St Brannocks

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 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.

People told us the staff took appropriate action when they reported safety concerns. One person said, “If I complain about something, the staff listen.” The person told us about an incident in which they had felt unsafe, and said, “I said something to the [registered] manager and [they took action].” A professional told us, “[The person] feels safe and looked after especially when an incident is reported. [Staff] act immediately and are fully responsive to issues and concerns.”

Records showed that incidents were analysed and action was taken to try to prevent reoccurrence. The provider had a Positive Behaviour Support (PBS) practitioner to support the home to identify triggers and whether strategies to reduce people’s distress were effective. Staff and people who lived at the care home had opportunities to debrief after incidents, and the registered manager used a ‘safety huddle’ approach to ensure that changes and messages were communicated throughout the staff team. Staff told us they valued the support they received from the registered manager and the provider. One support worker told us, “Sometimes it's tough, you have to talk to each other and support each other.” Another support worker said, “[The provider] arranged counselling for me, and we had a debrief meeting outside [the home] so we could speak freely.” The registered manager said, “The whole team are so supportive of each other. We also have the PBS practitioner to help us with lessons learned and checks on the staff wellbeing.”

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 told us the staff helped them to feel safe living at St Brannocks. One person said, “I feel safe here because there are always staff around.” Another person told us, “I sometimes don’t feel safe because of [one person’s distressed behaviours]. The staff talk to me when it happens and make me feel better. I don’t feel I am at risk.” A person’s relative said, “I am very happy with the placement. I like the staff, [my relative] is safe.”

We saw that information was provided to people to assist them to understand safety in their home and in the community. This was presented in easy read format with pictures for people who needed this to understand.

Records showed that concerns were routinely reported to appropriate bodies, such as the local authority safeguarding team, and the CQC. The registered manager and staff team worked collaboratively with professionals to ensure that concerns were fully investigated, and plans put in place to keep people safe. One professional told us, “I discussed a recent safeguarding incident with [person]. They say they do not wish to take the matter further and are confident the staff will deal with it effectively.”

The registered manager ensured that appropriate applications had been made where people were deprived of their liberty for their own safety, and where applications had been authorised that any conditions were known to the staff and followed. Where restrictions were in place, the staff team worked together to ensure these were the least restrictive possible.

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.

Each person had a range of risk assessments documenting identified risks, and these were regularly updated as risks changed, and mitigation strategies were tested. People contributed to their support plans including any risks. One person told us, “[The staff] know what to do. I am not at risk.” Some people also had thorough, detailed and holistic PBS plans that ensured staff were aware of identified proactive and preventative measures to avert crises before they occurred.

Staff had been trained in people’s specific medical conditions, and we saw people had specific risk assessments relating to these. There were clear guidelines in place for people who had epilepsy. Staff also told us about potential risks they had identified for some people; they shared these with the registered manager who organised training to ensure staff had the skills and knowledge to support people safely. For example, one support worker told us about how they had noticed that 2 people ate quickly and were at potential risk of choking. The provider had facilitated training in dysphagia and changes were made to the people’s support plans to encourage them to eat more slowly. Thresholds were also noted for when people should be referred for professional assessment.

Staff dynamically assessed risks as they supported people and were creative in mitigating these. They knew people and their communication needs very well and understood potential triggers to people’s distress. Person-centred physical interventions were used as a last resort, when necessary, to ensure people’s safety.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. However, some of the communal areas of the home were in need of redecoration and repair, and didn’t feel homely.

The provider had an effective system of checks in place to ensure the environment was safe for people and staff. These were undertaken by the registered manager, the senior support worker and the operations director also carried out a periodic check. Fire safety was considered; the home had a fire safety risk assessment by a recognised professional and people and staff participated in regular fire drills to ensure they knew what to do should they need to evacuate in the event of an emergency. Information about the evacuation procedures was presented in formats people could understand.

The registered manager arranged for other systems, equipment and facilities to be regularly checked as required. There was a maintenance plan in place and the deputy manager told us that maintenance concerns were addressed swiftly by the provider.

People’s rooms were decorated as they wished. We saw staff supported people to make changes to their bedrooms as they desired. One person told us, “I would like some more nails in the wall so that I can hang up more baubles” and a support worker agreed to ask the provider’s maintenance officer to do this for them. However, we noted that some of the communal areas of the home were in need of redecoration and repair, weren’t a comfortable environment in which people chose to spend time and didn’t feel homely. The management team had a plan in place to address this. People told us about how they had chosen new furniture, paint colours and décor items so the living areas felt like their home. One person said, “I can’t wait for the lounge to be redecorated and be made more nicer. It’s going to be lovely.”

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 told us there were enough staff to support them safely and for them to do the things they wished to do. One person said, “I think the staff have enough training.” A relative told us, “[My relative] has 1:1 support. I know who his keyworker is. They are really getting to know him. I am sure that the staff have the training to look after [my relative].” However, one person told us they felt there sometimes weren’t enough drivers. They said, “We could do with more drivers. Only 3 of the staff drive. This can mean I can’t go to a certain place if there isn’t a driver.” The registered manager ensured staff had the training they needed to provide person-centred, safe support. Staff told us they had additional training to meet people’s specific needs. One support worker told us, “We have had training in schizophrenia, autism, epilepsy, dysphagia, PBS and physical interventions plus all of the usual like food and nutrition, first aid, fire safety, medication, safeguarding.” Records showed that staff training was comprehensive and supported by the management team and provider. People benefitted from staff who were safely recruited and whose work was supervised and checked to ensure they remained competent. The provider undertook the checks required for safer recruitment such as a Disclosure and Barring Service check and references. New support workers had a thorough induction and worked several shifts shadowing more experienced staff before they supported people on their own. Most people had 1:1 support from staff, most of the time. This allowed people to undertake the activities of their choice and ensured there were enough staff for supporting people to appointments.

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