The Bungalow

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 66 (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 and demonstrated an openness to learning in order to improve people’s care. However, the processes in place for documenting the learning from incidents and accidents were not always robust. For example, we found incident reports did not always include sufficient detail about the circumstances of the incident, how the concerns were investigated or what the impact on the person was. Following our feedback, the registered manager responded promptly, reviewing and updating the relevant documentation to ensure investigation reports were more detailed.

The provider worked well with people and healthcare partners to establish and maintain safe systems of care. Where people were moving from or to other services, the provider ensured people were supported to transition in line with their individual preferences and needs. The provider shared information appropriately to ensure continuity in their care whilst managing and monitoring their safety throughout the process.

The provider’s safeguarding processes had not always been implemented effectively. During the inspection, we found a safeguarding concern which had not been reported to CQC in line with the provider’s regulatory responsibility. Recommendations from safeguarding incidents had not always been fully actioned.

Despite these concerns, the registered manager was able to evidence a number of improvements to their processes in recent months, following support from the local authority. Additional safeguarding training had been completed by all staff and managers and guidance documents were in place to support managers with identifying safeguarding thresholds. Improved systems for storing and recording safeguarding information had been implemented. Following our feedback, the provider confirmed all safeguarding recommendations were now in place.

People and their relatives had access to safeguarding policies in formats they could understand. Staff understood the importance of listening to people, recognising signs of harm or abuse and reporting any safeguarding concerns immediately.

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. People’s risk assessments were detailed and personalised. People were supported to try new things, including a range of different activities. Staff and managers monitored and reviewed these activities to minimise and manage any risks associated whilst ensuing people were empowered to carry on doing the things they enjoyed.

The provider detected and controlled potential risks in the care environment. The layout and design of the service met people’s individual needs and the provider ensured the equipment, facilities and technology supported the delivery of safe care. Regular maintenance and equipment checks were completed to monitor the safety of the environment. During the inspection, we found minor concerns with the condition of 1 person’s bathroom fittings, which could pose a slight risk of injury if not repaired. The registered manager responded promptly, arranging replacement the following day.

The provider made sure there were enough staff available to meet people’s needs and preferences. Staff knew people well and were consistent in their support. Where people were receiving one to one support, the provider had ensured staff had the correct skills and experience and were well matched in terms of supporting people to go out and do the activities they enjoyed.

Staff received relevant supervision, training and support to carry out their role. At the time of the inspection, we found not all staff had up to date practical training, for example in supporting people with their emergency epilepsy medicines. However, the registered manager confirmed trained staff were always available on site. Following the site visit, they sent evidence the relevant practical training had been booked.

Staff recruitment was safe, although some minor improvements were required to ensurestaff’s previous care positions were fully explored in line with the provider’s own recruitment policy.

The provider assessed and managed the risk of infection and detected and controlled the risk of it spreading. The service had an infection prevention and control policy in place for staff to follow and relevant training and resources were in place to support staff to follow good hygiene practices. During the inspection, we found minor concerns with the cleanliness and condition of the tiles and grouting in 1 person’s bathroom. The registered manager responded immediately, arranging replacement and amending their infection prevention and control audits to ensure more detail was included.

People’s medicines and treatments were safe and met their needs. People’s medicines were reviewed regularly with relevant health professionals to ensure they remained appropriate and were best suited to the person’s needs. However, we found people’s as and when required [PRN] medicines were not being regularly counted to check the balances were correct and to evidence what medicines were held on site. It was not always clear from the medicines records where some emergency rescue medicines were being stored. People’s care plans did not always contain up to date information about their medicines. Following our feedback, the registered manager responded promptly, implementing a new medicines check for as and when required medicines and updating documentation to ensure medicines information was recorded accurately.