Bywell House Care 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 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 and changes were made to reduce risks. For example, walking frames and side tables were moved away from lounge doors after the registered manager highlighted them as potential trip hazards. The registered manager demonstrated reflective practice and learning from previous experiences. They explained that face-to-face assessments were now always completed before admission to avoid unsuitable placements and ensure needs could be met safely. The registered manager said, “We have to act in the best interest of the residents and not put them in jeopardy.”

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. Transfer of care documents were available and contained essential information about people’s needs when moving between services, such as, to hospital or if a person required a nursing home. The registered manager told us if needed staff could provide full electronic care plans to the other services to promote a continuity of care. Prior to people moving into the service, staff obtained details from professionals to ensure the right equipment was in place and if needed referrals were made in readiness to support a smooth admission for the person.

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. Staff were confident in their responsibilities and knew how to act if they had concerns. A staff member said, “Any safeguarding concerns I would speak to [registered manager], if needed I could go to the top management. If outside the company I would go to CQC and social services. I could read the policy and go to the right people.” People told us they felt safe living at the service. A person said, “I feel safe in the knowledge I am here and people are here to look after me.” 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 policies were accessible and DoLS conditions were monitored and met.

The provider had not always worked well with people to understand and manage risks. However, staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. A person’s care plan did not include much detail in respect of diabetes management. However, staff had received effective diabetes training and knew how to recognise hyper and hypoglycaemic episodes; nurses also visited the person daily. The registered manager responded to our feedback and updated the person’s care records during the inspection process. Other risks were assessed and managed well, for example, people’s mobility needs and risks in relation to skin integrity. A relative commented, “100% [person] is safe as staff are always around. I've seen them as soon as a resident gets up they are right there to help them. They are very much in the background but there if anyone wants anything.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. A programme of maintenance was in place to update and upgrade areas of the service. A relative said, “The home is old but clean and homely. Maintenance issues are dealt with immediately.” Another said, “I can't praise them enough. I can't think of a negative, don’t judge a book by its cover, the outside is not so pretty but the care inside is second to none.” Fire safety risk assessments had been conducted and staff training included day and night evacuation drills. Personal emergency evacuation plans (PEEPs) were up to date and available should emergency personnel need to access them.

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. There were enough staff to meet people’s needs. Staff training had improved following recent changes to training systems. The registered manager told us, “I am proud of the team for completing all training and working together.” The staffing team was consistent and the service had not needed to deploy agency workers. A relative commented, “There always seems to be plenty of care staff. They know people well and treat them as individuals.” Recruitment processes included pre-employment checks, new staff completed an induction before starting work.

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. Housekeeping staff worked hard, the service was clean. A person commented, “It is clean here, no complaints.” A relative said, “Any mess or anything, they are on it. The cleaning staff work hard.” Infection prevention and control (IPC) audits were completed with no outstanding actions. We observed staff followed the provider’s IPC policy during mealtime support, care and medicine administration by using personal protective equipment (PPE) appropriately and practicing hand hygiene. People were supported to wash their hands before mealtimes.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines were managed safely and in line with best practice. Staff used the electronic Medicines Administration Record (eMAR) system effectively and audits were conducted to ensure compliance. We observed a medicine round to be person-centred, with staff explaining medicines during administration. A professional commented, “Since the new management, medication is stored correctly and care plans are followed.” People told us they were supported with medicines in a way that met their needs. A person said, “They give me all my medications. They do everything well.” Staff also described their approach to safe practice. A staff member said, “Training all completed for medication, I have done the updates too, I’m updated 6 monthly. I have been watched (by the registered manager) to make sure I give it properly.”