Brockholes Brow - Preston

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

Improvements had been made to the processes in place to manage risk. People benefitted from regular assessments and reviews of individual risk and were supported by staff who knew the help people needed to promote their safety. People lived in a clean and hygienic environment and staff followed processes to minimise the risk and spread of infection. People received medicines safely from staff who were trained and competent to administer medicines. Systems were in place to protect people from abuse and harm. Staff were recruited safely, undertook training and were deployed so people received support when this was needed or requested. People lived in an environment that was well maintained and equipment was also checked appropriately, to ensure its safety.

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.

Risks were assessed and if things could be done differently this was actioned. When required, people received one to one support to ensure their safety was maintained. People told us they had built positive relationships with staff and management and felt confident they would be treated positively if they raised any concerns. A relative shared how their family member was supported to manage risk individual to them, they said they felt their family member was safe.

The provider had acted in response to feedback from our last inspection. Information on best practice had been shared with staff, and refurbishment of the building had taken place. Staff told us positive changes had taken place. One staff commented, “We’re here for the change and we’re on board, we can be part of the change.” The provider recruited deaf staff in line with equalities legislation. A deaf staff member shared on a social media platform, ‘I’ve been working with the Deaf and hearing staff so that we can communicate, understand and work better together to create a better environment.’

Accidents and incidents were reviewed and analysed to see if actions could be taken to minimise the risk of reoccurrence. Learning was shared with staff and risk assessments and care documentation was updated to reflect any changes made. The registered manager and provider understood their responsibilities in relation to Duty of Candour and a policy was in place to guide staff. Duty of candour is a legal requirement that ensures providers are open and transparent with people who use services when things could have been done differently.

Care and support was planned to help ensure people’s needs were understood and met. In the event of emergency support being needed, information was shared with health professionals to support effective decision making.

The provider told us that care and support was planned and organised with people and interpreters to ensure deaf people were able to communicate effectively and share concerns with health professionals.

External health and social care professionals raised no concerns regarding management of safety and risk.

Pre-admission assessments were carried out to ensure the service could meet people’s needs. Whenever possible, health professionals and those important to the person were included, this helped ensure all information was gained about the person and care was planned to meet their needs and wishes. If people's needs changed, referrals were made to appropriate health professionals for further advice and guidance.

People were appropriately supported so they felt safe. They said they understood what it meant to feel safe and could say how they would raise any concerns. People told us they felt confident the registered manager and provider would act on any concerns raised.

Staff had received training in safeguarding and understood the signs that could mean a person was at risk of harm and/or abuse. Staff told us they would report concerns to the registered manager and senior leadership team and they were confident any concerns would be actioned. A staff member commented, “I’d report any safeguardings, something would be done I’ve no doubt.” Staff were also aware of how to raise concerns to the local safeguarding authority should the need arise. External health and social care professionals raised no concerns regarding the safety of the service.

We observed staff deliver care safely. People were appropriately supported by skilled staff, so people did not feel unsafe or neglected. Staff had time to meet people’s needs and gave people the time to share their thoughts and feelings. Staff were observed to respond to people’s requests and provide them with the support they needed. The registered manager informed the local safeguarding authority and the Care Quality Commission of safeguarding concerns in accordance with legal requirements.

The provider had a system in place for the management of safeguarding concerns. This meant people were protected from the risk of harm or abuse. The management team carried out audits and checked the standards and quality of the service people received. This included monitoring people's health and weight regularly. The registered manager sought legal authorisation where people were subject to any restrictions for their safety. Where deprivation of liberty safeguards (DoLS) authorisations were granted, we saw the service ensured any conditions were met.

People and those representing them, were involved in the management of risk. A relative told us they had been consulted when additional risk controls to promote their family member’s safety had been introduced. They told us this had helped maintain their relative’s safety.

Staff knew the support people needed and understood the risk assessments in place to help maintain people’s safety. Staff were in the process of taking part in further training to support people to positively express their feelings and anxieties safely. Staff told us risk assessments were reviewed regularly and they could ask for further guidance from the senior management team if this was needed.

