Byron Court Care 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

People told us they felt safe living at Byron Court Care home. The registered manager understood their safeguarding responsibilities and staff had a good knowledge of the action they should take to ensure people were protected from abuse. Staff were safely recruited. There were enough appropriately skilled and trained staff to meet people’s needs. People told us they were confident in the staff’s ability to keep them safe from harm. However, risk assessments were not always in place or sufficiently detailed to guide staff in keeping people safe. People were generally happy with the support they received with their medicines and told us they receive their medicines when they need them. However, medicines records did not always demonstrate people always received their medicines as prescribed We found no evidence people had been harmed. However, during our assessment of this key question, we found concerns around the management of people's medicines and people's individual risks which resulted in a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

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.

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

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.

Staff demonstrated a good knowledge of safeguarding processes and could describe the action they would take if they felt someone was being abused. Staff described the skills they gained from completing training in this area and felt confident to raise concerns. A staff member told us, " I would look for any physical and emotional signs of abuse such as marks, bruises and changes in personality. I would report all abuse to the manager or the local authority". The registered manager understood their safeguarding responsibilities and told us safeguarding was always discussed in staff supervisions and team meetings.

Effective systems were in place to ensure safeguarding concerns were shared with the safeguarding authority as required. Lessons were learnt from safeguarding investigations and the registered manager implemented measures to reduce the liklihood of incidents re-occuring. Safeguarding processes were subject to manager and provider scrutiny. A safeguarding audit was completed to check all safeguarding systems and processes were in place and remained effective. The audits identified areas for improvement and we were assured action was taken . For example, the registered manager identified an absence of safeguarding information visible around the home, our observations found this was acted upon. Staff had received training in safeguarding adults and whistleblowing as part of their mandatory training. Staff had access to a robust safeguarding policy which provided clear guidance on what they should do if they suspected abuse. An accessible version of this policy was made available to people who lived at the home.

People told us they felt safe living at the home. Comments included," "Oh yes, I’m safe alright. They treat me very well indeed". Relatives also had confidence in staff's ability to keep people safe. A relative told us, "I’m really confident [Person] is safe, [Person] was in another care home before here and I am much more confident about [Person's] safety now. I go home feeling [Person] is very safe and don’t worry at all".

Staff practice was safe. Our observations found staff acted to ensure people were protected from potential risk and abuse. Safeguarding information was displayed in the home to guide staff on how to raise concerns and included contact information for the local authority safeguarding team.

People told us they were confident in staff’s ability to keep them safe from harm. Comments included, " They know what I need help with so I am safe. I need a lot of help, I can’t move safely on my own, the staff help" and "Staff are careful with everything they do".

Not all records demonstrated risk was accurately assessed, monitored or mitigated. People's care planning records did not always provide staff with clear guidance on how to manage risks safely. For example, a risk assessment had not been completed for a person who was receiving a modified diet due to a risk of choking. For another person, a risk assessment had not been completed to guide staff on how to keep the person safe when they experienced a physical response to periods of emotional distress. There was a process in place to review risk assessments. However, the reviews undertaken were not always effective as they failed to identify records were not always reflective of people's current needs and risks.

Our observations found staff took the necessary action to ensure people were safe and supported effectively. Staff recognised potential risk and offered support to people when needed to ensure they were kept safe. For example, we observed a staff member encouraging a person to move to a more comfortable chair when they identified a risk with use of their mobility aid.

Staff understood where people required support to reduce the risk of avoidable harm and were able to describe how they supported people safely. However, some staff told us the information in people's care records needed to be improved to ensure temporary agency staff understood people's needs and risks. Staff explained the action they take when a person's risk assessment required updating, or if people's needs changed.

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

People and their relatives provided positive feedback about staffing levels . The majority of people told us their needs were met in a timely way. Comments included, "There always seems to be enough of them [Staff]. Someone comes when I need help. They come quickly" and "there seems to be enough staff when I visit, and someone is always available to talk to if I need to ask anything". People told us they were supported by knowledgeable and experienced staff. Relatives also felt staff demonstrated the necessary skills and competence to effectively support people. Comments included, "They sure know what they are doing and do it very well in my opinion" and " The carers all seem to know what they are doing, and the nurses are brilliant, they all understand [Person's] condition and know what to do if [Person] shows signs of being unwell".

Suitable recruitment processes ensured staff members employed had the required skills and characteristics to work with the people living at the home. Staffing levels were continually reviewed in line with people’s needs and rotas were planned to ensure a suitable number of staff were deployed. The registered manager and deputy manager operated an on call system at weekends to provide managerial support for staff. A system was in place to ensure staff were supported through regular one to one meetings, team meetings and a yearly appraisal. An effective system was in place to ensure staff completed a range of training the provider considered mandatory. Training records were well maintained and we were assured staff received the necessary training to equip them to carry out their roles effectively.

Staff provided mixed feedback regarding staffing levels. Some staff felt there were enough but others felt more staff were needed. Staff described the impact as a lack of quality time to be able to sit and engage meaningfully with people and described how they felt rushed at times. The registered manager told us agency care staff were deployed to support when staffing levels were low and where possible, they used the same staff to ensure people received consistent care and support. A staff member shared their concerns about agency staff competence and described how this lead to an unequal workload for permanent staff. The most recent staff feedback survey requested by the provider contained similar feedback from staff regarding agency staff's competence.

Our observations found there were enough staff to meet people's basic needs but care was often task focussed and staff were sometimes rushed in their approach, specifically at meal times. We shared our observations with the registered manager who committed to undertaking a review of the deployment of staff at meal times to better improve people's meal time experience.

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.

People were generally happy with the support they received with their medicines and told us they receive their medicines when they need them. People explained staff followed good practice as they explained what medicines they were administering. Comments included, " They tell me what I’m taking and what it’s for", "When we came in they went through them with me to make sure they were right" and "They tell us what they’re for and if they are long or short term".

Medicines records did not always demonstrate people received their medicines as prescribed. For example, we found gaps on a person's medicine administration record (MAR). The records did not provide assurance the persons always received medicines to treat the symptoms of an ongoing health condition. For another person, the MAR did not show they had received a course of antibiotics to treat an infection. The initial administration attempt was not successful due to the person refusing or being asleep. However, records did not show administration had been reattempted. We found medicines stock was not always effectively managed. For example, a person did not receive medicines required to treat the symptoms associated with a mental health condition for 3 days as the medicine was not available to administer.

Staff told us they received training to manage medicines safely and a regular assessment of their competency was undertaken. We saw records showed these had been completed. The registered manager explained they had recently implemented a new electronic medication management system. They had identified concerns with the implementation of the new system and the accuracy of the records. Prior to the assessment, the registered manager had contacted the local authority medicines management team for support and guidance.