The Bungalow

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 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 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.

Staff knew how to raise and report safety concerns and incidents promptly. The registered manager reviewed information and updated care plans or risk assessments where required. A debrief was carried out following incidents with all individuals involved.
 

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 spent most of their lives living at the home and had settled routines. People visited day services that were managed by the provider. Staff completed handovers to day services staff and information was shared throughout the day to keep the home updated on the person’s wellbeing.
The registered manager attended a weekly meeting with the GP to discuss any ongoing or new health needs. Where referrals were necessary to other healthcare services, these were made promptly and people’s health conditions were managed safely.
 

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.
For example, the registered manager had a monitoring system for all safeguarding incidents, and they were reported to the local authority promptly. The registered manager could demonstrate how to look for trends and themes and learn from events. Staff we spoke with had a good understanding of safeguarding procedures and knew how to raise concerns. They had safeguarding training during their induction, and this was refreshed every 2 years.
People had access to an easy read version of the safeguarding procedure. Family members knew how to raise concerns with the provider and who to contact if they weren’t happy with the response.
People were involved in completing mental capacity assessments to demonstrate their ability to make decisions about their care and support. Where people lacked mental capacity, best interests’ decisions were made with the person and whoever was important to them. Applications for Deprivation of Liberty Safeguards (DoLS) authorisations were submitted and approved appropriately, and people were included in this process where appropriate.
 

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 were supported using proactive, person centred approaches to manage risk. Social stories were used to help people understand and prepare for upcoming events and appointments. Positive behaviour support care plans provided staff with clear guidance to support people effectively during periods of heightened emotion or distress. Staff supported people to identify safer ways to meet their sensory needs, which reduced the risk of harm and promoted their safety and wellbeing.
 

The provider did not always effectively manage and control potential risks in the care environment. For example, we observed black mould around the window of a person’s bedroom. We noted a smell of damp within a storage cupboard in the hallway. The provider acknowledged there was an ongoing problem with damp due to the age of the building, however, there was a monitoring process in place, improvements had been made and a damp specialist survey was due to be completed in the next 6 months. There were humidifiers in place to mitigate the risk further.
The provider made sure equipment, and facilities supported the delivery of safe care. For example, the provider had a ten-year plan for maintenance and renovation of the building. Regular safety checks were completed to ensure the environment was safe and well maintained, these included emergency lighting, fire alarm systems, equipment, gas, water and electricity. Any irregularities on these checks prompted an action plan, which the registered manager would complete in a timely manner. If building repair issues were identified by staff, there was an internal facilities team who quickly made necessary repairs.
 

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 assessed needs.

The provider made sure people were recruited safely by completing all necessary pre-employment checks and using a specific induction tool. Staff employed had relevant qualifications and were well experienced. Staff told us they received regular supervision and annual appraisal.

People received care from regular staff who knew and understood their needs. Family members told us they thought staff were responsive to their loved one’s needs and the home only used temporary staff as a last resort.

The provider ensured staff had access to a wide variety of training courses tailored to the needs of the people they were supporting. There was an employee handbook giving staff access to relevant policies and procedures within the organisation.

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.
Cleaning rotas were used throughout, and it was evident the home was clean and hygienic. Although mould was identified around some windows due to damp, the provider had identified the risk and there was ongoing work to address this. When this was found, staff ensured the window was cleaned. The issue did not compromise overall infection prevention and control arrangements, which remained effective. People were supported to clean their bedrooms with staff support if needed. We observed bedroom door handles to be worn and rusty, which could impede effective cleaning, however, we raised this with the registered manager, and they had been replaced by our second visit. Staff used Personal Protective Equipment (PPE) and were tested annually on their knowledge of good hand hygiene.
 

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.
People received their medications as prescribed and a safe system was in place to ensure medications were kept safe in a locked cabinet. There was a safe process for ordering and receipt of regular medications, completed by the team leader. Mental capacity assessments were used for determining whether people were able to manage aspects of their medication. A recent assessment for one person concluded their medication support could vary depending on their capacity on a particular day and it was safe for their medication cabinet to be stored in their bedroom with staff ensuring the safety of the medication cabinet. The person told us they were happy for this change and liked the cabinet being moved to their bedroom. Staff who were responsible for administering people’s medication had appropriate training and their competency was assessed annually. Medication audits were completed monthly by the registered manager and there have been no actions on recent audits.