Britannia Lodge

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. This is the first assessment for this service registered under a new provider. This key question has been rated 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. The registered manager understood their responsibility under duty of candour to be open and honest, to share information with relevant stakeholders about safety concerns. This included notifying the relevant authorities and keeping people and families informed. Staff listened to concerns about safety and investigated and reported safety events. The registered manager fully investigated concerns and kept a log of any accident, incidents or safeguarding concerns as investigations progressed and analysed for any themes or changes needed to support people safely. Lessons were learnt to continually identify and embed good practice. Lessons learned and necessary adjustments were shared with staff through staff meetings and supervision.

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. Before people moved to the service the registered manager completed a full assessment of their needs and met with them, their family and relevant health professionals involved in their care. This was to ensure people’s needs could be met safely by the service. People’s preferences for care were recorded including, how they wished to be supported and their likes and dislikes. This was frequently revisited with them in case their preferences or needs changed. If a person needed to be transferred to hospital in an emergency, there was a handover document with all important relevant information that could be shared with other health professionals to help with continuity of care.

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 had received training in safeguarding and knew how to safeguard people and raise concerns. One member of staff said, “If I had concerns, I would speak to the manager and if I was still not happy, I would report externally. We have all the numbers to call and know how to ‘whistle blow.” We saw guidance around the service on how staff can raise safeguarding concerns externally and the registered manager had policies in place to support this. The registered manager shared concerns quickly and appropriately with the local authority and worked with them to investigate concerns to keep people 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 them to do the things that mattered to them. Staff identified risks to people and put safeguards in place to mitigate these risks. For example, if a person was at risk of pressure ulcers staff ensured they had all the correct equipment in place to minimise this risk. People were supported to live full lives and this included going out into the community safely with staff or relatives. Risks associated with this were assessed and steps put in place to lessen these risks. Where one person had a preference to smoke cigarettes staff had taken steps to ensure they did this safely to lower the risk of injury. This had included using a cigarette holder while smoking and use of a fire blanket. With staff support this person was able to continue to smoke safely and independently.

The provider detected and controlled potential risks in the care environment. There was work underway at the service to add additional space and improve the environment for people. Whilst this work was underway the registered manager had a risk assessment in place to identify and manage potential risksthat could arise during the improvement works. The provider shared improvements which were planned over the next 12 months to update the service. The registered manager completed environmental checks at the service and ensured equipment in use was in good order and regularly serviced. Safety certificates were up to date for gas safety, legionella, water temperature testing, hoists, lift and fire equipment testing.Staff had received training in fire safety and each person had a fire evacuation plan in place to safely evacuate them from the building. The provider had a business continuity plan in place should there be any disruption to the running of the service.

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 told us they had fully recruited staff and did not need to use agency. This meant people were supported by staff who knew them well and offered continuity of care. We observed people had good relationships with staff who knew their social and well-being needs. One person said, “I have a buzzer to use when I need staff, and they come in and check on me.” Another person said, “The staff are very good, we go out a lot to different places for fresh air.”

The registered manager had robust recruitment practices in place including checking applicants provided a full working history, references and undertook a disclosure and disbarring check (DBS). DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

When staff first started working at the service, they underwent an induction, which included shadowing more experienced staff who could mentor them. Staff completed training both on-line and face to face. Staff new to care completed the Care Certificate a national recognised set of care standards to provide staff with the skills and knowledge they need to work in the care industry. The registered manager monitored new staff during their probation period and met with them regularly to see how they were progressing.

Nurses at the service were supported to re-validate their registration. This meant they were supported to keep their skills and knowledge up to date and were legally able to continue to hold their nursing registration. One nurse told us, “I keep a file for evidence of revalidation which has all my training evidence, and I keep up to date with on-line training provided by the Royal College of Nursing.”

There was a system in place for all staff to receive regular supervision and meetings were held to share updates and discuss the general running of the service.

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 had received training in infection prevention and control (IPC). IPC audits were completed by the registered manager to ensure IPC was being implemented correctly to prevent the risk of the spread of infections. Staff had personal protection equipment (PPE) and used these appropriately.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were supported to have their medicines by staff who were suitably trained and skilled to administer medicines. Staff had their competency checked regularly to ensure they were using safe practices. Medicines policies were in place to support the safe administration of medicines and the medication records we reviewed were in good order to support the management of medicines. People told us they received their medicines when they needed them and had reviews with the appropriate health professionals.