Bradbury House - Care Home with Nursing Physical Disabilities

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 the 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 management team had a proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. The management team supported a culture of learning and continuous improvement. For example, the team had recently identified the Internal audits did not identify issues accurately, such as conflicting prescribing instructions, and missing incident reports. The registered manager used Gibbs'ReflectiveCycle with staff to support them examine the reasons behind this outcome, learn lessons from this and then put measures in place to reduce this reoccurring. Staff described feeling listened to and involved in shaping practice. A staff member said, “I do feel listened to, I have in the past made suggestions for how we can do things better for the people within our service and these ideas and recommendations have been taken on board.”

Systems were in place to ensure safe care pathways and transitions. Information was shared appropriately with relevant professionals to support continuity of care. Staff understood their roles in supporting transitions and followed agreed pathways. Staff worked collaboratively with healthcare professionals to respond promptly to changes in people’s conditions. A relative said, “It’s very well run by the manager and deputy manager who seem to be on the ball with most things and the senior staff are very helpful. If you need to go and discuss anything it’s done immediately. The nursing staff are brilliant and are always at hand if we have any concerns.”

Staff 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. When incidents occurred staff completed a full investigation and took a proportionate, balanced approach when dealing with them. Staff had training and a good understanding of what to do to make sure people were protected from harm or abuse. Records showed safeguarding incidents were investigated and lessons learned were shared with the team. Staff understood when Deprivation of Liberty Safeguards (DoLS) authorisations would need to be sought and what to do if there were conditions imposed.

Staff 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. Risk assessments were in place and assisted staff to identify how to mitigate risks. These were regularly reviewed to ensure they remained accurate and enabled staff to manage presenting risks effectively. Staff described how they worked in partnership with people, using shared decision-making to promote autonomy and positive risk-taking. People felt confident staff understood them and could support them to manage any risks posed.

The provider detected and controlled potential risks in the care environment. The provider had determined a full programme of refurbishment would be completed over the next year. People were supported to be as independent as possible within the environment. Environmental risks were assessed and addressed. They made sure equipment, facilities and technology supported the delivery of safe care and worked with external professionals to review people’s aids. The staff team knew who to contact when people might benefit from additional aids or equipment. Staff were trained to use any equipment people needed.

Staff worked together well to provide safe care that met people’s individual needs. Staffing levels ensured people were safe, but the management team had recognised increasing both the nursing team and support staff team would ensure people’s complex needs could be more readily met. Also, this would ensure if there was an emergency staff would be able to evacuate the building in a very timely manner. A staff member said, “There is not always enough staff on shift, which at times could be hard, especially if people are unwell. Due to the complexity of people’s health, in my opinion, there should be 2 qualified staff on each shift.” People confirmed there were always enough staff on duty. Recruitment practices were meeting requirements, and the new administrator had reorganised the files to show they clearly met the regulatory requirements. People were actively involved in recruiting staff. The provider promoted a learning culture and ensured staff had access to a wide range of training. Staff had received mandatory and condition specific training. Staff supervision sessions were completed in line with the provider's policy.

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. Staff followed infection prevention and control protocols, including appropriate use of personal protective equipment and regular audits.

Staff made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff who administered medicines had the appropriate training and competency checks. Storage areas were secure, and temperature checks were recorded. Medicine Administration Records (MAR) were accurate, and controlled drugs were handled in line with regulations. Regular audits were regularly completed. If any issues were identified action plans were implemented to address them, and staff were reminded of best practice. These practices ensured staff consistently managed medicines safely.