Bassett 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 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 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.

The provider operated a system to ensure incidents and accidents were recorded and shared with the registered manager. If the incident was serious or had caused injury, staff added a ‘flag’ to the record to make sure management were aware and could act to prevent a recurrence.

Management analysed incidents checking for any patterns or trends. Learning was shared with staff and where needed. For example, if needed staff had been provided with further training.

Staff told us there was a focus on learning from events, to help ensure the service improved so that incidents did not happen again. Staff said investigations were completed by managers and prompt action was taken to update care plans where needed.

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.

For people who had frequent hospital visits, care planning documents demonstrated a joined up working approach. For example, we found professionals had shared a person’s digital record with the provider which highlighted developing health concerns. This meant all relevant professionals worked together to implement a dynamic care plan for a person to support them with their complex healthcare requirements. If attending hospital was necessary, the person and their needs would be known to hospital staff prior to arrival.

For other people we found they had a transfer to hospital document in their file for emergencies. This record provided hospital staff with information on people’s needs such as communication and important medical information such as allergies.

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.

Staff demonstrated a comprehensive understanding of their safeguarding responsibilities and said they completed regular safeguarding training. Staff were confident managers would act if they reported safeguarding concerns and knew how to raise concerns outside the organisation if they needed to.

The registered manager was confident staff had the knowledge needed to identify and report potential safeguarding concerns. They said, “Staff are trained well in safeguarding, and we genuinely have an open-door policy. If they have concerns, they report them.”

All safeguarding concerns had been reported to the local authority and notified to CQC where needed. The registered manager had strong links with the local authority safeguarding teams and worked in partnership to resolve any concerns.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. 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 staff were working to the principles of the MCA and had applied for DoLS authorisations appropriately.

Where DoLS had been authorised, staff made a note of any conditions in people’s care records. Action had been taken to meet those conditions.

People told us they felt the service was good, they knew the staff and felt able to raise any concerns if needed.

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 assessed risks to people’s health, safety and welfare and action taken to manage those risks. For example, people at risk of developing pressure ulcers had a support plan and risk assessment in place. Where needed, advice had been sought from skin integrity professionals to ensure staff had all the guidance and equipment needed to provide safe care. People being cared for in their rooms had increased checks on their safety and welfare. People at risk of malnutrition or choking had modified diets and staff had contacted dieticians or the persons GP for guidance. Staff recorded care and monitoring checks on the electronic care plan system.

Staff demonstrated a comprehensive understanding of the risks people faced and how to support them safely. Staff told us risk assessments were regularly reviewed and updated as people’s needs changed. Staff said they had immediate access to updated plans through the electronic care planning system and were notified of any changes.

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 was completing a refurbishment of the service which included adding kitchenettes for people to use. These areas were free from any hazards and clean. The provider had a refurbishment plan and risk assessment in in place. Staff ensured these areas were kept clean and tidy whist work was in progress.

The provider had a schedule to ensure all equipment such as call bells, hoists and slings were serviced. There was a system to flag if equipment was not safe to use and we saw staff had clearly labelled any equipment awaiting repairs. This decreased the risk staff would use the equipment before it was repaired and deemed safe.

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.

Records showed staff received a range of training to help them undertake their roles safely and effectively. Topics included safeguarding, first aid and fire awareness, and additional learning related to people’s needs, such as nutrition, wound healing and reducing health inequality. Records showed nursing staff had competed training to enhance their clinical skills. One staff member told us training was provided from various sources and delivered in different ways to add interest. They said interactive learning and training from other health care professionals was beneficial.

Staff received meetings with their supervisor to discuss their roles, and there were regular informal discussions. This enabled an open, supportive culture and staff confidently raised any queries or concerns. Records showed staff were recruited safely and had a detailed induction upon employment at the service.

Most staff felt staffing levels were suitable to meet people’s needs. The registered manager told us there was an on-call system for staff to ring if there was short notice sickness. The service did use an agency to cover gaps in staff rotas, however, the registered manager said they were in the process of recruiting some ‘bank’ staff. This would help cover staff sickness and holiday and would provide improved continuity of care for people.

People and relatives said there were enough staff available and felt staff were trained. One person said, “I think there is enough staff around, they are adequately staffed. Service is not delayed.” Another person said, “The staff are trained and they understand my condition.”

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. Despite the work ongoing at the service for the refurbishment, the service was visibly clean.

We observed staff following infection prevention and control (IPC) practices, including wearing gloves and aprons when needed.

The provider had various policies and procedures to give staff guidelines on IPC. Prior to our inspection, there had been a respiratory outbreak at the service. The registered manager had informed the correct agencies and acted on their advice. Safe procedures had been followed, such as isolating infected people and increased handwashing.

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.

At the last inspection we identified medicines administered to people covertly were not always accurately recorded. The provider had addressed the shortfall and was no longer in breach of legal regulations. Systems to support people with covert medicines were now being followed consistently. Records demonstrated people only received their medicines covertly where they lacked capacity to consent and the best interest decision making process had been followed. Relevant people had been involved in these decisions, including checking with a pharmacist that the medicine was safe to be mixed with food or drink.

Staff received training in the safe management of medicines, and a manager regularly observed practice to ensure staff were competent and supporting people safely. Staff kept accurate records of the medicines people had been supported to take. People who needed time specific medicines were supported in line with the prescriber’s instructions. Staff told us medicines systems worked effectively, and they were able to meet people’s needs.

People and relatives said they were satisfied with how staff managed people’s medicines.