Bainbridge Court

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 Good. At this assessment the rating has remained 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 service had a proactive and positive culture of safety. Lessons were learnt to continually identify and embed good practice.

The manager and Positive Behaviour Support (PBS) team had oversight of recorded incidents to determine what actions were required and whether changes to people support needed to be made. Processes were in place to review behaviours of concern to protect individuals and others that may be affected. When there were incidents where people’s anxieties were heightened, the service had sought the input of its internal PBS team to review, learn lessons and provide additional guidance to staff.

Risks were not overlooked or ignored. They are dealt with willingly as an opportunity to put things right, learn and improve. Comprehensive risk assessments, which were regularly reviewed, supported staff to learn and mitigate risks to people’s wellbeing.

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.

The provider ensured this through a collaborative, joined-up approach to safety that involved them along with staff and other partners in their care. There was a strong awareness of the risks to people across their care journeys. Care and support was planned and organised with people, together with partners and communities in ways that ensured continuity. One professional said, “They were receptive to recommendations and suggestions.”

For example, the provider had followed a structured transition plan to safely support a person’s recent admission. Assessments and visits were completed at the person’s school, respite unit, and home, and completed in collaboration with the social worker. Transition calendars, involvement from the providers PBS (Positive Behaviour Support) team, together with visits to the home took place to ensure a safe, structured move. Case studies were completed, and support was put in place, for another person to clearly outline what they needed for a successful move into supported living. One support worker said of the transition of one person to the home, “She's made big progress. We said we need to be consistent. We started with her slowly until she started to engage.”

Staff had a good understanding of safeguarding and how to take appropriate action. Effective systems were in place to manage safeguarding risks. The provider had escalated incidents to relevant local authorities and CQC when needed.

Staff had the training and knowledge to ensure they could recognise when people may be unsafe and to identify potential signs of abuse. Staff understood processes for reporting these concerns. Staff understood people’s needs well which supported them in identifying potential areas of concern. One support worker said, “People have different ways of communication and because we know their routine, you can immediately see if anything is off.”

Staff and management worked within the principles of the Mental Capacity Act 2005 (MCA). 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 MCA. People were protected when issues around capacity had been identified. Mental capacity assessments had been conducted and recorded to determine whether they had capacity to make specific decisions about their care. Deprivation of Liberty Safeguards (DoLS) applications were completed appropriately and in people’s best interests with minimal restrictions. Where people had a DoLS in place, conditions to their authorisations were being met.

Risks to people had been identified and assessed. These risks were person centred and ensured that care plans had the information staff needed to manage and mitigate these risks safely.

Positive behaviour support was in place to manage risks when people communicated their distress due to their learning disabilities. Staff were provided with detailed person-centred guidance on what support to give and how to intervene when people displayed their distress. Risks to people’s health were mitigated and manged well. For example, detailed care management was in place to support one person with epilepsy. One professional said, “The staff demonstrated proactivity and were swift in implementing care plans and conducting risk assessments.” One relative said of staff’s approach to risk, “They are very good at looking after (her). She is completely safe wherever they take her.”

There was a balanced and proportionate approach to risk that supported people and respected the choices they make about their care. For example, specific risk assessments had been completed on activities people engaged in outside the home, so that they could participate in things that mattered to them.

Risks associated with the safety of the environment and equipment were identified and managed appropriately.

The provider detected and controlled potential risks in the care environment.

The provider made sure equipment, facilities and technology supported the delivery of safe care. Risks associated with the safety of the environment were identified and managed appropriately. Regular checks to ensure fire safety had been undertaken and people had detailed personal emergency evacuation plans. These informed staff of how to support people to evacuate the building in the event of an emergency.

The home was spacious and uncluttered and lent itself to a calming environment for the people who lived there. People were supported to use shared spaces as well as personalise their own rooms. The provider was in the process of developing a sensory room to meet the identified needs of two new people to the home.

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. One relative said, “They seem very hard working and know what they are talking about.”

New staff completed a full induction and probationary period. Staff complete a wide range of core training, while courses had been identified and provided to staff according to the needs of the people living at the home. These included learning disability, autism, communication tools, positive behaviour support and the Mental Capacity Act (MCA). The providers PBS Team provided person specific training to staff when people were admitted to the service. Competency checks and observations were completed to ensure that good practice and safe care continued. One support worker said, “Theres always training lined up. It’s targeted to what needs are in the service.” A team leader said, “It’s helped enhance so much knowledge. The needs are always changing so it's helpful to have ongoing training.”

Staff were consistently recruited through an effective recruitment process that ensured they were safe to work with people. Appropriate checks had been completed prior to staff starting work which included checks through the Disclosure and Barring Service (DBS). 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 service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff completed regular cleaning of the home, and we observed a clean environment throughout. Staff adhered to the providers policy on the wearing of personal protective equipment (PPE). They received training in infection control, health and safety and food hygiene training to support good infection control. Systems and processes were in pace to safely store, then dispose, of waste from the home. One relative said, “It’s always been tidy when we go in. They encourage (loved one) to keep his room tidy.”

Risks to people’s health had been assessed to identify, and manage, the risk of any health infections. We saw evidence to support the timely identification and support given to one person who had developed an infection.

The provider ensured that medicines and treatments were safe and met people’s needs, capacities and preferences. People’s medicines were managed, administered and stored safely. Staff had received training in medicines.

Staff used a digital system to record and monitor the administration of people’s medicines. The provider used this system in partnership with the local pharmacy to ensure continuity with the ordering process and accuracy of administration records. The manager stated that this was “an efficient and fluid system.”

The provider prioritised and focused on ensuring that medicines were prescribed and managed in line with their STOMP (STOMP stands for stopping over medication of people with a learning disability, autism or both with psychotropic medicines) policy. The management team held regular reviews with their PBS team to review restrictions (including medicines) and to reduce people’s need for these.

Detailed PRN protocols were in place for medicines which were prescribed on a ‘when required’ basis. Regular audits were carried out to ensure that medicine administration was effective, and to monitor stock levels and safe storage was appropriate.