Arun Lodge Residential Care Home

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 69 (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.

For example, where safety concerns were raised, they were investigated to identify lessons learnt and subsequently discussed at team meetings raising staff awareness. We raised a concern with the manager around the potential harm people could experience should they unintentionally access a fire exit; the manager responded to this consulting the relevant professionals and put measures in place to lower the risk of harm to people using the service.

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.

For example, the manager had developed a positive working relationship with local healthcare providers, including the GP and district nursing team, which meant people were able to access health care promptly and received care that supported their needs. One professional, when speaking about their experience of working with the manager and staff, said, “The manager is very approachable, sensible, and confident in taking responsibility for decisions regarding people’s care.” Another professional said, “They consistently seek advice or guidance at appropriate times and works collaboratively with our team at the surgery. The manager also ensures staff are well supported and that learning is continuously embedded into practice.”

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 had their needs safely met, by a staff team who knew the people they were supporting, and reported changes in people’s conditions to the manager who made referrals to specialist services where needed, for example people who were observed to have changes relating to eating and drinking had been referred to the Speech and Language Therapy (SALT) team whose guidance was then communicated to staff. We spoke to staff who were able to demonstrate a good understanding around people’s eating and drinking support guidance. Mental capacity assessments were completed for people, where needed, with best interest decisions made around specific decisions if people did not have capacity. Where there was a concern for people’s safety for example, leaving the home unsupported, a Deprivation of Liberty Safeguards (DoLS) application was made by the manager, a process was in place to track these applications. It is the registered manager’s responsibility to submit a statutory notification to CQC when a DoLS application is granted, this had not always been promptly completed, we raised this with the manager who subsequently submitted the outstanding statutory notifications relating to peoples DoLS and strengthened their process to ensure they are submitted in a timely manner in the future. Other statutory notifications, such as people’s deaths or serious injuries, had been submitted promptly in line with their duties. Staff supporting people had received safeguarding training, were able to recognise the signs of abuse and knew how to report their concerns, which were reinforced by the provider’s safeguarding policy.

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.

Risk assessments for people were in place which identified potential risks to people’s wellbeing with measures in place to reduce them to a safe level. People told us they were involved in this process and were able to take positive risks. For example, where it was safe to do so people were able to leave the service and access their local community unsupported. One person said, “They asked me what was important to me.” Personal Emergency Evacuation Plans (PEEPs) were in place for people, supporting them during an emergency such as a fire.

The provider did not always detect and control potential risks in the care environment. However, they made sure equipment, facilities and technology supported the delivery of safe care.

The manager had completed health and safety audits of the environment which included checking for potential hazards which could cause people harm, these audits had not always been effective in identifying potential risks to people. For example, we raised concerns with the manager about the potential danger from a fire escape on the first floor of the building posed to people living with dementia and people whose mental capacity may fluctuate, the manager then added measures to address this hazard and reduce the potential risk posed to people’s safety.

Other environmental risks to people’s safety had been detected and controlled. For example, risks of scalding and burns from hot water had a specific risk assessment with measures in place to reduce the risks to people. Equipment used to support people had been serviced, and facilities people used were well maintained, the manager worked with a maintenance provider to rectify issues when they were identified.

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.

Staff had received training relevant to their roles and were encouraged by the manager to request additional training they felt would increase the quality of care they deliver to people. People told us there were enough staff to support them. One person said, “They have time to talk to me and never rush me.” A staff member told us, “I received an induction and training before I supported people independently.” The manager used a training matrix to monitor the staff team’s compliance around training levels. The staff team received supervisions by senior staff and the manager providing a dedicated time to discuss work related topics.

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.

The service was clean and inviting, there was a cleaning schedule in place which was being followed. Staff had PPE available to use when supporting people with personal care. One person said, “They always use gloves and have aprons when they support me”The kitchen had a rating of 5/5 with the Food Standards Agency, indicating they were compliant and following good practice in this area. The manager utilised an external infection prevention and control audit provider, to check their compliance which showed they were meeting the requirements.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities but had considered their preferences. Staff involved people in planning, including when changes happened.

We observed medication not being administered, in line with the NICE medication administration guidelines (National Institute for Health and Care Excellence). For example, medication pots were given to people and left unattended in communal areas, which had the potential to impact on people’s safety. NICE guidelines make clear that when administering people’s medication, it must be witnessed to have been taken before a medication can be signed as administered. We informed the manager of our concerns who responded by implementing extra spot checks during medication rounds and raised staff awareness around this issue to improve their practice and were working on embedding this within the team. Other areas of medication administration were observed to align with the NICE guidelines, such as cross referencing original boxed medication with the persons Mar chart (medication administration record).Staff had received training in medication administration, with a period of shadowing a senior member of the team who then observed their practice with competency checks before they could administer people’s medication alone.