. People confirmed staff supported them to take their medicines and records showed people had their medicines reviewed regularly, attending clinics to monitor their medicines to ensure they were still effective and safe for them. Where people were prescribed ‘as required’ (PRN) medicines, such as for pain relief, we saw clear protocols in place to guide staff on when to administer them. The provider had systems in place to audit medicines to ensure any errors in administration were identified quickly and medicines stock was accurately tracked. The service used paper records for this process which required staff to accurately count all medicines to ensure the stock of each item was correct. The registered manager confirmed they had plans to move to an electronic system to record medicines administration and stock management which would support a more efficient way of managing medicines safely within the service.