Rosebank

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

We assessed 8 quality statements in the safe key question and found areas of good practice. Our rating for this key question is good. Lessons were learned from safety incidents and shared with staff to help improve practice. Incidents were analysed to help mitigate the risk of recurrence. Policies and practices helped protect people from the risk of abuse and harm. The provider worked well to help ensure people were transitioned into the service safely. Risks to people were assessed, mitigated and managed by staff who understood them. The risk assessment process was unique to each person. The service was kept clean and hygienic. Checks were in place to ensure the environment was safe and well maintained. Staff were recruited safely. There were enough staff to ensure people received safe, good quality care that met their needs in a timely way. People’s medicines were managed in a safe way. People’s behaviour was not inappropriately controlled by medicines.

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.

People told us they felt safe and knew who to speak to if they had any concerns about their safety.

Feedback from staff and leaders confirmed safety was a top priority for everyone and that risks were not overlooked or ignored. Staff were encouraged to raise concerns. Lessons were learnt with opportunities to learn from safety events being communicated to help support improvement. Staff told us they were kept informed about any changes which impacted on people’s safety and that incidents were discussed and lessons learnt and shared. The registered manager confirmed, “There is a learning culture here, following on from any incidents, we have de-briefs, and we discuss this with the person and any relevant others such as in house therapists, staff and family members.”

Processes were in place to help ensure risks were treated seriously and that management had an accurate picture of risks across the service at any one time. Safety and learning were part of the culture of the service. Policies were in place to help ensure people’s safety, such as a whistleblowing and safeguarding policy. We looked at the service’s analysis of incidents. It demonstrated a proactive and positive culture of safety based on openness and honesty in which concerns about safety were listened to, investigated and lessons were learned to continually identify and embed good practices.

People told us they were supported to access other services when needed. People told us they were supported by staff to attend any healthcare appointments.

Staff and leaders understood their responsibilities for ensuring safe systems of care. This included working with other professionals and services, to help ensure people received continuity of care. The registered manager told us, “Whilst we use an internal multi-disciplinary team, people also have full access to community based primary services, we are confident in recognising when a person requires support and when to initiate external referrals.” Staff had a good understanding of people's needs. They confirmed they had completed training to help them recognise when people were experiencing any changes to their health, and what action to take.

Feedback from external professionals confirmed the provider treated safety as a top priority. One professional told us, “The safety of individuals who reside at Rosebank is the priority of staff and my experience is that they work with all stakeholders, professionals and the young people to ensure safety.” They also told us they thought the provider managed risks to people well, “Staff have an excellent understanding of risks to people.” Another professional commented, “I believe that the model of care at Rosebank manages people's risks whilst trying to give them opportunities to develop socially and take part in community living to promote their development and aspirations.”

Processes were in place to help ensure people received continuity of care. Although the provider had access to its own in-house health care professionals, where it was appropriate to make referrals to external services, this was done when needed. People’s care records showed referrals were made in consultation with them.

People told us they were treated well and felt safe living at Rosebank. They said they would tell someone if they felt unsafe.

Feedback from staff and leaders confirmed there was a strong understanding of safeguarding and how to take appropriate action. The registered manager told us, “We have a safeguarding policy. Staff are confident as to what needs to be referred. Our priority is to make people safe.” Staff confirmed they had completed safeguarding training and had regular refresher training. Staff knew where to find safeguarding policies, procedures and other information to guide them on what to do if they needed to deal with a safeguarding incident. Staff provided examples of different types of abuse and told us they would not delay in reporting a safeguarding concern.

Staff were observed treating people well and with respect. People appeared relaxed and comfortable around staff.

Processes were in place to help people receive care in a safe way and to help keep people free from the risk of abuse and harm. Information was readily available and visible in the home to help people understand how to raise any concerns. A safeguarding policy was in place which provided up to date guidance for staff to follow.

People told us they felt safe and staff supported them to stay safe.

Feedback from staff and leaders confirmed they understood the risks to people and how to keep them safe. The registered manager told us, “We work with people to mitigate risk, it's a joint collaboration. We work with the person; it's not just about having something done to them.” Staff told us they knew about the risks people faced and that people's care plans were kept up to date regarding risks and how best to manage them to ensure people were kept safe. Staff explained they managed risk in a way which promoted people’s independence as much as possible. Staff confirmed they did not practice restraint unless it was absolutely necessary and they had completed the required training.

Our observations showed people were calm and relaxed in a safe environment.

