Brooke 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 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.

Lessons were learnt to continually identify and embed good practice. Staff knew what incidents to report and how to report them. The registered manager shared learning with staff through team meetings, supervision and staff communication channels.

The registered manager told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks along with themes and trends to ensure they could take appropriate action to mitigate these risks. A staff member told us, “When safety related events happen, we have staff meetings, more supervisions more training, and lesson learned are shared.”

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 initial assessment documents in place which covered all appropriate areas.

The provider had a robust admissions policy in place. The registered manager described how they assessed people to establish suitability and compatibility prior to moving in. Staff told us how people visited the home prior to moving in, 1 staff member told us, “Processes are in place to support people to view their new accommodation. We have a transition period to help them settle into their 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 told us they felt safe living in the home and staff knew how to protect people from abuse and who they would report any concerns to both internally and externally. The registered manager shared concerns appropriately by following the correct reporting process and informing all relevant agencies.

Where restrictive practices were in place we found restrictions were kept to a minimum. Where required Deprivation of Liberty Safeguards (DoLS) were in place to legally authorise, restrictions placed on people to keep them safe.

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.

Staff knew people very well and people told us they were involved in developing their risk assessments. People were supported to manage risk while maintaining independence and the service promoted positive risk taking. For example, people were assessed for risks of choking and risks relating to medical conditions.

The registered manager described a situation where they had collaborated with a person, their relative and healthcare professionals to ensure the least restrictive action was taken to support the person safely.

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

Health and safety and fire safety risk assessments were completed. The provider was checking hot and cold-water temperatures regularly. Temperature control is the traditional strategy for reducing the risk of legionella in hot and cold-water systems. They did not always record what action was taken when, for example, the cold-water temperature was out of the safe range. We spoke with the registered manager about this they assured us they would document this going forward.

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 registered manager had a training matrix in place which evidenced most staff had completed all their statutory and mandatory training and competency assessments to ensure they were able to meet people's individual needs. Staff had attended bespoke training relating to supporting people with a learning disability and autistic people. Where staff had not completed training, they were booked on to a session. The provider followed safe recruitment practices. Pre-employment checks were carried out to ensure appropriate vetting of staff.

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. Staff attended Infection Prevention and Control (IPC) training. We reviewed cleaning schedules which were consistently completed. People and their relatives told us the home was clean, and we observed this.

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

Staff received medication training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines. Staff supported and involved people to manage their medicines and followed best practice guidance for administering medicines. The staff team were proactive at reporting any changes to people’s medicines promptly.

People received their medicines as prescribed. Some ‘when required’ medicines protocols did not always include sufficient information to guide staff when and how to administer these ‘when required’ medicines. We spoke with the registered manager about this who was very responsive and immediately updated the ‘when required’ medicines protocols. Staff knew people well and were able to confidently describe how they would manage ‘when required’ medicines.

The registered manager told us, stopping over medication of people with a learning disability and/or autism (STOMP) plans were reviewed. They also shared with us an example of where recent medicines reductions had been made.