The Robert Atkinson Centre

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

At the lasted rated inspection this key question was rated as requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm. Recruitment practices were now meeting requirements. There were enough staff to deliver the care and ensured new care packages could be supported with adequate numbers of staff. A minimum of hour-long visits were provided. The registered manager worked closely with people to manage expectations around what could be achieve in the visit. Staff cooked a full meal from scratch, cleaned the house and provided support with personal care. The provider ensured care packages were flexible and built any additional domestic needs into longer visits. Staff understood safeguarding procedures and referrals were made as needed. Risks were assessed and action taken to mitigate any risks. The company the provider employed had completed a full review of the service and noted areas for improvement. The registered manager had ensured these improvements were made. People were supported to do the things that were important to them and manage any associated risks. The registered manager had established systems to identify safety events; they ensured these were investigated thoroughly and any lessons learnt were embedded in to practice. The registered manager actively promoted using information from lessons learnt to continuously enhance the service. They worked with people and partner organisations to maintain safe systems of care, which was based on openness and honesty. Medicine management was effective. Staff who administered medicines had the appropriate training. Staff followed appropriate infection control measures. The registered manager ensured staff were trained to use equipment and understand how to check items were fit for purpose.

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.

People found the care package met their needs. They felt involved in all aspects of the design of the care package and how it was delivered. Relatives told us that they felt able to share their feedback about the service. A person said, " A couple of carers did not meet my requirements then the manager arranged the right person for me.” A relative said, “We asked for the same carer and the same lady comes for all calls.”

The registered manager constantly critically reviewed the operation of the service and used all information to assist them to understand themes, reasons for the events and lessons, which could be learned. They actively made changes as and when these were needed. For example, they had recognised changes needed to be made to care records and packages when people’s needs became more complex. Staff found the registered manager encouraged them to be open and transparent with people. They discussed how they prioritised their work to ensure people were safe and well-cared for first. A staff member said, " Working here has been a positive experience. The team is supportive, and management ensures we have the resources needed to provide excellent care. Communication is strong, and any concerns are quickly addressed. I feel valued in my role, and overall, it's a great place to work."

Since the last inspection the provider had employed a company to assist them thoroughly review the service and identify were improvements were needed. On the back of this work the registered manager had put systems in place to identify any lessons learnt and take appropriate action. They continually looked at how to enhance the service and involved staff and people in thinking about creative ways to deliver optimum care and support for people. The registered manager could now readily identify where gaps existed and acted swiftly to address them. They effectively monitored the quality and safety of the service and ensured people experienced positive outcomes from the support they received. Action plans were used to monitor whether the changes implemented had improved the service. They used all feedback to assist them improve the quality of care. The team ensured any lessons learnt were shared with staff via meetings and supervision sessions.

People felt the service provided safe care and there was a smooth transition when the service started working with people. A relative said, “We had a different care company, but it did not work. This service is much better and they are doing brilliantly.”

Staff understood when people required support to reduce the risk of avoidable harm, and risk assessments were in place but at times needed to be a little more detailed. A staff member said, “I get to know each people and make sure I can follow the care plans. If there are any changes people’s need I report this to [registered manager].” The staff also understood the importance of ensuring continuity of care when people moved to and from the service. Staff ensured they spent time with people to learn how best to work with them as they transitioned to services.

The service worked in partnership with other agencies to improve people's opportunities and wellbeing. Staff worked as a team to ensure people’s support needs were met.

Systems were in place to ensure people transitioned to the service in a safe manner and there was continuity of care. The registered manager ensured care plans contained pertinent information about people’s needs and preferences. The management team matched people to staff, which enabled them to readily engage with individuals and provide appropriate care. Risk assessments were in place and assisted staff identify how to mitigate risks.

People reported they were very happy with the service. Relatives found the service ensured people were safe. A relative said, " [Person’s name] can hardly speak due to a stroke, but they feel safe with the carer."

The registered manager discussed how measures were in place to ensure staff understood when to make safeguarding referrals and how they worked as a team to ensure people were protected from harm. Staff made safeguarding referrals when needed. A staff member said, " The management and team are very supportive, providing the necessary resources, guidance, and training to perform my duties effectively. There's always someone available to help if any issues arise, making it easier to deliver the best care to our residents. I feel that risk is managed safely and effectively. We have clear protocols in place, and the staff are well-trained in identifying and addressing potential risks. Regular checks and open communication ensure that any concerns are promptly addressed, creating a safe environment for both residents and staff."

The provider had safeguarding systems in place. When appropriate staff had made safeguarding alerts to the local authority safeguarding team and sent us the required notifications and reports. Staff said they had training and a good understanding of what to do to make sure people were protected from harm or abuse. Staff said and we saw evidence that they had received safeguarding training.

