James Burns 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 inspection we rated this key question good. At this inspection 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.Lessons were learnt across the service. People were involved in their care.Relatives told us they were included in their loved one’s care, knew how to raise concerns and were confident they would be listened to. The service had a system in place for recording and reviewing incidents and accidents. Details of any incidents and accidents were recorded by the staff team. The management of the service undertook a quarterly analysis of all events and incidents within to identify themes and trends. Lessons learnt were discussed in team meetings and formed part of a person’s review of their care and supportto ensure care plans reflected people’s needs accurately.

The service 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 and their relatives told us staff communicated effectively when required with external health and social care professionals. The service had a summary of people’s needs and requirements, which was accessible to staff and relevant professionals. This meant a safe transition between services, such as, emergency admission to hospital. People’s needs, and care requirements were detailed within their care plans and risk assessments. Relationships between the service and external professionals were established. Health and social care professionals we spoke with were complimentary about the service.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately.People told us they felt safe living at James Burns House, a person told us, “The care is good here and I do feel safe.” observations of staff showed they were working in agreed ways to promote safety.Relatives told us they felt their loved ones were safe. A relative said, “Yes, I feel my loved one is very safe here.” A person told us, “The care is good here and I do feel safe.” We observed staff supporting people safely, for example, using specialist equipment for eating and drinking and using equipment for mobilising needs. Safeguarding procedures were in place to protect people from avoidable harm. Staff received training in safeguarding, and the provider had an up-to-date safeguarding policy in place.Staff told us they knew how to raise concerns and felt confident concerns raised would be investigated by the management team. A staff member said, “We can speak up, management do act on it, and we work here as a team. Everyone is approachable.” Records showed safeguarding referrals had been made as necessary and this included notifying CQC of certain events as required by law. We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA), whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). All legal applications had been made in accordance with DoLS this meant people’s rights were fully respected. The manager had oversight of DoLS applications, authorisations, and conditions. This meant people’s rights were fully respected.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.People told us staff worked to keep them safe and understood their needs.Individual risks, such as difficulty with swallowing, risk of falls, worsening of health conditions and moving safely, had been identified, assessed and measures put into place. All people had care and support plan and risk assessments which were regularly reviewed. Staff told us they understood people’s risks and individual care needs and were confident where to find the relevant information. Records detailed how staff should work to ensure people’s safety and contained incident logs and analysis. Staff understood how to keep people safe and had received training relevant to people’s needs. We observed staff working in accordance with people’s risk assessments. Staff said, “We have enough information about people’s needs.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.People told us they could move around the service safely and without restrictions. The service was accessible with level access to outside spaces. Staff told us they knew how to report maintenance issues using the service’s maintenance book. The maintenance book was managed by a designated staff member who would sign off tasks when completed. Safety checks were carried out regularly and included; bed rails, condition of furniture, window restrictors, garden and grounds safety, water safety, vehicle checks and more. The service used external specialists and contractors to undertake some checks, such as gas, electrical and fire safety. We checked certificates were in place for all household checks carried out by external professionals. Fire safety checks in were in place. A fire risk assessment had taken place and actions from the report were being completed. Each person had an individual plan on how to manage fire safety and evacuation.

The service 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.People were supported by enough staff to meet their needs. The provider assessed people’s needs and dependency to calculate staffing levels.A relative told us, “The staff are brilliant. My loved one has a complicated condition, and it is imperative that people know [person]. The staff jump if there are any issues and put actions into place immediately. They work alongside each other. I get on well with the staff they are all 10 out of 10. All problems are rectified ASAP. They are good at accommodating and resolving problems. They bend over backwards.” The provider told us they had recently reviewed levels of dependency and the staffing rota and had made changes to ensure all people’s needs were met. We observed sufficient numbers of staff were available to meet people’s needs and were unhurried. The service had a thorough induction, shadowing, competency checks and ongoing support processes in place. Formal supervisions were carried out in accordance with the provider’s policy and were a 2 way process, giving staff the opportunity to speak openly and raise any concerns or worries. Recruitment was carried out in accordance with legislation. Processes were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

The service assessed and managed the risk of infection. People and their relatives told us the home was clean. A relative told us, “It is always very clean, staff are always cleaning.” Another relative said, “Clean, always. Tidy? This is dependent on who is on. Laundry is not always correct, and clothes are not always ironed, but these are small things, generally it is very well looked after.” We observed staff cleaning over both days of the inspection. Cleaning schedules and check lists were in place to ensure all areas were routinely cleaned. We observed staff using personal protective equipment (PPE) and staff had access to suitable cleaning products. Staff told us there was plenty of PPE in the service. Staff had received infection prevention and control training.

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.People received their medicines safely and as prescribed. Staff had received medicine administration training and had competency assessments. The service had an up-to-date medicine policy in place. The service had a medication policy in place. The service conducted a monthly audit on medicines; however, the audit did not always pick up shortfalls with medication management. During the inspection plans were put in place to strengthen the medication audit ensuring the safety of medicines and storage. During the inspection plans were put in place to strengthen the audit to ensure the safety of medicines and storage. Where medicines were prescribed to be taken ‘when required’ there was personalised information in place to guide staff. However, this was not in place for all when required medicines. We were told that the service would update this and ensure all people had the personalised information in place. The service had an electronic administration system in place which created a timestamp when medicine was given. The system provided staff with important information regarding people’s medicines and other information, such as medicine allergies. Staff monitored storage temperatures to ensure they remained within safe ranges. The service had systems in place to investigate medicine errors.