Bracknell 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.

This is the first assessment for this service since registration. 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems were in place to ensure accidents and incidents were reported, investigated and action taken to minimise risks going forward. The registered manager told us they worked in a no blame culture where staff were encouraged to be open and transparent when accidents and incidents occurred. Investigations following incidents were completed quickly to ensure any issues were addressed in a timely way. Staff were involved in finding solutions to any concerns and lessons learnt shared in a variety of ways including in handovers, during staff meetings and through displaying written reminders for staff to refer to.

Accidents and incidents were monitored to identify potential themes or trends. Where an increase in minor skin tears was identified, additional moving and handling training was provided and clear direction around specific incidents shared with staff. The provider had a duty of candour policy in place. The duty of candour is a legal and professional obligation for health and social care professionals in the UK to be open, honest, and transparent with people or their relatives when something goes wrong that causes or could lead to harm. It requires an apology, a prompt explanation of the event or incident. Records showed this was followed, investigations shared with people, and apologies provided as required.

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 told us they were supported well when they needed to be admitted to hospital or attend appointments. One person told us, “A carer comes to all my hospital appointments with me.” They went on to say this made them feel cared for and reassured.

Systems were in place to share information between services to ensure continuity of care. A protocol and checklist was in place to ensure the correct information would be shared with the ambulance and hospital team should people be admitted to hospital. This included information regarding the persons medical history, medication, contact details, communication needs and things which were important to the person. Checks were completed prior to people being discharged from hospital, so staff were aware and equipped for any changes in their needs.

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 at Bracknell Care Home. One person told us, “I feel comfortable and safe here.” A second person told us the skills and knowledge staff had regarding both their health and care needs which made them feel safe and well cared for.

Staff received safeguarding training and were aware of their responsibilities to report any concerns. They were able to share the different types of abuse they should be aware of and signs of concerns to be vigilant for. One staff member told us, “We are always encouraged to speak out and to report anything we see as not being appropriate.”

Records showed that concerns were reported to the local authority as required. Where additional information was requested, this was detailed and provided promptly.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. Processes had been established to ensure people’s rights under the DoLs were protected. Where restrictions to people’s freedoms were in place, DoLS applications were submitted in line with requirements. A DoLS register was maintained which enabled the registered manager to monitor applications and approvals and to submit re-applications as required.

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.

People told us they were involved in managing risks to their safe care and treatment, and records reflected people and their relatives were fully involved in discussion regards their care. The registered manager and clinical team ensured there was a multi-disciplinary approach to people’s care which ensured people’s complex health needs were closely monitored.

Staff were aware of the support people required to maintain their safety and wellbeing. Records contained detailed guidance regarding the support people required to reduce risks and support their health whilst respecting their personal preferences. Information was available around people’s specific health conditions to ensure staff were able to identify and act upon and changes in people’s condition.

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 provider had robust systems in place to maintain the safety of the environment. These included ensuring equipment was regularly serviced, water safety checks completed and fire systems monitored in line with requirements. In addition, staff completed regular visual checks of equipment such as hoists and wheelchairs.

Maintenance issues were recorded and addressed promptly to minimise risks. There was an on-going schedule of refurbishment throughout the home. At the time of our assessment, work was underway in the garden area to ensure this was a safe and welcoming area for people to use in the warmer weather. People told us they enjoyed this aspect of the home and had spent much of the previous summer in the garden.

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.

People told us they felt staff were skilled in their roles and they did not have to wait for their care. One person told us, “They are very well trained. They know what they are doing.” A second person said, “I do have a call-bell, and they do come fairly quickly.” We observed staff had time to be with people and call bells and requests for support were responded to promptly.

Staff told us they felt there were sufficient staff and they did not need to rush people’s care. One staff member told us, “We have the staff we need, and we are a team together which makes things easier and more relaxed for everyone.”

Staff received training in their roles and told us they found this useful and relevant. In addition, staff took advantage of external training events offered by the local authority and care support partners to further inform their practice.

Safe recruitment practices were followed to ensure fit and suitable staff were employed to work at the service. Staff files contained evidence of recruitment checks including application forms where gaps in employment were explored, references from previous employers, right to work and identity checks being completed. In addition, Disclosure and Barring Service (DBS) checks were in place for all staff. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

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 told us they felt their home was clean and that staff kept them safe from the risk of infection. One person told us, “They wear plastic gloves and aprons when doing my personal care. My room is cleaned every day.”

Staff had completed infection prevention and control training to inform them of good practice. Personal protective equipment was available around the home, such as gloves and aprons. We observed these items were disposed of safely. The home was cleaned to a good standard with regular infection prevention and control audits completed.

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.

People told us they received their medicines in line with their preferences and had confidence in the way staff supported them. One person told us, “The medication comes as prescribed. There is a routine which they stick to.”

Medicines were stored securely and storage temperatures recorded daily. Medicines were administered by trained staff who had completed up-to-date medication competency assessments. Staff followed the home's medication policy and received annual refresher training.

Medicines rounds were unhurried, and staff were observed checking Medication Administration Record (MAR) charts carefully before administering medicines. MAR charts were completed accurately, and evidenced people received their medicines as required. Where medicines were prescribed to be administered as and when required (PRN), protocols were in place to guide staff on their safe administration.

Regular audits of medication practices were carried out by the management team. Where issues were identified, action plans were put in place and followed through to completion.