In general, people and relatives told us risks were managed but some relatives felt having the same team would assist staff to fully understand individual’s presenting needs. A person said, “I don’t like different care workers coming because they don’t know my needs or my health conditions.” A relative said, “The care workers come on time, but they are always different girls. I must brief them on everything about the service.” People were involved in the design of the care package, how it was delivered and felt their suggestions acted upon.

Staff understood when people required support to reduce the risk of avoidable harm. The majority of risk assessments in place were detailed and staff reported they assisted them to safely mitigate risks. A staff member said, “We involve residents in developing their care plans and risk management strategies by actively listening to their preferences, concerns, and goals. We also encourage residents to express their views on their daily routines and any potential risks, adjusting care plans as needed to reflect their choices and promote their independence. This collaborative approach ensures that care plans are personalized and responsive to each individual's needs.”

Risk assessments were in place and assisted staff identify how to mitigate risks. However, the risk assessments needed to include more detailed guidance around the exact actions staff needed to take when people displayed distress behaviours or exactly what technique staff needed to use to assist people mobilise. The company working with the provider had highlighted this as an area for development. The registered manager had worked with the staff to make the necessary improvements.

People told us staff had the skills and knowledge to carry out their role effectively and use any equipment safely. A relative said, “They use the hoist safely, and I am very happy and satisfied with the service.”

Staff had received training around adopting safe working practices and following best practices guidance. They felt safe working at the service and had access to all the appropriate equipment they needed.

The provider had processes in place to ensure the office was fit for purpose and staff could access equipment as needed. Policies in place for this and lone working procedures. The registered manager made sure staff had received training to support people who had equipment in their homes, which included how it was cleaned, calibrated and safe. They understood what risk assessments were needed to make sure staff followed health and safety guidance.

People found the care package met their needs and there were always enough staff to deliver it. A person said, " They are good. They give me food and medicine. No complaints." A relative said, “The care service is very good. The staff come on time, and we have never missed calls.”

Staff reported there were enough care workers to meet people's needs and they work together effectively to provide safe care that meets people’s individual needs. A staff member said, “I find that there is generally enough time and staff to complete the work. The team is well-organized, and shifts are structured to ensure we can meet residents' needs effectively. While care work can be demanding, the staffing levels allow us to provide high-quality care without feeling overwhelmed.”

At the last inspection the provider had not ensured staff were recruited safely. The service had not always carry out the necessary recruitment checks, and Disclosure and Barring Service checks (DBS) had not always been obtained. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. At this inspection we found the provider had improved recruitment practices and now made sure staff were suitably experienced, competent and able to carry out their role. The provider had been approved to operate the Home Office sponsorship scheme and employed staff from overseas. The provider had worked with the legal team they employed to ensure they adhered to sponsorship requirements, recruitment, disciplinary and capability processes were fair and there was no disadvantage based on any specific protected equality characteristic. We saw evidence confirming when there had been changes to individual’s packages of care the provider had worked closely with partners to ensure these changes were delivered safely. The staffing levels and skill mix ensured people received consistently safe, good quality care that meets their needs. The management team closely select staff when providing packages and find commonalities between the person and carers, which encouraged a good relationship and engagement. All of the staff employed were at least bilingual and some were trilingual, which meant they could readily chat with the service users who tended to speak either Urdu or Punjabi. Staff receive the support and training they needed to deliver safe care. This included supervision, appraisal and support to develop, and improve services and where needed. Staff received training around all aspects of care including condition specific train and the now required courses around working with people who lived with a learning disability and Autistic people.

People found staff followed expected infection control practices. A person said, " My mum has the same team of carers. They have great respect for [person’s name] dignity. They always wear PPE."

Staff confirmed they received training on infection control procedures. They had all the equipment they needed to reduce the risk of spreading infections.

The provider had systems in place to mitigate the risks of people and staff from catching and spreading infections. We saw evidence to confirm staff had received infection prevention and control training and their practices were regularly checked.

People’s medicines were managed in a safe manner. A very small number of people needed staff to support them with their medicine administration. People who did require staff support with their medicine just required prompting to take their ‘as required’ medicine or assistance to apply creams. People who received this assistance no concerns. One person said, “They are good and always make sure I have my medicine on time.”

Staff told us that they received training in how to safely administer medication.

Assessments were produced, which detailed what medication people received. The registered manager completed regular checks to ensure medicines had been given as prescribed and records were accurate. Staff were trained in medicines management and processes were in place to assess whether staff were competent to administer people’s medicines. Staff were given clear guidance on when to administer medicines.