5-6 Prior's Court Cottages: Bradbury House

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• 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

The provider had effective systems and processes in place to ensure people were protected from the risk of avoidable harm, neglect and abuse. The provider prioritised people’s safety which was nurtured through a culture of openness and transparency where concerns about people’s and staff safety were reported and investigated quickly. Lessons learned were shared with staff to improve staff’s practice and quality of care. Staff received training relevant to their roles and responsibilities. There were appropriate staffing levels and skill mix to ensure people received safe care in accordance with their needs. Staff understood and effectively delivered care and support in accordance with the care plans and risk assessments. The provider encouraged open communication with the staff and families. People were supported with the provider actioning mental capacity assessments and best interest decisions. People were supported safely which was least restrictive of their freedom. The provider reviewed risks to improve on practice, continuous improvement and prioritising the needs of the people. The provider followed the Right Support, Right Care, Right Culture guidance.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The feedback from staff demonstrated the team nurtured an open and transparent culture where concerns about people and staff safety were reported and investigated quickly. Staff consistently reported the management team had created a blame free culture where staff were encouraged and supported to raise concerns which were acted upon. Staff spoke with pride about the open and transparent culture within the service. Leaders spoke positively and highly about the provider and the care people received.

The provider prioritised safety through openness, transparency and sharing the learning from events. Lessons learned were discussed with staff to improve staff practice and quality of care. There were risk assessments in place to manage risks and to safely support people. The provider investigated and reported incidents and complaints promptly focussing on sharing any organisational learning and embedding good practice.

People’s families commented positively about the positive culture created by the staff and were aware of the support mechanisms if people needed to raise concerns using their communication plans. People and their families were involved in and contributed towards the development of the systems that ensured lessons were learned and to continually improve good practices. Families were confident the provider responded appropriately to concerns and they would be able to contact the provider anytime they needed to.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider had effective systems in place to review safeguarding concerns, accidents, incidents or near misses. The registered manager shared any learning from concerns investigated with the team to improve the practice and embed learning to safeguard people. The provider was committed to taking prompt action to support people to keep them safe, for example when working collaboratively with partners.

Staff had completed safeguarding and whistleblowing training and understood how to report concerns both internally and to external agencies when required. Staff consistently reported the management team had created a blame free culture where staff were encouraged and supported to raise concerns which were acted upon. Staff shared concerns quickly and appropriately. Staff were committed to improving people’s lives whilst protecting their right to live in safety, free from avoidable harm and neglect.

People were protected by safeguarding systems and processes that were in place to protect and uphold their rights. People were supported to make their own decisions and if they were unable to make certain decisions, mental capacity assessments and best interest assessments were in place. People were always supported in the least restrictive of their freedom options. Positive behaviour support plans were in place for people where staff needed to be aware how to best support people experiencing episodes of anxiety.

Staff and leaders feedback demonstrated a holistic approach to meeting the needs of people safely whilst supporting people to do things they wanted to do. The provider prioritised identifying risks and implementing risk assessments that empowered people and staff to take positive risks. Staff told us how they supported people to make their own choices, so they had as much control and independence as possible. Staff demonstrated their understanding on how to support people effectively during episodes of distressed behaviour. There was a proactive approach to risks management that was recognised as the responsibility of all staff. A staff member told us of the immense pride they felt when they recently de-escalated a situation by engaging effectively with the person using distraction techniques based on the person’s interests and personal preferences. A staff member told us the care plans and risk assessments were the best they had ever seen and contained all of the necessary information for staff to provide a personalised approach. Staff and managers told us about the holistic, multi-disciplinary approach to each person’s care and about many successful outcomes achieved for people.

The provider had effective procedures to proactively manage any risks and emergencies which were individualised to meet people’s needs. Staff were aware of and followed the guidance in relation to positive behaviour support included within people’s care plans. There were thorough and detailed person-centred risk assessments, which were regularly reviewed to reflect when people’s needs changed. The care plans clearly identified risks, were detailed and enabled staff to keep people safe. Communication plans reflected people’s preferred communication needs and how each person was to be supported to ensure meaningful engagement. The provider operated a bespoke and innovative learning framework that supported the following 7 areas of care delivery; Healthiness, Communication, Positive Behaviour Support, Daily Living Skills, Vocational Skills, Functional Academics, Keeping me Safe. The framework specified how the progress needed to be tracked. The provider ensured people had regular access to advocacy services. The planned approach for each person was individualised and tailored to meet the needs of people.

