Branksome Heights

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

At our last inspection the service was rated good. At this assessment, the rating has remained good.



People received safe, effective care that met their needs. The service had a culture of respecting people as individuals and treating them with kindness, compassion and dignity. Staff were supported by leaders who understood the responsibilities of their role.

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's quality assurance surveys reflected that people and relatives were confident the service would listen to, and act on, concerns and complaints.

Staff told us they knew how to raise concerns with the registered manager and felt confident they would be treated with compassion and understanding. One staff member told us, “If an accident happens, the emergency bell goes and everyone has to attend. That's the first protocol and management are on that response as well. Everything is documented on the electronic system by a carer or whoever is at the scene. They would document exactly what happened.” Another staff member said, “The nurse on duty or senior staff also document what they did, and it automatically sends the incident to be reviewed by the registered manager. We would look at an incident root cause and take any actions, update the care plan, if they need a sensor mat and update the falls risk assessment.” Staff took part in regular individual and group supervisions to ensure lessons were learned from safety incidents or complaints, resulting in changes to help prevent a recurrence.

There was a relaxed atmosphere at the service; people were at ease with staff and each other. Staff knew people well and were responsive to early signs of upset or distress. There were posters around the building with details of how to report actual or suspected abuse.

Health and social care professionals were complimentary about the service and the registered manager. One health and social care professional told us, “The registered manager consistently demonstrates a well-led, effective, and safe approach to care, and serves as a trusted and supportive peer to others across the sector.” Another health and social care professional said, “Speaking with the residents, they are very happy living at Branksome Heights and feel very well looked after.”

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People and relatives described feeling they and their family members were safe from harm. Comments included, “Staff are lovely”, “Everybody is lovely” and “The staff are very nice.”

Staff ably described signs that might alert them to abuse. They understood how to report these. The registered manager and operations manager confirmed training about safeguarding children had been made compulsory for all staff.

There was a relaxed atmosphere at the service; people were at ease with staff and each other. Staff knew people well and were responsive to early signs of upset or distress. There were posters around the building with details of how to report actual or suspected abuse.

The service had a clear overview of who was deprived of their liberty and when people's existing DoLS authorisations were due to expire. The management team applied to the appropriate authority for authorisation of any deprivations of liberty. They monitored any conditions of authorisation and ensured these were met. The service's continuous improvement plan addressed how it would meet its obligations under DoLS, by ensuring people's care plans continued to describe any conditions specified in DoLS authorisations. There was a high completion rate for staff training in safeguarding adults and about the Mental Capacity Act 2005 and DoLS. Policies in relation to safeguarding and personal/sexual relationships upheld people's human rights. They referenced current legislation and good practice and clarified circumstances in which safeguarding adults referrals would be required.

People told us they felt safe and happy at Branksome Heights. For example, someone said, “I feel very safe here.” Another person described how staff had supported them to be safe yet active when they were experiencing mobility difficulties: “I can go [out] on my own now… At first, I couldn’t go on my own and staff always came with me.”

The management team and staff had detailed knowledge of people's individual risks and how they should support people to manage these. Care staff confirmed they had been able to read people's care plans.

People received assistance to manage risks in ways in a way that was acceptable to them. For example, a person lost weight through having a weight reducing diet. There was no loss of their enjoyment in food, and they became much healthier, requiring fewer medicines.

In staff surveys, staff reported their experience of effective communication about people's needs, and that they were kept informed of any changes.

Care staff had access to people's risk assessments and care plans through handheld devices they kept with them as they worked. Staff provided the support people needed to help them feel safe and comfortable.

People's individual risks were assessed and reviewed as part of their comprehensive individual assessments.

The service's continuous improvement plan addressed how the service would continue to manage risks safely and effectively. This included behaviour that challenges, swallowing difficulties, pressure ulcer risk, malnutrition, and epilepsy.

The continuous improvement plan also addressed the ongoing safe use of bed rails. These were used only where risk had been assessed and with the person's consent or in their best interests.

The service had a clear, comprehensive service continuity plan.

The service's policy for behaviour that challenges upheld human rights. It referenced Positive Behaviour Support principles. Positive behaviour support is a person-centred framework for supporting people with a learning disability or mental health needs, or autistic people, who display behaviours that challenge. It was consistent with the restraint policy, which was also centred on people's human rights and followed Mental Capacity Act 2005 principles.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

In quality assurance surveys, people and relatives reported their confidence in the abilities of staff. They said there were enough staff to provide care promptly.

People and relatives told us there were plenty of staff on duty and that they did not have to wait a long time if they pressed their buzzer for assistance. Comments included, “Staff are well trained to meet [person's] needs… They are walking up and down the corridor all the time” and “The carers are all very good. They know what they’re doing… If you press the buzzer, they come in a few minutes.”

