Bletchley House Residential Care and 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. 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 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. For example, incidents, accidents and near misses were reviewed by leaders and changes were made as a result of any learning to reduce reoccurrences.

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 example, the provider worked closely with the local hospice. Following recent communication difficulties with the hospice, the provider had developed and implemented an action plan, including putting additional processes in place to ensure clear communication and ways of working to best support people using the service at the end of their lives.

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 had a good understanding of safeguarding and were able to tell us signs of abuse they would look out for and report to leaders and external agencies if needed. People told us they felt safe, one person said, “I feel safe here because of plenty of people and the fact I am not alone.”

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were in place for specific health conditions where required, for example, for people on anti-coagulant medicines (an anticoagulant medicine is prescribed to prevent blood from clotting too easily, reducing the risk of dangerous blood clots that can cause illnesses such as strokes or heart attacks). Where people were at risk of experiencing emotional distress, risk assessments were in place, however these would benefit from being more person centred to help staff identify possible triggers, and the best strategies to help support someone when they are distressed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Since our last inspection, areas within the home had undergone refurbishment. Equipment to support people, for example, with moving and positioning was in place and regularly serviced. One person told us, “If I want to go out from my room, I use a wheelchair. All my equipment is here in my room; I’m very lucky the room is large, and I still have plenty of space to go around. It’s not cramped, and I made it like home with my family’s photos.”

Whilst we observed there were enough staff to meet peoples’ physical needs and staff were recruited safely, where many people chose to remain in their bedrooms, it was difficult for staff to spend meaningful time with people outside of their care related tasks. One person told us, “I am not sure if there are enough carers, sometimes I feel there is and sometimes there is almost nobody to see. Some staff are difficult to understand, and they do speak their own language.” A relative told us, “More staff would be lovely, but they are constantly saying they have enough staff. I think my relative would benefit if somebody can sit with them for a while and maybe talk, especially on a day when we are not visiting.” However, another person said, “I think there are plenty of staff and they are very efficient, and I don’t miss anything.” The provider was responsive to this feedback and told us they would review this.

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. Overall, we observed the service was clean and free from malodour. Staff had access to enough personal protective equipment.

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. Overall medicines were managed and stored safely. Following lessons learned, the provider had recently introduced additional tools to support people with their pain to ensure pain relief was administered appropriately. Where medicines were given ‘as required’, (PRN), protocols were in place, however, would benefit from review with people, to better reflect how they will communicate to staff when these are required. The provider took our feedback on board and developed an action plan to address this area.