Royal Mencap Society - Rotherham and Sheffield Domiciliary Care Agency

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 66 (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. Effective systems were in place to report any safety incidents, which helped identify any themes or trends. Service managers discussed incidents and safety events within team meetings with staff, to ensure continuous development of learning and rectifying any concerns raised.

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. Prior to receiving a service, people’s needs were fully assessed, often within their own homes or a health-care setting. These assessments comprehensively covered people’s health, well-being and the personalised support the person required. People also had hospital passports in place, which provided important information on a person’s conditions, communication needs and preferences for care and treatment. One relative told us, “The hospital have [person’s] passport and were impressed with how comprehensive it was."

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 had received mandatory safeguarding training and when spoken to, were confident in protecting people from abuse or neglect. One staff member told us, “If I suspected abuse, my priority would be the person's safety. I would make sure they are safe in the moment, then record my concerns clearly and report them straight away to my manager. If I felt the concern was not taken seriously, I would escalate further, because protecting people from harm always come first."

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. Within majority of the services we visited, the risk to people was being managed effectively. Staff had the appropriate guidance within risk assessments to support them in safely managing risk for people and keeping them safe from avoidable harm.However, in 1 service we found the risk to people was not always managed effectively. For 1 person who required staff to monitor and record water temperatures, due to them not being temperature aware. This recording was not always being completed by staff. This person was also on a Level 6, soft and bite sized diet, with guidance stating not to have crusts. In 2 separate records, this person had received toast. But there was no documentation to state whether this had been prepared in line with their modified diet guidance. The area manager assured inspectors that the concerns raised would be actioned accordingly and provided an action plan on resolving and monitoring the risks raised.

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 suitable to meet the needs of people who lived there. People’s rooms were positioned based on individual needs, one relative told us, “Staff noticed [relative] was having difficulty using the stairs to go to their bedroom. They moved [relative] to a nice room downstairs and decorated it all first.” There was equipment in place for people if they required it and systems were in place to ensure equipment was regularly maintained. The staff carried out regular checks on safety, including fire safety. The staff had developed personal evacuation plans to ensure the people at the service were evacuated safely in an emergency.However, at 1 service, we found concerns around the fire safety, with the building only having one accessible fire exit and 1 member of staff to support at night. The area manager promptly contacted external agencies to request additional funding for an additional member of night staff to support with safe evacuation. The local fire service were also contacted for their assessment of the service’s current safety and evacuation procedures.

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 told us they felt supported within their roles and spoke positively of leaders at the service. Staff had completed a good variety of training, including recommended learning for supporting people with learning disabilities, autism and behaviours that challenge. There were enough skilled and competent staff in place to ensure people’s needs were met safely and there were effective systems to ensure only suitable staff were recruited. Within the interview process, staff complete values and activities-based interviews, which involve people living at the service. People’s feedback on candidates supports leaders to make decisions as to whether candidates will work in line with the service’s values of "passionate, kind, inclusive, positive and brave."

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. There were suitable procedures in place at each service to ensure cleanliness, infection prevention control, waste management and laundry were effective. One relative told us, “I visit twice a month, [relatives’] home is spotless, and [relative] is always clean and tidy.” Another relative commented, “It’s a lovely home, always nice and clean.” Staff spoken to understood the importance of wearing Personal Protective Equipment (PPE) when carrying out care tasks and told us they had received infection prevention and control training.

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. There were systems and processes in place for the safe management and administration of people’s medicines. Records showed that staff received medication training and attended refreshers. The provider had a medication policy in place and ongoing assessment of competencies for staff. People received their medication from trained and competent staff and had this need risk assessed and detailed the level of support people required. Regular audits were in place to ensure people received their medication in a safe way.However, at 1 of the services we found medicine standards were not as effective. The inspector found medicines unlocked and accessible. For 1 person, we found staff were not consistently recording the reason and outcome for administering this person’s PRN medicine.Following this, the area manager assured us of their plans to ensure safe medicine administration at this service going forwards. These included increased checks and observations.