We observed positive risk taking with people being supported to be independent. This was in line with best practice. Staff supported people in accordance with risk assessments, care plans and health professional’s instructions.

Individual risks were assessed and reviewed regularly, and risk controls were in place to minimise the risk of avoidable harm. These were proportionate to the risk presented and supported people's right to be independent. Care documentation recorded the needs of people and the actions staff had taken to help people maintain their safety and wellbeing.

People were supported in a clean and safe environment that had been adapted to meet their needs. A visual fire alarm system was in place and each person had an individual emergency evacuation plan. This ensured people could be evacuated quickly in a way that met their individual needs. People could personalise the houses they lived in and their private rooms in the way they wished.

The provider had plans to improve parts of the service. We were told work to improve the appearance of the external corridors was planned to take place next year and additional private rooms were being built. The registered manager and nominated individual told us they supported people's rights to visit other houses than the ones they lived in, and this was assessed to minimise any associated risks.

We observed staff completing fire training related to horizontal evacuations in response to a change in the fire evacuation procedures, this ensured staff could respond effectively in the event of a fire. An interpreter was present to promote deaf staff knowledge and understanding. People could personalise the house where they lived and their rooms according to their tastes and preferences. Bathrooms and communal facilitates were of good design and met people's diverse needs.

The provider had systems and processes in place to detect and control potential risks in the care environment. The provide employed facilities staff to ensure the equipment, facilities and technology supported the delivery of safe care. Essential servicing and maintenance of the gas, electric, fire alarm system, emergency lights, moving and handling equipment had taken place.

People were supported by sufficient numbers of staff who were trained to meet individual needs. A rota system was in place and additional staff were provided if this was needed. Due to a recruitment drive, the use of agency staff was minimal. This meant people were supported by staff who were known to them.

Staff spoke positively about the arrangements for staffing. They said there were enough staff to ensure people got the help they needed when they needed it. A member of staff told us, “They make sure there’s enough staff, they’re really supportive.” Staff told us the management team encouraged their professional development. A staff member told us they were excited to start additional British Sign Language (BSL) training. Staff also shared they completed regular supervisions and appraisals so they could get feedback on their performance and discuss any concerns with a member of the management team. A staff member commented, “I can speak to the managers about anything."

We observed staff completing fire training related to horizontal evacuations in response to a change in processes at the service. An interpreter was present to promote deaf staff knowledge and understanding. Training documentation showed that training was planned to ensure staff remained up to date with best practice.

Prior to working at Brockholes Brow – Preston staff followed a recruitment process to help ensure they were suitable to work with people who may be vulnerable. Staff completed an induction which included shadowing an experienced member of staff before working unsupervised. Staff started to learn (BSL) while they were on induction and it was a contractual obligation that further training in this area was completed. This ensured they had the skills to communicate effectively with people at Brockholes Brow – Preston. A staff member told us, “I’ve learnt loads here.”

People told us they had their rooms cleaned regularly and relatives we spoke with said the service was clean.

The registered manager and staff told us a housekeeping team were deployed to maintain a clean environment. They followed cleaning schedules to ensure the service remained clean and hygienic.

We saw the environment and equipment was clean and personal protective equipment stations were fully stocked.

The registered manager had implemented an audit that met best practice requirements, this was completed to ensure the houses and equipment remained hygienically clean and any shortfalls were identified and actioned. Staff shared they had completed infection control training, and this was annually refreshed to ensure knowledge remained current. A staff member shared, “We have enough PPE (personal protective equipment), more than enough.”

People were supported to take their medicines when they needed them and the use of anti-psychotic medicines was reviewed to identify and prevent overuse. Medicines were stored safely and only accessible to people who were authorised to do so. We noted one medicine had not been recorded correctly, the registered manager took action to minimise the risk of reoccurrence and further training for staff has been arranged to ensure that recording is appropriate.

Staff told us they were trained in the safe management of medicines and checks were carried out to ensure their competence.

Information regarding people’s allergies was recorded accurately on the electronic medicines administration record (eMAR). For medicines to be administered ‘when required’ (PRN), person centred protocols where in place. These provided staff enough information to administer these medicines appropriately.