Processes were in place to help ensure there was a balanced approach to risk in line with their choices and ability. Risk assessments reflected positive risk taking, as well as the abilities and choices of people. Assessments of risk were reviewed in a holistic way and in a way which was unique to the person. More specialised risk assessments, which utilised measured objectives, were used to help capture the wishes and long term goals of the person.

People were happy with their home environment and felt it was safe. People told us they liked their home a lot and felt it was safe. People told us they got the help they needed in the kitchen when preparing their food and drinks.

Feedback from staff and leaders confirmed had a good understanding of their responsibilities for ensuring a safe environment. The registered manager confirmed, “I do a daily walk around and a weekly health and safety check.” Staff knew of their responsibilities to make sure the environment was safe. Staff told us they would report any safety concerns immediately and that regular checks were carried out on the safety of the environment and utilities. Staff told us they had completed health and safety training including fire awareness, first aid and moving and handling. Staff confirmed they felt the environment was safe and suitable for people.

The environment, including outside spaces, were observed to be safe and well maintained.

Processes were in place to help ensure the safety of the environment. Safety checks on the environment and any appropriate equipment were carried out at the required intervals. Any safety concerns were dealt with in a timely way. An up-to-date PEEP (Personal emergency and evacuation plan) was in place for each person. This was important as it helped to ensure people could be removed from the home safely in an emergency.

People had established positive and trusting relationships with staff. People told us there was always enough staff and that staff were good at their jobs. People told us they viewed staff as their friends and could talk to them about anything. People told us staff understood them and were very patient and helped them a lot. People also confirmed ''there was always staff around and lots of them.''

Feedback from staff and leaders confirmed there was enough of them on duty to support people safely. The registered manager told us, “There is always a senior or manager on shift.” Staff told us they received the training and support they needed for their roles, and received any specialised training to help meet people's specific needs. Staff told us they had daily handovers, regular meetings and supervisions. Staff confirmed they understood their roles and responsibilities and lines of accountability. Staff were given the opportunity to develop within their roles, some staff had been promoted into more senior positions.

We observed the right amount of suitably skilled and experienced staff on duty. Staff were present in communal areas to support people to do the things they wanted to do. The registered manager, deputy manager and a senior care worker were present supporting and working alongside a team of care staff. We observed data which highlighted the occurrence of incidents was more frequent in the evenings when the registered manager was not present, we spoke to the registered manager about this who confirmed a senior staff member was present and there was always a manager on call. The registered manage confirmed this was a situation which was continually reviewed.

Processes were in place to ensure staff were recruited safely and supported to perform their role in a safe and competent way. Staff completed a thorough induction which included mandatory training and bespoke training aligned to the individual needs of people. The ethos of the service was to ensure staff were trained sufficiently to help them have a good understanding of the people they were working with and the approaches that would be most effective.

People had no concerns about the cleanliness and hygiene of their home. People told us they kept their home clean with the help of staff.

Feedback from staff and leaders confirmed there were clear roles and responsibilities around infection prevention and control. Staff confirmed they had a good stock of the right PPE, and they knew how to use and dispose of it safely. The registered manager told us, “We have cleaning rotas and schedules, people and staff do this daily. This also helps develop the life skills of the people we support.”

The cleanliness and hygiene of the environment was maintained to a high standard. People and staff had access to information and equipment to help minimise the risk of the spread of infection. There was an area in the kitchen with a notice board for people which displayed guidance and information about hand washing and maintaining cleanliness. Colour coded chopping boards were in the kitchen and colour coded cleaning equipment was also in use.

Processes were in place to ensure the risk of the spread of infection was minimised, and the environment was kept clean and hygienic. Cleaning schedules were followed, and people were encouraged to actively participate in cleaning and domestic tasks, to help develop their life skills.

People told us they received their medicines at the right times.

Feedback from staff and leaders confirmed medicines were managed safely and that people were encouraged to be involved in their treatment. The registered manager told us, “If a person wished to self-medicate, this would be risk assessed and managed accordingly, to ensure it was safe.” Staff confirmed those that managed medicines were trained to do so and had their competency regularly assessed.

Processes were in place to help ensure medicines were given in line with best practice guidance. The provider also adhered to the principles of STOMP (a national programme designed to stop the inappropriate prescribing of psychotropic medicines). Processes were in place for the safe management, use and oversight of medicines, including the use of controlled drugs. Practices were in place to help ensure people were involved in decisions about their medicines including their reviews. Medicine audits were regularly completed. Where shortfalls had been found, lessons were learnt. This included additional training with staff members. For people who were prescribed PRN medicines (as and when required) although PRN protocols were in place, further person-centred detail was required to help provide staff with accurate guidance. We spoke with the registered manager about this who began to act on our observation right away.