Buxton 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 inspection we rated this key question good. At this inspection 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People received care from a service which continually sought to improve and learn from events. Records showed openness and transparency when events occurred, such as falls and other events. Incidents within the service, were recorded, and discussed to prevent reoccurrence. Staff told us about the actions they took in real life events. Accidents, incidents and events were recorded on the provider’s electronic systems. The registered manager was informed of each incident and undertook monthly reviews to identify trends, these were shared and discussed across the providers locations. Health and social care professionals who worked with the service told us they were confident in the service to be open with them for the best interests of the people living at Buxton House. The provider’s comprehensive policies underpinned working practices within the service.

The service 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 felt confident their needs would be met by staff and information would be shared to promote seamless care. Information from medical professionals was included within people’s care plans. Staff told us information was available to them if they needed it. This included, if a person had gone to hospital or moved to a new care service. People’s needs, and care requirements were detailed within their care plans and risk assessments on the electronic system. A summary sheet was available if the person went into hospital or moved to another care home, this promoted continuity of care for people. Health and social care professionals told us the service escorted their visit which had promoted continuity in care and partnership working. A member of staff told us, “We have a strong, dedicated senior team who work exceptionally well together. Our relationships with external health professionalsincluding the district nurses, nurse practitioners, and GPs are solid and built on mutual respect and collaboration.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.

People told us they were safe living at the service. One person said, “I feel safe because staff are here if I need them.” All staff had received training in safeguarding adults; they told us how they would raise concerns and were confident the registered manager would act immediately with the information. Safeguarding procedures were in place to ensure people were protected from avoidable harm. Posters displayed within the service reminded people of contact details for reporting concerns both within the service and outside. A member of staff said, “I feel Buxton House is safe and the residents are well cared for. I would feel very comfortable reporting anything which needed to be reported to any senior member of staff knowing it would be dealt with correctly.” Records showed safeguarding referrals had been made as necessary and this included notifying CQC of certain events as required by law. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The registered manager had oversight of DoLS applications, authorisations, and conditions and used records to ensure all documentation was in date.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s health, safety and wellbeing had been identified, assessed and measures put in place to prevent harm. Risk assessments had involved people and their relatives and were clear and details for staff to follow. Safe ways of working were clear in the risk assessment, and these had been reviewed monthly or when a change had occurred. People told us they felt safe in their environment. Feedback from health and social care partners was positive about the provider’s post falls protocol in keeping people as safe as possible. We observed staff working in safe ways as detailed in people’s risk assessments, this had included, where people moved around the service with the support of staff and equipment. Environmental and general risk assessments were in place which considered people’s individual needs within the communal environment, for example, fire safety. The providers comprehensive policies underpinned working practices within the service.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were safe from risks within the environment. The service had undergone redecoration, and new spaces had been created for people to relax and enjoy. The registered manager told us there was an ongoing programme of redecoration and refurbishment. Equipment and utility checks were in place and closely monitored to promote safety. A dedicated staff member was responsible for maintenance within the service and undertook comprehensive checks. There was a programme of works and reminders of expiry dates. The service used external specialists and contractors to undertake some checks particularly where there was need for a specialism, such as gas, electrical and fire safety. Staff were complimentary about how the service was maintained. We observed various works and professionals in the service during the inspection, working to improve any areas of need.

The service 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.

People told us staff were kind, caring and there when they needed them. A relative told us, staff have shown ongoing genuine care and concern for mum. “Staff treat her with warmth, dignity and as an individual.” Staff received training and support to ensure they could carry out their role effectively. A member of staff told us, “We have a lot of training, it is important, and I enjoy it.” Staff were encouraged to undertake additional learning such as, national vocational diplomas in care. Another member of staff said, “My training has been second to none and if I have had any problems, I have been able to approach the management team who have been very supportive with offers of extra support if I have required it.” Staff told us they felt supported fully by the registered manager and the senior team. Formal supervisions were carried out and staff told us they could access support at any time. We observed staff who worked at the service to be calm and relaxed. Staff were busy and the number of staff were in accordance with the plan for the day. There was a process in place to measure people’s dependency and need which had informed staffing levels within the service. Staff were recruited safely, and recruitment records reflected this. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Staff learning and development was in place to ensure staff were properly inducted into the service and their competency assessed and their knowledge developed. The registered manager had oversight of training within the service and these details were shared with the provider and across their locations.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us the service was clean and tidy, this included people’s own bedrooms which were cleaned daily and had deep cleans regularly. Staff received training in infection prevention and control, and this had included observations of hand washing. Dedicated staff ensured the home was clean, they worked to agreed schedules. We observed the service to be clean and hygienic. Personal protective equipment (PPE) was worn appropriately by staff. Safe infection prevention and control procedures were in place, and this underpinned practices within the service. Infection control procedures and audits were in line with good practice guidance. Staff had plentiful supplies of cleaning materials, products, and PPE. Health and social care professionals commented positively on the cleanliness of the service.

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

People received their medicines as prescribed. There were safe processes in place for ordering, storage, administration and disposal of medicines. Staff who were responsible for giving people medicines were trained and had their competency assessed. Staff told us they worked well as a team to ensure medicines were safe. A robust programme of checks was in place to support safety. The provider’s electronic medicines system contained accurate recordings including stock counts. The registered manager and senior team had oversight of the system. Medicines were stored at safe temperatures and checks were in place to ensure this was maintained. We observed staff offering support and gaining consent when supporting people with their medicines. Safeguards were in place to ensure people were only given the medicines they needed. Guidance supported staff to ensure medicines taken occasionally were given in a consistent way. Medicines which required stricter controls were monitored and correct control measures were in place. The service had a ‘medicines champion’ this was a member of staff who took a special interest in this area and cascaded learning throughout the staff team. Audits and checks were in place to ensure compliance; this included internal audits and checks from the providers quality team.