Rother Valley View

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 under the old provider, we rated this key question requires improvement. At this assessment under the new provider the rating has changed to good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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. We found the management team were open and transparent and wanted to drive improvement at the service. Accidents and incidents were reviewed and analysed to identify themes and trends and measures put in place to prevent them happening again. Lessons learned were shared within the service and where appropriate the wider organisation. Learning from elsewhere in the organisation as well as from the wider social care sector were proactively shared with the manager and staff team through team meetings and team communications to reduce future risks. This included guidance on preventing the development of closed cultures. The manager understood their responsibilities under the duty of candour and where incidents had occurred, these were reported to the appropriate authorities such as the local authority and CQC.

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. Where people were moving on or moving in the manager worked with people and those close to them to establish their plan of care and ensure individual transition plans were in place, prior to the person moving between services. This approach helped to eliminate any risks and to ensure the person received continuity of care. Visits to the service were available so people could spend time getting to know their new environment and staff before they moved in permanently. This gave staff an opportunity to work with them, their families and other healthcare professionals to ensure they could meet their needs safely. One family member told us, “Contacted [Name of manager] about visiting and it was all sorted. Staff very welcoming and [Name of person] immediately felt relaxed when we visited.” A professional told us, “[Name of person] visited and absolutely loved it and the staff greeted [person] with patience and warmth.” Electronic care plans allowed people’s information to be shared more easily with other professionals to enable them to access the most effective care and support. Hospital passports were in place should people need to access healthcare support in an emergency.

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. Effective systems to provide oversight of accidents and incidents including safeguarding’s were in place. Records showed safeguarding concerns were reported promptly to the local authority and notifications submitted to CQC. Staff had completed safeguarding training and the provider’s safeguarding policy guided staff about different types of abuse and how to raise a concern to ensure people were protected. One staff member told us, “Report to senior first and nothing done take it further to the manager and if still nothing done take it further. Always document it.” Another staff member told us, “Take to management straight away. Take right through to yourselves (CQC) if don’t think anything being done. Follow whistleblowing procedure.” We observed that people were comfortable and at ease with staff. The atmosphere at the service was calm, relaxed, friendly and homely. Staff were attentive and alert to any changes that might indicate people needed support. A family member told us when asked if they felt their relative was safe, “No worries. No issues at all…they make an effort all the time. I can’t fault.” People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 had been assessed and risk assessments were in place to ensure people’s safety. The manager recognised that many everyday activities people engage in carry risks, but they need to do them as safely and sensible as possible. This meant they still empowered people with activities but took steps to mitigate the risks. People's risk assessments were reviewed regularly or as required, such as in response to their changing needs or after a significant event. We asked the provider to review some areas including checks undertaken and information to keep people safe to ensure they were fully robust. Where we identified improvement, the manager actioned these immediately. Staff knew people well and understood when people required support to reduce the risk of avoidable harm. Staff had completed a range of training including positive behaviour support training to support with managing risk. One staff member told us, “Positive Behaviour Support (PBS) taught me a lot of different ways of dealing with situations.”

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 home was safely maintained; all necessary safety checks had been completed in relation to the premises. Infection prevention control risks were safely managed. We observed the home to be clean, tidy and secure. In addition to each person having their own self-contained flat they had access to communal spaces and a secure garden area. Flats were personalised and reflected the people that lived there. People were supported to choose paint colours for their rooms and purchase items to personalise their environment. The provider had policies in place for maintaining health and safety within the service. We asked the provider to assess the arrangements for storage of cleaning chemicals in one area and to review the items in their emergency grab bag. The manager took immediate action to address areas highlighted. People and their relatives were positive about the environment. One person commented, “Lovely place.” Another person told us, “Yes” when asked if they liked their flat. A relative commented, “Impressed with [person’s] room and size of accommodation. Didn’t realise [person] would have so much room but [person] was really pleased as they have a lot of stuff.”

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 had enough time to provide people with the care and support they needed. Managers made sure people received care and support from the same staff where possible to maintain consistency in people’s care and support and daily routines. Staff were supported with their learning and development needs and encouraged to continually improve in their role. Staff had undertaken training to support the needs of people who lived at the service. This included training in autism awareness which was in line with the Oliver McGowan Code of Practice. Staff were positive about the training they received. One staff member told us, “I have completed the Oliver McGowan training in Learning Disability and Autism. I found this very useful as all our residents have autism.” The provider operated safe recruitment practices and only suitable staff were employed to work at the service. Staff told us they felt well supported and were receiving regular supervision. Records showed supervision being completed with staff and which if continued would meet the required frequency identified by the providers policy by the year end.

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. The service was visibly clean and hygienic. Infection control and prevention (IPC) were undertaken, which supported the management team to identify any shortfalls and address them. A person told us how they felt the home was always clean and they kept their personal space clean with staff support. Personal protective equipment (PPE), including gloves and aprons, were available and used by staff as required. Staff received training in IPC. We observed that people were clean, tidy and suitably dressed. People’s care records included specific support they may require reducing the risks of cross infection, such as prompting people to wash their hands after using the toilet.

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. However, some creams did not have the date of opening or if they did were past their use by date. Although these creams were in use we noted no negative impact on those affected. Some Medication Administration Records (MAR’s) were handwritten and were not countersigned by 2 staff as per the provider policy. The manager took action immediately to address these issues. People felt involved in their care and were supported in ways that promoted their independence, dignity, and personal choice. They received their prescribed medicines as intended and were supported to self-administer or apply their medicines, including creams, where this was assessed as safe and appropriate. Topical medicines were recorded appropriately, with clear body maps in place to guide application. Detailed, person-centred guidance was in place for 'when required' (PRN) medicines, such as pain relief. This included clear instructions on when and how to administer medicines based on individuals’ needs and behaviours. Staff received the necessary training, and their competence was assessed regularly. They worked closely with other healthcare professionals to ensure people’s medicines were reviewed regularly. They did this taking into account the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and made sure people's medicines were reviewed by prescribers in line with these principles. Regular medicines audits were carried out to ensure systems remained safe. However, some of the issues we picked up on our visit had not been picked up by provider audits. We advised a review of the audits in place to include all areas of improvement noted.