BrendonCare Otterbourne Hill

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 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 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.

The management team demonstrated a proactive and positive safety culture grounded in openness and transparency. There was a culture where staff felt safe to raise concerns, which were addressed promptly, and any incidents were thoroughly investigated. Lessons learned from falls, pressure injuries, anxiety related behaviours and safeguarding events were used to improve practice. Duty of candour records confirmed timely communication with people and external professionals. Visiting health professionals reported confidence in the responsiveness of the service and learning culture.

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.

People’s care was carefully monitored by nursing staff, the management team and by external healthcare professionals to ensure continuity, particularly during hospital admissions or unit transfers. Multidisciplinary team meetings, including nurses, therapists, dietitians, and visiting health professionals, ensured people’s care was coordinated. Care plans were updated regularly to reflect changes in people’s health, mobility, or mental wellbeing.

Risk assessments were integral to these processes, addressing specific needs for people with conditions such as dementia, Parkinson’s disease, diabetes, and cardiovascular disorders. These assessments considered mobility, nutrition, hydration, medication side effects, and cognitive fluctuations, ensuring transitions were safe and well-managed. External professionals praised the continuity of care and the structured approach to risk management.

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 were protected from abuse, neglect, and discrimination while maintaining dignity and autonomy. Staff were alert to vulnerabilities associated with people’s age, cognitive impairment, mobility needs, and chronic conditions. One person said, “When they [staff] help me with personal care, they are always kind and patient”. Staff responded appropriately to people’s anxiety related behaviours, using person-centred strategies and de-escalation techniques to ensure people were supported in the least restrictive way possible. A member of staff said, “We use their history, talk about old jobs they used to do and places the enjoyed going on holiday. It really helps”.

Safeguarding plans incorporated risk assessments for conditions that could increase vulnerability, such as dementia or Parkinson’s, ensuring proactive measures were in place. Professionals told us that safeguarding processes were robust and that people’s wellbeing was prioritised.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs which were safe, supportive and enabled people to do the things that mattered to them.

People were actively involved in managing risks to their safety. Individualised risk assessments assessed and mitigated people’s risks in relation to falls, skin integrity, mobility support, diabetes management, and anxiety related behaviours. For those with health conditions, such as dementia or Parkinson’s, assessments included strategies to reduce risks associated with cognitive decline, swallowing difficulties, and medicine side effects.

For example, where someone cared for in bed and at high risk of pressure injuries, their skin integrity plan included detailed preventative measures and regular repositioning, which resulted in no pressure injuries over the previous six months. A relative said, “[Person] is prone to sores, so they keep her on an air mattress and always make regular checks of her skin to make sure she is not uncomfortable”.

Mobility plans specified the exact assistance and equipment required for safe movement, which reduced falls and enabled people to maintain independence where possible. Nutritional and hydration strategies had been tailored to individual health conditions, leading to improved hydration scores and fewer urinary tract infections.

Staff supported people to balance independence with safety, and restrictive interventions were used only when necessary. Records demonstrated one person was encouraged to participate in therapeutic exercise and encourage to use their mobility aids to support their wellbeing and independence. External professionals noted confidence in the risk management strategies employed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The nursing home maintained a safe and accessible environment. Equipment and mobility aids were checked and serviced regularly. Risk assessments were tailored to people’s individual needs, including those with reduced mobility or at risk of pressure injuries. People’s skin integrity was a key focus, with prevention plans embedded into daily care routines, including repositioning schedules and specialist mattresses.

Observations confirmed staff followed protocols to maintain a safe, supportive environment. Visiting professionals noted the premises were well-maintained and conducive to safe care. One relative commented, “Its brilliant. She is totally supported to look after herself and be independent whilst being in a controlled and monitored environment where she is totally safe”.

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.

Staffing levels were sufficient to meet people’s needs, and staff were appropriately trained in person-centred care, safe manual handling, skin integrity management, diabetes care, and de-escalation techniques. Training also covered risk management for conditions such as dementia and Parkinson’s, ensuring staff could anticipate and respond to changes in behaviour, mobility, and health status. Professionals highlighted care was delivered reliably and safely, reflecting competent staffing.

The provider had safe recruitment procedures in place and records demonstrated the required pre-employment checks were carried out. A relative said, “The home was chosen due to its reputation as being very good and it has totally lived up to our expectations”. Another relative said, “We are very reassured by the number of people around and their knowledge and skills, which is why we feel she is totally safe there”.

The provider assessed and managed the risk of infection. They detected and controlled the risk of infection spreading and shared concerns with appropriate agencies promptly.

Infection prevention and control measures were consistently applied. The service was clean and well maintained. Staff adhered to hand hygiene, Personal Protective Equipment (PPE) protocols, and cleaning routines. People at risk of wounds or with chronic conditions were monitored closely for infection, with audits and outbreak plans implemented according to best practice guidance. Professionals visiting the service noted compliance with IPC standards and protocols were embedded into daily routines. A relative said, “They provide a very pleasant environment. Her room is clean and comfortable and provides everything she needs”.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines were managed safely, reflecting people’s preferences and clinical needs. Protocols were in place for ‘when required’ medicines and audits were conducted regularly. Risk assessments considered medicine-related risks for people with conditions such as Parkinson’s and dementia, including monitoring for side effects and ensuring safe administration. People were involved in discussions about their medicines, to support then to understand why their medicines had been prescribed and to gain their consent. Health professionals commended the approach to medicines management and noted safe administration practices. A relative said, “She requires a lot of medication for pain relief, and this is well managed and given on time”.