Brailsford 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

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.

The provider was previously in breach of legal regulations relating to safe care and treatment and safeguarding. Improvements were found at this assessment, and the provider was no longer in breach of these regulations.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager ensured the service had a proactive learning culture. Staff raised any concerns about people’s safety and wellbeing with management, and these were investigated and shared with other agencies when appropriate. Lessons were learned from accidents, incidents and complaints and shared with staff to reduce the risk of future incidents. Where shortfalls in staff practice or processes were identified, these were addressed appropriately, to ensure people lived in a safe environment and received care which reflected good practice.

Leaders ensured there were effective systems in place to monitor and manage people’s safety. A pre-admission assessment was completed, and people were encouraged to visit the service before they moved in; to ease their transition into the service and ensure staff were able to meet their needs safely. When people needed specialist support or equipment to live safely, referrals were made to community health and social care agencies. Staff worked well with these agencies to ensure people received the care they needed to maintain their safety. Staff were updated when there was a change in people’s needs or risks.

The provider had systems to ensure people were protected from the risk of abuse, neglect and avoidable harm. Safeguarding incidents and concerns were managed appropriately. They were investigated by the registered manager, and action was taken when necessary to keep people safe and reduce future risks. Incidents were reported to the local authority and CQC when appropriate. Staff completed safeguarding training and could explain the action to take if a person was experiencing or at risk of abuse or neglect. No one we spoke with raised any concerns regarding neglect or abuse.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalfof people who may lack the mental capacity to do so for themselves. The MCA requires that, asfar as possible, people make their own decisions and are helped to do so when needed. Whenthey lack mental capacity to make decisions; any made on their behalf must be in their bestinterests and as least restrictive as possible. People can only be deprived of their liberty toreceive care and treatment when this is in their best interests and legally authorised under theMCA. 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 that people were supported in line with the Mental Capacity Act 2005. People’s capacity to make decisions about their care was assessed and when they lacked the capacity to express their views, their relatives or representatives were consulted to ensure any decisions made were in their best interests. When people were being deprived of their liberty to keep them safe, appropriate authorisation had been requested.

The registered manager ensured risks to people’s health and wellbeing were managed well, by providing people with safe, supportive care that reflected what mattered to them. People and relatives told us staff provided safe care. They commented, “I feel very safe here. They are very nice and will do anything to help you. Nothing is too much trouble” and “They [staff] make sure when you are walking around that you are safe.”

People’s care plans and risk assessments included detailed information about their needs and risks to guide staff on how to support them to manage their risks and live as safely as possible. People’s needs and risks were reviewed regularly and their documentation updated if there were any changes. Staff received updates when people’s needs changed, which helped to ensure people continued to receive appropriate care.

The home environment needed improvement, and an improvement plan was in place. During our first visit we identified some minor improvements which were needed to ensure the service was safe and suitable to meet people’s needs, and these were completed prior to our second visit. A number of improvements had recently been made to the environment, with further work planned, including replacing flooring and furniture.

Checks of the safety of the home environment, such as equipment, water and fire safety, were completed regularly, which helped ensure people were protected from the risk of avoidable harm.

Improvements were needed to ensure staff completed the training necessary to meet people’s needs and keep them safe. Records showed two newer staff members had not completed all the provider’s mandatory training, and three staff members’ training was out of date or overdue. We discussed this with the registered manager who advised this would be addressed with staff.

The provider ensured staffing levels were appropriate. Most people and relatives were happy with staffing levels at the service and told us support was provided when it was needed. They commented, “I think there are enough staff. There always seem to be staff around in the lounges and corridors. They are the same staff and that makes me feel comfortable” and “You only have to ask and they attend to you. They come almost instantaneously when you call.” Staff felt staffing levels were appropriate to meet people’s needs and keep them safe.

The registered manager ensured staff were recruited safely. Appropriate pre-employment checks were completed to ensure new staff were suitable to support people living at the service. Staff received regular supervision and yearly appraisals when their performance was discussed, and they could raise any concerns.

Leaders ensured people lived in a clean environment and were protected from the risk of infection. We found the service environment clean, and people and relatives told us they were happy with standards of cleanliness. A person commented, “They are always cleaning and keeping everything clean and tidy. I have clean bedding and towels.”

Staff completed infection prevention and control (IPC) training, and we observed them adopting safe IPC practices during our assessment.

Leaders ensured people’s medicines were managed safely, in line with national guidance. Staff had completed appropriate medicines training and were assessed regularly to ensure they were competent to administer people’s medicines safely. People told us they received their medicines when they should. One person commented, “I get my medication, I have it after breakfast. I think it’s all alright. If I have a headache they give me paracetamol. They do care.”