Bourne House Nursing 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 newly registered service, following a change of provider. This key question has been rated Good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a positive culture that promoted learning and improvement. Systems were in place to review incidents, accidents and complaints, with learning shared through daily management meetings, weekly clinical risk meetings and serious incident reviews.

Most staff described managers as supportive and said they felt able to suggest changes and contribute to improvements in care delivery. The registered manager promoted an open-door approach and described encouraging staff to raise concerns through management channels and whistleblowing processes. Relatives consistently told us concerns were dealt with promptly, and they were able to suggest improvements to improve care.

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 received coordinated care which involved healthcare professionals and supported continuity of care. Staff told us they had positive working relationships with a range of health and social care professionals. Care records contained personalised information and risk assessments, and people’s needs were reviewed through monthly resident reviews. Relatives told us they were informed promptly when people experienced falls, changes in health or hospital admissions. One relative explained, "They immediately ordered a new bed and put safety matting around it, plus reconfigured the furniture to remove any risks following a fall.”

Health and social care professionals described the service as collaborative and responsive, stating communication with external agencies was timely and professional.

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 were protected from the risk of abuse and avoidable harm. Managers and staff had received safeguarding training and understood how to identify and report concerns. Staff said they felt safe raising concerns with managers and knew safeguarding procedures. Relatives consistently told us their relatives felt safe in the home. There were systems to monitor incidents, falls and risks, and safeguarding concerns were discussed with external agencies when required.

Applications had been made for Deprivation of Liberties Safeguards (DoLS) in a timely manner and best interest decisions were documented. DoLS protect the human rights of people who cannot consent to care that restricts their liberty.

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 and those important to them were involved in managing risks and supporting safe care. Risk assessments were in place for areas including nutrition, bed rails, mobility and swallowing difficulties and were reviewed when people’s needs changed.

Staff demonstrated an understanding of individual risks and relatives gave examples of risk management measures being implemented following falls and changes in health needs. The provider used dependency tools, electronic monitoring systems and monthly reviews to assess changing levels of support.

During observations, people were encouraged to remain independent and staff supported them safely at their own pace. A relative told us, "The staff tend to watch [person] carefully now, which is good". Relatives were kept informed and involved when decisions were required.

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 premises were safe, and appropriate systems were in place to monitor equipment and environmental safety. Safety certification, fire checks, water testing and maintenance records were available and current. Secure entry systems, coded stair gates and monitored call bell systems supported people’s safety.

Relatives spoke positively about environmental safety and security. One relative said, "The security arrangements are pretty good.”

However, we observed a stairgate was unlocked, and exposed electrical cables were identified in a storage area. These issues were immediately shared with managers, who acted during the assessment to address the risks.

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 were supported by caring staff who understood their needs, and observations showed positive interactions between staff and people using the service. Relatives often told us staff were kind, responsive and quick to provide support. One relative said, "The staff go out of their way to make sure [my relative] is safe.”

Staffing levels were monitored through dependency tools and managers could request additional staffing when required. The provider had vacancies in care and housekeeping roles and relied on bank and agency staff to maintain staffing levels.

The provider had systems in place for supervision and professional development. Staff told us, “The training is good. We have opportunities to learn and become trainers ourselves.”

However, the provider had not ensured appropriate oversight of externally commissioned agency staff working within the home by ensuring they obtained agency compliance records. This was discussed during the assessment, and managers took action to rectify this.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

Systems were in place to support infection prevention and control, and staff demonstrated good practice during observations. During lunch, staff disposed of clinical waste appropriately, supported people’s hygiene needs respectfully and maintained infection control measures.

Relatives described the home as clean and well maintained. However, we observed environmental concerns which could affect the consistency of infection prevention and control arrangements. We found that some communal bathrooms required cleaning or refurbishment, and one bathroom was out of use awaiting this. Although infection, prevention and control audits had identified these issues, the required improvements had not been completed at the time of the assessment. These findings demonstrated infection prevention and control processes were not always effective and timely.

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 managed safely and people received their medicines as prescribed. Medicines were stored appropriately, including controlled drugs and refrigerated medicines, with stock checks and temperature monitoring completed.

Staff had received relevant training, including syringe driver training, and medicines administration. The deputy manager completed medicines audits and systems were in place to identify areas for improvement.

Relatives consistently reported confidence in how medicines were administered. One relative said, "They are very on top of the fact that my [relative] medication has to be taken at specific times.”

Although medicines audits identified actions relating to completing competency checks and updating records, these actions were not routinely reviewed to ensure they were effective and timely. Overall, medicines management processes supported people to receive safe care.