Walton Lodge

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 service was in breach of legal regulation in relation to people’s safe care and treatment.

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. Lessons were not always learnt to continually identify and embed good practice.

Accidents and incidents were recorded and reviewed so any trends or patterns could be identified. However, there was limited, or in some instances no details about the nature of the incident, what actions had been taken, the outcome and if any lessons had been learned and/or changes made to practice to keep people safe and reduce the likelihood of a re-occurrence.

The registered manager understood their responsibility under the duty of candour to be open and transparent with people and their relatives. Where accidents and incidents had occurred, people and relatives were informed.

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.

Staff worked with a range of other health and social care professionals such as speech and language therapists, dieticians, social workers and local authority and health care commissioners. Working in partnership with these other professionals helped to achieve positive outcomes for people. One relative said, “They [staff] explain what medication [relatives] having and tell me about their upcoming health appointments.”

At the time of our assessment there had been several incidents reported, which were being investigated. The provider had taken several steps to ensure people were safe, including increasing staffing levels and the amount of well-being checks being carried out by staff. However, we received mixed feedback from staff about how safety and safeguarding events were being listened to and managed at the service.

People who lived at Walton Lodge communicated in various ways to tell us they felt safe. Family and friends spoke positively about the standard of care and support people received. One relative said, “I’ve not had to raise any issues in relation safeguarding at Walton lodge. They give me peace of mind because I know [relative] is safe at Walton Lodge. I trust them implicitly.” We saw staff treating people with kindness, supporting them with their care and providing activities.

Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team. This meant staff understood their responsibilities to protect people from harm. Staff had a good understanding of whistleblowing and felt they would be protected from being identified should they raise any concerns.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found when needed, DoLS applications and authorisations were in place for people. Care records contained information to inform staff if a person had a DoLS in place. However, review of recent incidents showed further training was required to strengthen understanding and application of the Mental Capacity Act (MCA) in practice, ensuring compliance with legal requirements and promoting best outcomes for individuals.

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.

Risks had not always been assessed and there was a lack of guidance about how to support people who may require additional support to manage their emotions or underlying health conditions. For example, when people experienced self-harm or anxiety there was limited guidance for staff around potential triggers, consequences, outcomes or guidance for staff on how to respond if the person was feeling anxious. Some people living at the service required support to manage difficult or distressed behaviours and staff said they did not feel there was clear guidance, or training on how to safely support people expressing these behaviours.

People told us they liked living at the service and were free to decorate their room how they wanted. While the people we spoke to expressed, they were happy with the environment, our assessment found elements of care did not meet the expected standards.

We observed 1 kitchen needed repair or replacement and therefore, could not be effectively cleaned. Staff completed regular cleaning with appropriate products. However, their efforts were compromised by the poor state of repair of the kitchen which meant some areas were difficult to clean effectively. This was discussed with the registered provider who said they would take immediate action to address this concern.

The environment was adapted to meet the needs of people living there. People had access to outdoor spaces, providing an opportunity to enjoy fresh air and relax in the garden. One relative said, “The layout is really good, plenty of space They have got a lovely area outside. I think it’s good there’s plenty of room and [relative] likes to walk.”

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. 

We observed staff were available to support people in line with their assessed needs. However, we received mixed feedback from staff about staffing levels. They noted last minute sickness had an impact, but people remained safe.

Staff had received training, up to date policies, regular supervisions and were recruited safely. However, following recent incidents the provider had identified a number of areas where staff required either further training, or refresher training. For example, following recent incidents at the service they had identified staff needed further training on implementation and understanding of the MCA, positive behaviour support and confidentiality.

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.

Systems were in place to assess and manage the risk of infection. For example, staff had completed infection prevention and control (IPC) training and had access to current IPC good practice guidance. There was a good stock of PPE available, and staff used and disposed of it safely.

People’s relatives raised no concerns about the overall cleanliness. One person’s relative said, “It’s always spotless, There's no smells. [Relatives’] room is always spotless, bed always made.”

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People’s medicines were administered safely. Medicines were stored securely following current guidelines for the storage of medicines. Staff had received training, and competency checks were completed to ensure staff were suitably skilled to do their roles. The medicines administration records contained the necessary information for safe administration of people's medicines.