Bradbury 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

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 requires improvement. At this assessment 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.

Incidents, accidents and near misses were recorded with clear details of what had happened, including what people were doing in the lead up to the incident. This helped staff identify situations which could escalate people’s anxieties. Staff took a pro-active approach to prevent situations escalating where possible and minimise distress for people.

Incidents were reviewed by managers to ensure action taken to reduce the risk of a repeated incident. Staff told us learning from incidents was shared with them and gave them clear information on any changes to the way they needed to support people.

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.

Relatives told us systems worked well when people started using the service, with good communication. This information was reviewed each time a person stayed at the service, to ensure information was up to date, for example any changes to medicines. People’s health conditions were documented, and they were supported to access services from a range of professionals including specialist epilepsy, nutrition and learning disability nurses.

People had been supported to develop hospital passports, to ensure key information about their needs and how to meet them was shared with medical professionals if needed.

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.

People and relatives said they felt safe when staying at Bradbury House. Staff demonstrated a good understanding of their safeguarding responsibilities and said they completed regular safeguarding training. Staff were confident managers would take appropriate action if they reported safeguarding concerns but were aware how to raise these concerns outside of the organisation if they needed to.

Where appropriate staff had applied to the local authority for Deprivation of Liberty Safeguards (DoLS) authorisations. The manager had a record of all DoLS applications that had been made, including details of any conditions to the authorisations.

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.

At the last inspection we identified shortfalls in the way risks were assessed and managed. At this inspection we found this had improved. People had now been supported to develop clear positive behaviour support plans, setting out support they needed to managed periods of anxiety and minimise distress. The plans had been developed with relevant professionals and had been regularly reviewed and updated as people’s needs changed. Staff now demonstrated a good understanding of the risks people faced and how to support them safely. Staff told us risk management plans were regularly reviewed and updated, alongside people, as their needs changed. Staff had immediate access to updated plans through the electronic support planning system and were notified of any changes.

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 provider completed various health and safety checks to make sure the premises, and any equipment was safe. All equipment was being serviced regularly, and external contractors were used to check safety systems such as fire and water safety. Staff on site completed some checks such as fire alarms and means of escape routes in the event of a fire. Records demonstrated all checks were completed in line with the provider timescales.

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 been recruited safely. All the pre-employment checks had been completed prior to staff starting work. During our inspection we observed there were enough staff to safely meet people’s needs. Staff were available to take people out in the community and to be present at the service and encourage people to engage with indoor activity. Staff said the number of staff scheduled on each shift varied, depending on the needs of people staying at the service. Staff felt there were sufficient staff provided to meet people’s needs.

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 clean and smelt fresh. All areas of the service were frequently cleaned and well maintained. Staff had appropriate access to personal protective equipment and had received training on infection prevention and control good practice.

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.

People had their medicines as prescribed, however, there were some improvements needed to make sure medicines were managed and stored safely. Where people needed ‘as required’ medicines, there was not always guidance available to help staff know when this medicine would be needed. Not all the ‘as required’ guidance that was in place was clear about when to administer certain medicines. For example, where there were variable doses to administer, guidance did not specify what dose to give and when. Some medicines containers did not have dates of opening recorded on them. For example, 1 eye drops container and some topical creams bottles were opened but did not have a date of opening recorded. Some medicines lose their efficacy when opened for long periods of time. The manager took immediate actions to address these shortfalls during the inspection.