46 Bath Road

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 remained good. This meant people were safe and protected from avoidable harm.

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.

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.

Accidents and incidents were monitored, reviewed, and any trends were explored. This included what the concerns were, what action had been taken to minimise further risks and any learning.

Accident and incident reports were reviewed by the registered manager and by the provider to ensure risks had been minimised. The staff recorded this electronically so this could be monitored promptly and remotely to ensure appropriate actions had been completed swiftly. This also enabled them to share learning across the organisation where relevant.

There was evidence of openness and transparency, in line with duty of candour requirements. The registered manager and the service coordinator were clear about their responsibilities for reporting to the Care Quality Commission (CQC) and the regulatory requirements of their role.

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.

People had healthcare passports, which could be shared with other health and social care professionals to ensure continuity of care. This included what was important to the person, the support they needed to keep safe, information about how the person communicated and the support required to make decisions about their care and support. This included others that must be involved such as a relative. This enabled other agencies to get to know the person and what was important to them.

People’s needs were assessed before moving to the home. A new person and their family representative were supported to visit the home to meet the staff and the people they were planning to live with. People’s views were sought in respect of the new person, to ensure they were compatible living together. The registered manager and service coordinator had visited the new person enabling them to get to know the person. The new person confirmed that they had met the staff and management before making a decision to move to the home and they told us they were settling in well and really liked their new home.

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 were relaxed and comfortable with the staff who were supporting them. One person told us they liked all the staff and had no concerns about the home. Another person told us they were happier and felt safe now they were living at 46 Bath Road after spending a prolonged period in hospital. Relatives said people were safe living at the service and knew who they could talk to if they had any concerns.

People were supported by staff who had completed safeguarding training and understood how to recognise and report any safeguarding concerns.Staff understood their role in reporting and escalating any concerns. They were confident the management team would take prompt and appropriate action to ensure people were protected.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found appropriate assessments and applications had been made. No one had any specific conditions as part of their DoLS.

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.

People’s care and support needs had been clearly identified, and risks had been planned for. Detailed risk assessments and care plans were in place to guide staff practice, including risks relating to choking, mobility, support with finances, accessing the community, and risks associated with any health conditions.

Staff we spoke with understood risks to people and how to support them to remain safe. A member of staff told us, “We ensure a preventative approach that prioritises individual empowerment, creating individual risk assessments that focus on what makes the person safe.” All staff we spoke with confirmed risk assessments were accessible and if they had any concerns they could speak with the service co-ordinator or the registered manager and this would be addressed.

Staff delivered care that was safe and supportive while enabling people to take positive risks and engage in activities that were important to them. For example, one person had recently been swimming something they had not done since leaving school. Their relative said this had been a positive experience for them. A member of staff said the activity had really been enjoyed by the person and they were planning to do this as a regular activity as it helped with relaxation.

Environmental risk assessments had been completed, so any hazards were identified and the risk to people removed or reduced. The staff completed regular checks on equipment that people used to keep them safe including wheelchairs, bathing equipment and sensors, which monitored any epilepsy seizures during the night where this was needed.

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 design and layout of the premises was safe and met people’s individual needs. The accommodation was wheelchair friendly with level access to the front of the property. There were raised flowerbeds in the garden and handrails leading up to the property. There was an open plan lounge/diner, and bedrooms were situated off a short corridor either side of this area.

A routine maintenance programme was in place. Staff told us, flooring had been recently replaced throughout the corridors and the main lounge/dining area. The service coordinator told us they were planning to refurbish the bathrooms, and work was underway in the garden to make it more accessible removing the overgrowth to the side of the property. The recent fire risk assessment identified fire doors needed replacing and assurances were provided that this work had commenced.

Systems were in place to ensure the home was safe. This included checks on equipment, legionella, fire and gas appliances checks. Adaptations such as window restrictors and radiators being covered all helped to keep people safe. The staff knew who to contact when people might benefit from additional aids or equipment. Staff were trained to use any equipment people needed. This included moving and handling training.

Personal emergency evacuation plans were in place for each person. These considered the person’s mobility, health needs and behaviours that might affect how they left the building in an emergency. Staff and people had completed fire drills to ensure people could evacuate the home safely, whilst evaluating the effectiveness of safety equipment and evacuation plans.

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.

The provider followed safe recruitment practices to ensure people were protected. This included obtaining a full work history, references, checking the right to work and a Disclosure and Barring Service (DBS) check. DBS checks provide information about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Staffing was planned to ensure people received the support they needed and to do the activities they enjoyed. Staff confirmed there was always enough staff to support people to go out on a daily basis and provide support when a person needed this. A member of staff told us, “(Name of service coordinator) will always change the rotas around to meet the needs of the people we support. There is always enough staff to do what people want to do.”

Staff had the knowledge and skills required to meet people’s needs. New staff completed an induction including the care certificate. The care certificate is a set of standards that new care workers must learn and demonstrate in practice. Staff confirmed they completed a 6 month probationary period to ensure they were suitable to work at 46 Bath Road.

There was a guide available for agency staff and bank staff. This included information about the home, key policies and emergency procedures. Agency and bank staff completed an induction when they first started working at the home. This ensured continuity for people.

Training and supervision arrangements were well embedded within the service. Staff completed a range of mandatory training to ensure people were supported safely, alongside bespoke training tailored to the specific needs of people living in the home. This helped ensure staff had the appropriate skills and knowledge to provide safe, effective and person-centred care.

Staff confirmed they received regular supervision and had opportunities to reflect on their practice and discuss development 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 home was clean throughout with routine cleaning taking place during our visit. Staff told us they had access to sufficient gloves and aprons when they needed and received suitable training. We observed staff following good infection control practices.

Infection prevention and control policies were in place alongside regular audits to ensure policies were adhered to.

Staff had completed food hygiene training to ensure that they understood how to handle, prepare, and store food properly to protect people from illness. Records were maintained demonstrating food preparation was completed satisfactory with regular food probing and cleaning records maintained. All food items were dated once opened.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

People's individual medicines were stored in a secure cabinet in their rooms. This helped staff to provide a more person-centred approach to the administration of people’s medicines. Each person had a medicine profile describing how they wanted to be supported and information about their medicines.

Staff assisted people to take their medicines. However, systems were in place to check if a person wanted to self-administer their own medicines ensuring they were safe to do so. People confirmed they were happy with the arrangements for their medicines. One person told us, “I now prefer the staff to help me.”

Electronic medicine records were maintained of all medicines administered. This enabled the registered manager and the provider to monitor medicines remotely. Alerts were sent if medicines were missed meaning staff could rectify this promptly.

Staff received training in medicine management, and their competency was checked before they were authorised to administer medicines. There was a medicines policy in place. There was a process in place to report and investigate medicines errors and incidents. Staff carried out daily medicine checks, including storage temperatures. Medicines were audited as part of the provider's quality monitoring processes to identify gaps and make improvements.

The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. Annual health reviews were completed to ensure people were receiving medicines appropriately.