Broughton House Residential Home

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 good. At this assessment the rating has changed to requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider was in breach of legal regulation in relation to infection prevention and control.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager 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. For example, events such as accidents and incidents were promptly reported, and the necessary action was taken to ensure lessons were learnt to prevent further occurrences.

The registered manager 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. For example, staff worked well and shared relevant information with other services such as community matrons, GP’s and dieticians.

The registered manager worked with people and 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. For example, managers and staff completed safeguarding training and understood their responsibilities for protecting people from the risk of abuse. They promptly shared safeguarding concerns with the relevant agency.

The registered manager worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. For example, risk assessments were completed and measures put in place to minimise the risk of harm to people. Aspects of peoples care where there was a known risk were monitored such as food and fluid intake for people at risk of malnutrition or dehydration.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. For example, flooring across parts of the home were torn and uneven and pathways and fencing in the garden were damaged increasing the risk of trips and falls. There was a general lack of maintenance across all areas of the home. However, regular safety checks were completed on utilities and fire systems.

The registered manager 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. For example, staffing rotas, observations and discussions with people and staff evidenced enough of the right staff on duty throughout the day and night. Safe recruitment practices were followed to ensure staff was suitably fit for the role. Staff told us they felt well supported through regular monthly meetings and one to one supervision.

The provider did not assess or manage the risk of infection. They did not detect and control the risk of it spreading. For example, parts of the home inside and out and items of equipment were unclean. Wheelchairs, commodes, falls safety mats and easy chairs were stained and damaged and there was a build-up of food debris on side tables people dinned from. Parts of the kitchen were unclean including light switches, door handles and the food trolley. Containers storing food items such as biscuits and cereals were unclean. Food items and preprepared food did not display opening and use by dates.

The registered manager made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. For example, the registered manager had a medicines policy which supported the safe management of medicines. Medicines were stored safely and managed by suitably trained and competent staff. Regular medicine audits were completed. Medicine stocks tallied with medication administration records (MARs) indicating people had received their prescribed medicines at the right times.