Rawlyn House

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

People were protected from risk of harm and abuse. Staff received safeguarding training and understood their duty to keep people safe. People and relatives were involved in understanding and formulating plans to reduce the risks associated with people’s care. Risks associated with people’s on going care needs were identified and acted on. There were sufficient staffing levels and oversight to ensure people’s needs were being met and people received their medicines as prescribed.

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.

Relatives we spoke with told us they knew how to make a complaint if they needed. One relative described how when they had made complaints these were resolved quickly and to their satisfaction. They told us “Only very small complaints, all dealt with extremely well, we know the owner, manager and management structure”. Other relatives we spoke with told us they had never had to make a complaint. Comments included “I have never had to complain about his care” and “Never complained and no accidents or falls”.

Records showed complaints that had been raised through the providers formal complaints procedure had been dealt with in line with the provider's complaints policy. The registered manager and senior leaders described the system for recording, investigating, and monitoring accidents and incidents within the service. The registered manager explained that all incidents were logged and reviewed by the registered manager to ensure the appropriate action had been taken. This information was then monitored by senior leaders and the provider to identify any themes or trends. The registered manager was able to describe their duties in relation to The Duty of Candour, the actions they would take, their understanding of and how (where appropriate) they would include relatives and or advocates.

There was evidence of continued learning. There were systems and processes in place to learn lessons, including when incidents and accidents occurred. This included putting measures in place to reduce the risk of recurrence. Records showed complaints had been dealt with in line with the provider's complaints policy.

Relatives told us if people became unwell, staff would act on it and contact health professionals as needed. Comments included “Professional like GP can be accessed”, “GP, Chiropodist, Hairdresser and Dentist all visit” and “Staff will phone us with little nuances they observe, for example if she is unwell”.

Observations, discussions with the registered manager and records confirmed the service worked with healthcare professionals such as, occupational therapists and physiotherapists to ensure that people received effective and responsive care.

We spoke with 2 professionals from partner agencies who told us Rawlyn House worked in partnership with them and raised concerns and sought advice appropriately. One professional told us “They always get in touch as and when they need to. Communication is good”.

Where healthcare professionals provided advice about people's care this was incorporated into people's care plans and risk assessments. People’s care records contained documents which they could take with them to hospital or healthcare appointments. These documents contained important information about people’s care and communication needs, including personal details, the type of medication people were taking, and any pre-existing health conditions.

We spoke with 8 relatives of people who used the service. Without exception all relatives told us they felt people were safe living at Rawlyn House. Comments included. “Rawlyn’s is an oasis, it has changed our son’s life”, “We do feel she is kept safe; we watch over everything from a distance”, “She is kept extremely safe, staff are really good with her care, we are very happy” and “Very safe, care is phenomenal in Rawlyn’s, they really are amazing, no complaints at all”.

The registered manager understood their responsibilities to identify, report and investigate allegations of abuse. They told us “Safeguarding starts at point of staff induction so we can reinforce the safeguarding culture we have here (at Rawlyn House). Safeguarding forms a standard topic with 1-1 supervisions and staff are given opportunities to raise concerns and feedback on how people are receiving their care”. The registered manager and provider’s quality assurance leads were able to articulate the systems and processes and how these systems were aligned to the provider’s policies and procedures. Staff were aware of types and signs of possible abuse. Staff had completed safeguarding training and understood their responsibilities to identify and report all concerns in relation to safeguarding people from abuse. One staff member told us “If I witnessed anything I would go straight to my manager and if it was not dealt with, I would ring head office and speak to them. So, like physical abuse or if you notice bruises and that would flag something and if we ever do that get it is reported on our system immediately and like sexual abuse or like with our guys look out for any changes in their mood or psychological or financial.” Staff we spoke with also confirmed safeguarding concerns were discussed during their individual 1-1’s with their supervisors.

During the assessment we observed many positive interactions between people and staff. For example, we saw staff took time to meaningfully engage with people prior to a music activity taking place. We saw how some staff comforted and redirected people when they became emotionally distressed or offered assistance sensitively when people needed support to maintain their personal care. People were supported in line with the principles of the Mental Capacity Act 2005. Where people were thought to not have capacity to make certain decisions, capacity assessments had been carried out. Where people did not have capacity to make specific decisions, these had been made in their best interests by staff following the best interest process.

Safeguarding systems and processes were in place to identify report and investigate, allegations of abuse. The provider had logs and records that showed appropriate action had been taken where necessary. Systems were aligned to the providers policies and procedures.

We received positive feedback from relatives about their involvement in people’s care. Relatives told us they felt involved in managing people’s risks and staff kept them updated on any changes. Comments included, “We are actively involved and always informed about her care, we have a very good relationship with the staff, we trust them all with the care of our daughter and they all learn ways of treating her condition” and “(Person) has a special diet, small and often, staff monitor her weight, they all make a real effort with her diet.”

The registered manager described how the staff assessed people’s needs on an ongoing basis and ensured relatives were kept informed of any changes to people’s care. Reviews of people’s care were used to ensure care plans and risk assessments were up to date. Staff were aware of people's individual risks and knew people well which enabled them to provide safe effective care.