Staff surveys reflected that staff had received suitable training, including an induction, and that they felt well supported.

Staff told us there were enough colleagues on duty to work safely and effectively.

Staff confirmed they had the training they needed to perform their roles effectively. They also said they felt well supported through supervision meetings with senior staff and ongoing informal conversations with the management team.

In a March 2024 survey, health and social care professionals who had contact with the service praised highly the abilities of the staff and the care they gave. They reported enough staff on duty to provide the care and support people needed.

Staff worked competently and calmly, in an organised manner. People responded to them in a way that indicated this was routine.

Staff answered call bells promptly.

Staff demonstrated good practice in hand hygiene, moving and handling, and in the way they communicated with people.

The training plan reflected a range of face to face, and online seminar, training. This included key safety topics such as moving and handling, fire training, emergency first aid, and basic life support.

Staff new to the service received an induction that included basic training and shifts observing an experienced colleague.

Staff rotas reflected staffing levels that enabled staff to provide safe, effective care, day and night.

The service's training matrix, which summarised all staff training received, reflected a high rate of training completion in key topics. This included autism, and dementia awareness.

People told us they thought the service was clean. One person said, “The cleanliness here? I can't fault it. It is second to none. They do a daily clean of your room and every 3 months they tell you in the morning you're in for a spring clean and they do, move all your furniture, get the machine on the floor, everything.” Another person told us, “Staff are always around, cleaning this, sorting that. Staff are very good here.”

The March 2024 survey reflected 100% agreement amongst residents and relatives that the home was kept clean, with positive comments about this. Responses to the survey under way during the inspection were similarly positive. People and relatives told us they were pleased with the cleanliness of the home. Comments included, “[Person's] room is cleaned regularly” and “It’s a very clean, welcoming place.” Staff surveys reflected that staff found the home to be clean, tidy and free of odour. In their March 2024 survey responses, health and social care professionals gave positive responses and comments about the cleanliness and fresh smell of the premises.

The premises were clean and smelt fresh.

Corridors, toilets and communal areas were clean and bright. Toilets had cleaning checklists clearly visible, noting when they were last cleaned.

Staff used personal protective equipment correctly.

Hand hygiene facilities were readily available to staff. Alcohol hand gel stations were replenished as required.

People had individualised infection control risk assessments. The provider completed regular health and safety audits of the premises. Staff completed relevant training. During the inspection we observed staff had completed some cleaning records ahead of time. We also observed some food items were opened and not labelled to indicate when they should be discarded. In response to our feedback the registered manager investigated and undertook supervision sessions with relevant staff.

People told us they were happy with the medicines support they received. One person said, “They are very good with my tablets, bring them all to me ready, I don't have to worry here. Everyone is lovely, a family really.” Another person told us, “It's a big change but I don't have to worry any more, the care staff do everything for me, all my tablets and that. They seem nice, I've no complaints so far it's just very different being in a care home.”

We observed people receiving their medicines safely. Staff knew people well and were aware of protocols for medicines given ‘as required’ (PRN). We observed staff members checking with people in case they needed their PRN medicine. Staff spoke with people in a kind manner, knocked on their bedroom doors before entering and gained consent before medicine administration. The service had recently introduced an electronic system to support staff with safe medicine administration, which significantly reduced the risk of a medicine related error occurring.

Staff handled medicines safely. They locked unattended medicines cabinets when giving people their medicines. Staff gave people the time and explanations they needed about their medicines. They also asked people if they were in pain or checked for signs of pain if people were unable to say.

Medicines were recorded on a computerised system, which flagged up if medicines had not been administered as prescribed. However, on occasions where they did not administer medicines staff recorded the reason why, such as the person not wanting them.

There were instructions for staff regarding when and how to administer medicines prescribed as needed. These stated the maximum dose in any 24 hours, and when staff should seek further medical advice.

Where people who lacked the capacity to make decisions about taking medicines required medicines to be disguised in food or drink in their best interests, the service had consulted with the person's healthcare professionals.

Medicines were stored securely in locked cabinets, with additional precautions for controlled drugs. Medicines storage was organised with each person's boxes of medicine in individual baskets. Additional medicines that had been ordered and were awaiting use were organised similarly. Medicines stocks were not excessive.

The medicines room was kept at a moderate temperature, so that medicines did not become too warm to be effective. Medicines that required chilled storage were kept in a medicines refrigerator. The refrigerator temperature was monitored to ensure it remained within safe limits.

The head of care took the lead for the management of medicines at Branksome Heights. They undertook or oversaw regular checks of medicines stocks, storage and records.

Staff who handled medicines had up to date training about the safe handling of medicines. Senior staff observed them at least annually while they administered medicines, checking they were competent to do this safely.

They had obtained advice from a pharmacist about how this could be done safely, with food and drink that would not interact with the medicines.