People were at the heart of the service delivery. People and their relatives were fully involved in their care planning. The provider proactively engaged with people, families and professionals to manage risk so people’s autonomy and independence were maximised. One relative told us, “We have an annual review meeting where we contribute to the development of [person's] goals and outcomes. Staff are always available to discuss [person’s] progress.” Another relative told us, “When there is any kind of crisis, in my [person’s] case often a health-related crisis, the staff come into their own. They put aside their own plans and commitments to provide whatever support is required and I am confident that [person] is in safe hands.” The provider aimed to find the best way forward for people and their future and achieved that through ensuring transparent and positive culture that encouraged open communication in relation to people’s care. People were enabled to take positive risks and were supported effectively to ensure their independence was maximised.

We saw people were supported by staff that showed a genuine interest in their well-being, improving their quality of life and creating a warm, inclusive atmosphere. We observed staff caring for people with kindness and a friendly demeanour that positively impacted on people’s spirits and mood. We observed people consistently receiving a kind and compassionate approach from staff using positive and respectful language. Staff used communication aids recognising people’s individual communication needs and to maximise effective communication with people. Staff were exceptionally skilled in recognising and responding to people’s needs well and adapting their approach, body language and tone of voice to meet the needs of each person. There was a tangible, person-centred culture within the home and we consistently observed staff demonstrating genuine empathy for people and passion for providing high quality care. We observed people establishing a very positive rapport with the registered manager and their key staff, with whom they had developed a special bond. We saw only positive and caring interactions; people were observed smiling, enthusiastically engaging with staff and they appeared relaxed, content and meaningfully engaged.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us there were always sufficient and suitably qualified staff to meet people’s needs and to provide stimulating activities to enrich the quality of their lives. Staff confirmed they received effective training and meaningful supervision through bimonthly one to one meetings. Staff praised the quality of training and support they had. Staff also told us they were able to access further training and gave us examples of when they had done so. There was a pathway approach to support staff professional development and progress in their roles. A staff member told us they felt the ability to achieve different competency levels for Autism Practitioners created an opportunity that enabled them not only to progress in their continued professional development but also inspired excellence in the care provided to people.

The provider had a comprehensive training plan to support staff in delivering effective care to people. They introduced a new system to facilitate opportunities for staff to support their continued professional development. Development of different levels within each role meant there was a clear career progression pathway. The provider was in the process of reviewing mixed feedback received from staff about this scheme. The records demonstrated where agency staff had been deployed, their training completion was checked. They were additionally required to complete some of the provider’s training modules, particularly in relation to autism. The provider followed safe recruitment and selection process to ensure only staff suitable to support vulnerable people were employed. Staff files contained full employment histories and DBS checks and staff conduct in previous care roles had been fully explored.

Our observations demonstrated people received prompt support from staff. We observed staff deployment contributed to people receiving continuity of care. This also meant people were supported by staff that knew people’s needs well and were not only able to support people safely but also provided stimulating activities that enriches the quality of people’s lives.

People benefitted from safe staffing levels with the consideration given to the right skill mix. There were sufficient suitably qualified staff to meet people’s needs safely and provide stimulating activities to enrich the quality of their lives. A family member told us, “The staff work across the residents, rather than always being with one individual, and we have observed that they adapt their way of working, the way that they interact and the activities that they do to meet the needs of the young person that they are working with on that shift. It is very clear who the main member of staff is for each resident on any one shift and I really like that focus.” Other comments from people’s relatives included, “Yes, staff are very good at reading [person] which is essential as [person] is non-verbal. They know what to give [person] and what not to give [person]” and “Staff who work with [person] are always at hand if [person] is ever distressed or unhappy. They are aware of [person] needs, and of how [person] communicates with them.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.