Brampton View 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 requires improvement. At this assessment the rating has changed to 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 fostered a proactive and positive culture of safety, based on openness and honesty and collective responsibility. Staff listened and reported concerns about safety and when things went wrong; these were investigated. Staff told us learning from incidents was shared with them in supervisions and team meetings. Records showed safeguarding referrals were made when required and action had been taken to prevent recurrence. Where required staff completed additional training to ensure they delivered safe care.

Processes were in place to investigate, analyse, and respond to accidents and incidents. A staff member told us, “We constantly get updates and information about changes to people's needs. It’s good because we should be helping people in the right way, like reminding the person to use their frame if they're likely to fall again.” This approach contributed to staff development and shared learning to continually identify and embed good practice.

People felt staff provided safe care. People’s information was monitored to ensure staff worked from accurate and current information. One person said, “I have no worries at all, and if anything was to happen, I know staff will come quickly.” Relatives were happy with the care provided to their family member.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, where safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Management and staff worked in partnership to ensure there was continuity of care when people moved between services.

The provider had effective and safe admission process in place. People, their family and if required health professionals were involved in the process to ensure their needs were assessed and care was planned. A relative said, “It's been a positive experience. We were involved in [Person name’s] assessment and the move. They answered our questions and listened to what [Person name] care needs were and planned for them. They have a care plan, and staff knew about [Person name] when they arrived.”

People’s information on the digital care system was kept up to date and was accessible to staff. For example, hospital transfer records were available including people’s medicines records and resuscitation decision documents. This helped to ensure people’s care was provided in a planned, responsive and coordinated way.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff received safeguarding training and understood their responsibility to protect people from abuse, discrimination, neglect, and when to report concerns. Staff used respectful language when describing people and their care needs.

There was a strong safeguarding culture across the service. Policies and procedures in relation to safeguarding adults and the Mental Capacity Act were accessible to staff, people and visitors to the service. People and relatives told us they felt safe with the staff and the care provided. One person said, “It’s safe for me because I am not alone; carers are around and I have my call bell all the time. I have no problems so there’s no reason to complain.” Relatives told us their family member was safe and had been informed if any concerns had arisen and the actions taken.

Systems were in place to record, report and act on safeguarding issues, and concerns were notified to the local authority and CQC appropriately. Management worked collaboratively with the safeguarding team to prevent recurrence. One relative said, “We know [Person name] is safe here. They have never been neglected, but quite the opposite; staff know and care for them in the right way.”

The registered manager and staff understood their responsibility under the Mental Capacity Act. Where required, people had a Deprivation of Liberty Safeguards in place and conditions were met in accordance with legal requirements.

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. Processes in place ensured risks to people were assessed, mitigated effectively, and monitored, such as risk of falling and developing pressure sores.

People were encouraged to be involved in their own risk assessments and were supported to make decisions about how risks were managed in their daily lives. A person told us, “Before I moved here, they asked me all types of questions, and I was happy with the care agreed for me. I have my call bell pendant and I'm able to move around my walker on wheels.”

Risk assessments covered areas such as mobility, nutrition and skin integrity. People’s care plans reflected their wishes and decisions made had been documented. Risk assessments and care plans were regularly reviewed using a digital platform to ensure they reflected people’s current needs. A relative said, “Staff know my [Person name] well. Each time their needs changed; their care plan and risks were reviewed with us.” Care plans provided clear instructions to enable staff to support people safely. For example, use of pressure relieving equipment and frequency of positional changes a person requires to prevent further skin damage. However, a person’s care plan for catheter care did not contain all relevant information and staff relied on the information in the catheter passport, used by healthcare professionals. There was no evidence of inappropriate care provided but the absence of clear guidance for staff increased the risk of inconsistent provision of care. This was raised with the registered manager and addressed immediately. Furthermore, a full audit was carried out to ensure people’s catheter care plans were completed fully.

Audits and observations helped to identify new risks and hazards, so these could be mitigated. Staff were able to describe how people living with dementia expressed pain or discomfort and the best way to support them, consistent with their care plan. Assistive technology was used such as sensor equipment to alert staff when people at risk of falling were moving around.

Personal emergency evacuation plans were kept up to date and were accessible to staff to support people safely in an emergency.

Staff were trained in topics related to managing risks such as moving and handling, using equipment, first aid and health and safety. We observed staff using equipment correctly to move people safely. One person told us, “I had lots of falls at home but not here, staff are doing good job telling me to use my walker and I use wheelchair when I am going out. It’s so much easier here and in this room because there is space for all that.”