It was clear from our observations that staff had developed good relationships with people. We saw how staff were anticipating people’s needs and identifying triggers and redirecting, preventing people experiencing emotional distress and or increased anxieties. For example, we saw how staff took time to explain to people what they were doing and allowed people time to process information.

There were robust systems in place to ensure risks associated with people’s care were managed and mitigated. Staff were provided with all the information they needed to support people safely. People's care plans contained risk assessments which included risks associated with moving and handling, epilepsy and pressure damage. Where risks were identified plans were in place to identify how risks would be managed. There were systems in place to ensure people living with epilepsy were kept under review and seizures were monitored and recorded so that any increase or decrease was reported to epilepsy specialists.

We received positive feedback from relatives about people’s living environment. Comments included, “Security getting in and out is good”, “The place is always clean and tidy” and “(person) is kept extremely safe, staff are really good with her care, we are very happy with it, she is mobile.”

The registered manager, staff and the provider explained the systems they had in place to keep people safe whilst living at Rawlyn House. The provider explained how they carried out regular risk assessments on the environmental needs of people and how they would respond in the event of any incidents.

From our observations we were satisfied that the Rawlyn House was a safe environment, that was fit for its intended purpose.

The premises and equipment were maintained, and regular checks were undertaken in relation to the environment and the maintenance and safety of equipment. For example, water temperature testing, portable appliance testing and moving and handling equipment was regularly serviced and checked for safety. Fire safety systems were serviced and audited regularly, and staff received training in fire awareness.

People were not able to tell us if there were enough staff to meet their care and support needs. Relatives told us there was enough staff to meet people’s needs and that staff were knowledgeable and competent in their roles. Comments included, “Staff numbers have increased, recent recruitment campaign, they look after their new staff and team well I feel.”, “I think there are enough staff, high turnover but some familiar faces.” and “The Home is well-staffed, high turnover but some staff are long term, we recognise her carers, they do indeed treat her with respect and dignity.”

The registered manager and staff told us there were sufficient staff to meet people's needs. Comments included “yes, I feel there is enough staff, and we are pretty much fully staffed currently. We have been through some tricky times, but we are doing ok now. If we are short and they are stuck they will send a message to all staff offering enhanced pay to cover”, “We don’t have the problem when we were short often anymore. It was very bad after covid” and “Yes, I feel there is enough staff to help people feel safe and happy.” Staff told us they received adequate training to support them in their roles. One staff member told us “The training is very good, and we do get some on paper, online and we do practical manual handling. We have (specialist training) training, and a nurse will come in, because you need to be witnessed and signed-off. There are other training courses that you can put your name down”. Another staff member said, “I would say yes the training is good and we have the practical epilepsy, manual handling and first aid every 6 months”.

Observations and staffing rotas confirmed sufficient and safe staffing levels were in place. Some people had commissioned 1-2 and 2-1 support and these staffing levels were being maintained.

Records showed that staff completed required training. Newly appointed care staff went through a comprehensive induction period. This included training for their role, shadowing an experienced member of staff and having their competencies assessed prior to working independently with people. People were protected against the employment of unsuitable staff because the provider followed safe recruitment practices. Staff personnel files showed that staff received regular supervision, This provider has a system in place that provided an overview of all staff training requirements for the registered manager to monitor. Training was up to date, and it was clearly recorded when the updates would be due. Staff have spot checks on their practice and annual competency checks.

People were not able to tell us if there were sufficient Infection prevention and control practices in place. However, relatives we spoke with did not raise any concerns. From speaking with the registered manager and staff and observing practices we were satisfied there was appropriate measures in place.

The registered manager described the measures that were in place to support best practice Infection prevention and control practices. Staff told us they had free access to Personal Protective Equipment (PPE) and were able to describe types of PPE alongside describing best practice Infection prevention and control techniques. Staff told they were trained in infection control and had access to PPE such as gloves. One staff member said, “We have infection control training which is mandatory”.

All parts of the service without exception were immaculate. We observed staff using PPE in line with the providers policies and procedures which were aligned to nationally recognised best practice.

The provider had systems in place to ensure people were protected from the risk of infection. The providers systems were underpinned by policies and procedures.

Relatives we spoke with told us people received their medicines as prescribed. Comments included “Medication is handled well”, “Medication is always correct and signed for.” And “(Persons) medication is bang on”.

The registered managers and staff were able to describe how they ensured people received their medicines as prescribed. Staff told us they received medicines training and had their competencies checked regularly by the provider. Staff told us “Yes, I do support people with medicines. Yes, I have been trained, we have to do training and then it has to be witnessed 3 times by a member of the management team and then we can be signed off. The registered manager told us “Medicine practices are individualised”.

Medicines were ordered, checked and available when people needed them. Medicines were stored, administered, recorded and disposed of safely. Staff were trained and assessed as competent to administer medicines. They were regularly supervised to make sure they were following best practice. Staff knew how to administer people’s individual medicines and supported safe administration in a caring manner. Additional information was available to support staff make consistent decisions about when to give a when required medicine or where to administer emergency medicines. These records were accurate and fully completed.