Sidney Avenue 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 changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The provider had failed to robustly assess the risks relating to the health safety and welfare of people. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service scored 59 (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 did not always have a proactive and positive culture of safety, based on openness and honesty.

Incidents and concerns were always discussed within the team and staff understood how to report concerns. However, this was not always documented adequately. This made it difficult for healthcare professionals to understand timelines of events and what actions had been taken in response to any concerns. This is discussed further in the well led section of this report.

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 living at the home had been there for several years. Staff understood their needs and worked well with other healthcare professionals to maintain joined up working. This ensured people experienced continuity of care.

At the time of the assessment, there was one vacancy. There was a process in place for new referrals. This took into account how to support people and how to help them understand the process and be fully involved.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

People and relatives told us they felt safe living at Sidney Avenue. Staff knew people well and understood their care and support needs around keeping them safe on a day-to-day basis.

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 were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse.

Staff confirmed they had received safeguarding training and were able to explain how they would report any concerns. Feedback from people and relatives was positive and relatives felt their family members were safe with staff.

We spoke with a visiting healthcare professional during our inspection. They told us staff were working well with a person, who had changing care and support needs, to maintain their safety whilst balancing their independence.

People who lacked capacity to make certain decisions for themselves or had fluctuating capacity had decisions made by staff on their behalf in line with the law.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People’s risks were not always identified or adequately risk assessed. For example, a person with diabetes had no comprehensive risk assessment to explain how their diabetes affected them or how staff could recognise when they should act on any risks associated with the condition. Another person could become distressed in certain situations, had no specific information recorded on what triggered their behaviour and how staff should manage this. Falls risks were not adequately assessed for one person.

People had individual Personal Emergency Evacuation Plans (PEEP’s). PEEPS explain what support each person would need in the event of a fire. Whilst individual PEEPs were in place, the registered manager confirmed the home did not conduct fire drills. This was because it was felt people could become distressed by the loud noise. In the absence of fire drills, the provider could not establish how effective people’s PEEPs were. One person’s PEEP noted they did not recognise alarms. We spoke to the registered manager about working effectively with people to understand what the fire alarm was and how to respond appropriately in the event of a fire.

Whilst risks were not well documented, staff knew people well and were able to tell us what people’s risks were and how they would respond.

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

The back garden was extremely cluttered with old furniture, items that were not in use and 3 old exercise bikes. The clutter in the garden posed a risk to people. The 3 exercise bikes had not been checked to make sure they were safe and functioning correctly. The home also had several cats and there was a sizable cat house at the bottom of the garden. There was cardboard on the pathway along the garden to the cat house which created a trip risk to people. We spoke with the registered manager who accepted the garden needed to be tidied and said this was being planned. However, the provider had not assessed risk posed to people from the garden or cats.

There were enough staff to provide care and support for people. However, the provider did not always make sure staff received effective support, supervision and development.

Staff had not always received refresher training to make sure their skills and knowledge were up to date. We raised this with the registered manager. The registered manager confirmed training and training records were not up-to-date and told us staff were being registered for training and a new training record was being completed. Following the assessment, the registered manager sent us an updated training matrix to show staff had completed relevant training, including working with people who have learning disabilities and / or autism.

Staff told us they felt supported by the registered manager and were able to talk to them at any time. However, there were no regular documented supervision records. The registered manager told us they had started to document supervisions so there was a record of the support staff received.

Staff were recruited safely and all appropriate background checks were carried out before staff started working at the home.

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 house was clean and smelled fresh. There was a cleaning rota in place and we observed staff cleaning. The service had good arrangements for keeping the home clean and hygienic. Staff used personal protective equipment (PPE) effectively and safely. Staff were encouraged to be vaccinated against flu to help prevent the spread of infection.

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.

Staff followed effective processes to assess and provide the support people needed to take their medicines safely. People were supported by staff who followed systems and processes to prescribe, administer, record and store medicines safely. Medicines errors were fully documented and assessed for any learning.

The service ensured people’s behaviour was not controlled by excessive and inappropriate use of medicines. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. People could take their medicines in private when appropriate and safe. People received support from staff to make their own decisions about medicines wherever possible.