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

The care home had been refurbished, which promoted people’s quality of life and safety, including for people living with dementia and sensory impairment. All areas of the care home were clean, with good lighting, clear signage and wide corridors free from hazards to enabled people to move around safely. Robust systems in place helped to ensure the facilities and equipment were safe, well maintained and supported staff to deliver safe and effective care. Regular checks were carried out to ensure wardrobes and other high furniture remained secured to the walls. Equipment used in the delivery of care was accessible and stored securely when not required. The contingency plan in place covered outbreaks, loss of power, fire and other emergencies.

People, relatives and visitors were complimentary about the décor, facilities and the overall environment. People and relatives had been involved in choosing the colour of their bedroom walls and new furniture. Comments included, “I love the way the home looks now; beautifully decorated, the furniture and the space, it's like living in a 5 star hotel every day” and “I feel very safe because of staff and because I can move around safely; not many care homes have large rooms like this.” A relative told us, “Love the refurbishment; looks stunning but it's about the care, which in my opinion from what I've seen, it's very good.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care that met people’s individual needs. Staff described the team culture as supportive and responsive. We observed staff were able to respond to people’s needs in a timely and coordinated way.

People told us there were enough staff available to meet their needs. One person said, “There's always staff around, sometimes, too many but all are very good.” Another person told us, “The staff can't do enough for you. If I need them, I press the buzzer, and they come within a minute or two.”

Relatives were complimentary about the staff, and they supported people without delay. One relative said, “Staffing levels are good, there's always someone around. The fact you may not see them all the time, is because they may be helping a resident, but if the buzzer goes off, someone will respond immediately.”

We received mixed feedback about staffing from some relatives and staff, but they all confirmed people’s needs were met. Staff told us the staffing numbers had increased in response to people’s changing needs and as new people were admitted to the care home. Staff rotas showed shifts were fully covered and included additional safety hours. People’s needs were kept under review to ensure staffing levels remained safe. Call bell response times were analysed and provided further assurances staffing numbers and deployment remained appropriate.

New staff, including nurses, were recruited safely. Staff completed induction and essential training to ensure they had the necessary skills for their role. Training to meet people’s specific needs, along with refresher courses ensured staff were confident to provide safe care.Staff competencies were assessed regularly. Nurses were supported to maintain their professional practice and knowledge. Staff were supervised and received feedback on their performance.

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.

People lived in an environment which was clean, hygienic, and free from unpleasant odours. A person said, “My room is cleaned every day and it’s spotless. Every so often they move the furniture and clean it from top to bottom.” Relatives shared similar feedback and one relative said, “It's clean and there's never any smells. Obviously when people have accidents, staff deal with it straight away with no fuss.” Another relative told us, “Laundry staff are great at labelling clothes if I get something new for [Person name].”

The provider had invested with new furniture and proactively identified when replacements were required. People who required a hoist to help them transfer, had their own slings. This helped to reduce the chances of cross contamination. Despite the increased occupancy, there was only one laundry staff. The registered manager assured us this would be reviewed.

The provider had an effective infection prevention and control policy and procedure, which staff had access to. Staff were trained and understood when to use and dispose of personal protective equipment (PPE), such as gloves and aprons. We observed staff practised good hand hygiene principles and used PPE to help prevent and control the spread of infection.

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.

Medicines were safely stored, administered and managed safely including the use and oversight of controlled drugs which require stricter controls. Medicines with a limited shelf life, such as liquids and creams, were dated when opened. People received their medicines from nurses and staff trained and assessed as competent. Audits and checks were completed regularly and where shortfalls had been identified, actions had been taken. Procedures were in place investigate any medicine related incidents and actions were taken.

People told us they received their medicine as prescribed. One person said, “After CQC’s last visit, my medications were sorted, and I am ever so grateful for whatever you said but all my medicines are now ordered on time and delivered on time. I still have control of them just with a lot of help with what I cannot do. So, medicines are improved 100%.” A relative said, “There is no problems with medicine, senior nursing staff are first class.” Another relative told us their family member had already taken their morning tablets but later found a small paper cup with tablets in the room. The registered manager assured us this would be investigated.

People were involved in managing their medicines where possible, and care plans clearly reflected the support they needed. This included clear guidance and protocols for staff to follow where people were prescribed ‘as required’ medicines such as pain relief. People’s medicines were regularly reviewed by external medical professionals as part of their ongoing health care support.