Brookland House

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.

People’s relatives told us they were informed of any concerns about their loved one. A relative told us, I am informed in a timely way. If there are any concerns, they [staff] contact me by message or phone.”There were systems in place to record and learn from any accidents or incidents. A member of staff said, “I report any accidents or incidents promptly. Management shared the learning in a supportive way through handovers and updates. I am always made aware when care plans are reviewed and updated after incidents.” A stakeholder involved with the service told us they were always informed about any concerns relating to people they were involved with. They also said, “The manager responds quickly to any comments we make.”Following concerns raised by people, their relatives and staff about difficulties in being able to contact the office, especially out of hours the provider installed a new telephone system which improved the situation.A stakeholder told us, “There have been no recent concerns logged about the service. The main concerns being logged with ourselves related primarily to calls i.e. duration of calls and missed calls, staffing issues and care concerns. These issues were all addressed and dealt with by the manager.”

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 were assessed before a package of care was offered to ensure the agency could meet their needs and aspirations. The registered manager told us they ensured staff had the necessary skills and training to meet people’s needs before a package of care was agreed.People and their relatives told us they were involved in planning and reviewing the care provided. A relative told us, “I was involved, and [relative] was there and involved as much as possible.” However, people and their relatives told us they did not have access to a care plan in their home. We shared this feedback with the registered manager who explained they were in the process of completing these for people which could also be shared with health care professionals in the case of an emergency or admission to hospital.

Staff told us they had the information required to meet the needs and preferences of the people they supported. A member of staff told us, “I receive clear communication through handover notes, emails and team briefings when someone starts using the service. I’m made aware of their health needs, wants and wishes by reading their care plans, speaking with senior staff and getting updates from the team.” Another member of staff said, “The care plan is sent, and I ensure to read it thoroughly before visiting new clients.”

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 they felt safe with the staff who supported them. One person said, “I feel safe with them [staff].” Staff had received training about how to recognise and report abuse. They knew how and when to report concerns both internally and to other organisations such as the local authority, CQC and the police. A member of staff told us, “I feel confident and supported in raising any abuse concerns, and I know they would be taken seriously and acted on quickly. Even though I haven’t needed to raise one yet, I’m clear on the procedure and trust the team would respond promptly to keep people safe.” There were systems in place to ensure all staff received training and regular refresher training in safeguarding adults from abuse.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and their relatives told us staff respected their wishes and treated them with respect. One person said, “I’m treated with dignity and respect. They never make me do something I don’t want to do. They know me well now and I call a spade a spade, so I’ll soon say if something is up.” Staff had been trained about the principles of the Mental Capacity Act 2005. A member of staff told us, “I’ve had training in the Mental Capacity Act. I always seek consent before supporting someone, and if they refuse, I respect their choice, try again later, and follow their care plan to keep them safe.” People’s care records contained assessments of their capacity to consent to the care and treatment they received. The registered manager told us people were provided with information in a format they could understand. People’s care plans detailed their communication needs which were understood by staff.

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.

Risks to people were assessed and a plan of care was in place to guide staff how to support people in a safe way. People were supported by staff who knew the individual risks and assisted them in the least restrictive way possible whilst minimising the potential for harm. A member of staff told us, “Care plans and risk assessments give me clear guidance on each person’s needs, risks, and the steps I should take to support them safely. I feel I have enough detailed information to manage risks confidently and follow the right procedures.” Another said, “I’m supported through clear guidance in care plans, training in de-escalation, and advice from senior staff. This helps me respond calmly and appropriately when someone is 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.

People lived in their own homes and their feedback did not highlight any concerns around their environment. People’s care plans contained information about their needs and there were risk assessments for the environment and any equipment used by people. The service did not supply equipment to people however, records showed staff carried out regular visual checks on equipment.

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.

We received mixed views from people and their relatives about whether staff arrived on time or stayed for the duration of the call. Some were positive saying staff would arrive on time and often stay longer than allocated while others told us staff would often arrive late and leave early. We shared this feedback with the registered manager. People and their relatives told us they usually knew who would be visiting them however, this was not always the case especially at the weekend. They told us staff were kind and respectful. One person said, “I’m happy with staff. They are kind and I feel respected. We have good banter.” A relative told us, “The staff are kind and caring and treat [relative] with dignity and respect.”

Staff told us they had sufficient time to meet the needs of the people they supported. One member of staff said, “I have enough time to meet people’s needs safely.” Another told us, “I am confident I have enough time to meet people’s needs and if their needs are greater than average the call is generally longer to suit the individual.”

Staff told us they felt they had the skills and training to meet the needs of the people they supported; however, some felt they would have benefited from more shadow shifts and training during their initial induction. The registered manager told us they had already been made aware and were in the process of addressing this. A stakeholder told us, “This is an area that the provider is working on to improve following our visit in terms of extending shadowing for staff and ensuring staff have regular 1-2-1s and training updates.” The provider followed safe recruitment processes for staff.

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.

People and their relatives told us staff always wore personal protective equipment (PPE) such as gloves and aprons when they assisted them. Staff had received training about infection, prevention and control and had access to the PPE needed. A member of staff said, “I’ve received the necessary training, and I always have access to the right PPE to work safely.” A relative told us that staff “always wore PPE” before assisting their loved one.

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.

People and their relatives told us staff ensured medicines were administered when prescribed. Records were maintained to show when medicines had been administered. There were protocols in place to ensure staff followed a consistent approach when administering medicines prescribed to be taken on a when required basis. Staff had received training on the safe administration of medicines, and their competency was checked through spot checks and refresher training. A member of staff said, “I have received training on giving medication and have had spot checks done.” Another staff member told us, “I’ve had full medication training, and my competency is checked regularly to make sure I administer medicines safely.”