Chalfont 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 Requires Improvement. At this assessment the rating has changed to Good.

This meant people were safe and protected from avoidable harm.

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.

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.

People and staff were encouraged and supported to raise concerns, they felt confident they would be treated with compassion and understanding.

Staff told us they were updated about incidents and changes. Incidents and accidents were discussed in handovers, meetings and group supervisions. One staff member told us, “I am well supported here and management do listen. If there is a problem [registered manager] will deal with it and share the knowledge, so we all learn.” For example, 1 person sustained a fall. The registered manager conducted a thorough investigation and an in depth analysis of the results. Conclusions were drawn which included, a review of risk assessments, a GP referral and a review of the person’s medicines. Staff guidance was updated including increased monitoring and controlling the environment to mitigate the falls risk. Reflective meetings were held with staff and lessons learned were recorded and, where appropriate actioned. This meant the person’s risk was well managed and mitigated.

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.

The home worked with a number of professionals to ensure continuity of care within the home. The home had regular visits from external NHS physiotherapists. and made appropriate referrals to healthcare professionals. We spoke with a visiting healthcare professional who told us, “We have a great working relationship with the staff, they are all, very professional.” Another visiting healthcare professional said, “Communication with the home is brilliant, if I make a suggestion, it is always actioned.”

Staff knew people and their risks well and told us how they worked with professionals to keep people safe. One staff member commented, “I believe our residents [people] are safe and well looked after.”

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 using the service and their relatives told us they felt safe and were happy with their care. We were told, “[Person] is safe, absolutely, I have no problems with his safety or care at all, and he always appears content” and “I do feel safe, of course, everyone is very nice to me.”

We spoke with staff about working with vulnerable people. One staff member told us, “My staff report concerns to me with no hesitation, and I then escalate to the manager if needs be. It is an effective system.” Another said, “I would report all concerns to my manager.”

Peoplecan only be deprived of their liberty to receive care and treatment with appropriate legal authority. Incare homes, thiscan be donethrough a procedurecalled the Deprivation of Liberty Safeguards (DoLS),whichispart of the Mental Capacity Act 2005(MCA).We checked whether the service was working within the principles of the MCAand how they managed DoLS within the service. We found that where appropriate, mental capacity assessments were in place to safeguard people’s rights in relation to decisions about any risks and DoLS applications and decisions were managed appropriately.

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.

A risk management system was in place, and risk assessments were part of people’s care plans. These provided staff with guidance on how to manage risk. For example, 1 person was diabetic and their condition was managed with medication. Staff monitored the person’s blood sugar levels and were knowledgeable about the condition. The care plan also provided staff with guidance on what actions to take if the person was experiencing high/low blood sugars. Records confirmed all risks were reviewed annually, or ‘as required’.

A member of staff spoke with us about diabetes. They said, “We have some residents who are diabetic, most of them have different diet plans. The nurses make sure care staff are doing the right thing.”

We spoke to the chef who told us, “I am kept up to date with people’s dietary needs, including special diets for those with diabetes.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home had fire safety equipment to meet standards, and staff had completed the relevant fire training. All health and safety checks were in date and recorded appropriately.

The home was clean and free from malodours and designed to be dementia friendly. The windows all had window restrictors in place. People’s rooms were identified with clear door numbers and the person’s name, handrails contrasted with wall colourings and lighting was not too bright. This helped people to navigate around the home. Corridors displayed period pictures and posters that helped to create a calm and relaxing atmosphere.

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.

One staff member told us, “We are staffed well, I believe we have enough. The residents are very safe and well looked after.”

People told us there were enough staff. One person said, “I think for me, there is always someone around. Two carers [staff] and a Nurse are here at night, and they are always checking me every few hours.” Another person said, “I think there are enough staff and carers.”

Throughout the inspection, we observed staff responded to people promptly and had time to interact with people whilst supporting them.

The provider had robust recruitment systems in place to ensure people were supported by well trained, experienced staff. Background checks were conducted to ensure staff were safe to work with vulnerable people.

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.

Staff wore personal protective equipment (PPE) during personal care. Staff understood the need to wear PPE and how to manage the risk of infection. Infection control policies were in place and up to date.

Cleaning schedules were in place, and people’s rooms were maintained to a high standard. Toilets and bathrooms were clean and regularly checked.

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 received their medicine as prescribed. Staff had been trained to administer medicines, and their competency to do so was regularly checked. Records confirmed any medicine errors were reported and investigated. One staff member told us, “My competency is checked every year without fail. We need to be safe.”

Medication management was robust. For example, there was clear emphasis on timely administration of Parkinson’s medications to prevent symptom exacerbation. Medicine records were accurate and up to date and stock balances were correct. Drugs which required additional security were held securely and managed appropriately.

People’s medicines were regularly reviewed by the GP and regular audits monitored medicines to help the home manage medicines efficiently.