Loganberry 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 remained good. This meant people were safe and protected from avoidable harm.

Recommendations had been made at the last assessment regarding the deployment of staff. Improvements had been made, and staff were appropriately deployed across the service.

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.

The culture of the service meant that people’s safety was a priority. The provider’s system to ensure that all safety events, accidents and incidents were recorded, fully investigated and appropriate action taken in response had improved. Lessons were learnt and shared with staff in a structured and transparent way to continually identify and embed good practice.

Staff told us information was shared with them about any events or incidents that occurred at the service to prevent them from happening again. A staff member told us, “We are always made aware of things that have happened, and these are taken very seriously. We learn about how they could have been prevented. This helps me know how to keep people safe but still keep their independence.”

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 and relatives confirmed they were involved in the assessment process. We saw pre-admission assessments had been completed after a referral to ensure the service could meet their needs whether for a short period after discharge from hospital or longer term. A family member told us, “We were told on the day of discharge this was the one [relative] was going to. The home rang us to invite us to come and look around. We were shown round, and we liked what we saw. Staff are helpful and friendly, patient and tolerant. I do think staff are starting to get to know [relative] even though they have not been here long.”

Staff told us that effective handover and communication meant they had the information needed to ensure they were providing the right care and support. A staff member told us, “I find care plans are well detailed and accessible, handovers are completed between shifts, so we always know if there is a new person on the unit and make sure, we read about their needs and how to meet them.”

The registered manager had developed good working relationships with partner agencies to facilitate safe and effective transitions to the service. A professional told us, “Loganberry Lodge are a valued and good provider. We often make placements with them, both from the community in long-term support planning and in urgent, short-break admissions. They are a very helpful and responsive when it comes to supporting and facilitating successful hospital discharges.”

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 and family members told us they felt safe at Loganberry Lodge. A person told us, “I feel safe and comfortable here.” Another person said, “This is a lovely place where I feel safe and well looked after.” A family member told us, “My impression is that this is a good place. It’s safe, it’s clean. My view is very positive.”

The provider’s safeguarding systems, processes and practices had improved to protect people from abuse, neglect, harassment and breaches of their dignity. These were communicated effectively with people, relatives and staff. The registered manager maintained a comprehensive record of any referrals made to the local authority and the outcome, once received. Lessons were learnt as a result and cascaded to staff for their learning and understanding.

Staff knew how to recognise, respond to and report signs of potential abuse. Staff told us they knew the procedure to report allegations of abuse and were confident that the management would take appropriate action. They had received training in how to safeguard people, and their knowledge was updated through effective communication and the sharing of information. A member of staff told us, “I would go to my manager or the registered manager if I saw any type of abuse or if I had any concerns. I would not tolerate anything like this. I would take it higher to head office if I needed to, I am not afraid to speak out.”

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.

People and family members told us they felt staff knew and understood how to deliver safe care and support. A person said, “I have confidence in the staff who support and look after me.” A family member said, “The staff seem to have taken quite an interest in [relative] and his recovery. The care has changed since they arrived, and they are doing more for themselves now.”

Risks to people’s health were assessed to maintain their safety and wellbeing. These included mobility and falls, continence care, pressure care, dehydration, choking and using equipment. Risk assessments were person-centred, proportionate, and regularly reviewed so that they remained up to date.

Assessments and reviews were completed with the involvement of people and family members/representatives. This ensured an agreed plan of care could be managed appropriately with the least restriction placed on people. A family member told us, “My [relative’s] care plan is reviewed quite often, we usually sit in their room to talk about it, and [relative] has their say.”

There was a balanced and proportionate approach to risk that supported people and respected the choices they made about their care. Where appropriate, people were encouraged to take carefully managed risks in order to live fulfilling lives. For example, the use of sensor devices to alert staff when people might need support when walking, lap belts on wheelchairs to prevent them falling, and positive distraction techniques if people were distressed or anxious.

Staff were familiar with people’s care needs and the associated risks. They told us that the care plans and risk assessments in place informed them of the ways in which they should support people safely. All staff knew how to raise any safety concerns. A staff member said, “We build relationships with the people we support: By getting to know them as we care for them, asking about their interests and talking to them and their families. We involve people in decisions about their care: We will ask people what is important to them.”

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

People told us they enjoyed living at the service. A person said, “I have no worries. I feel I have the freedom to walk about and be myself.” A family member told us, “Looking back, I’m not sure why we worried and to quote my [relative], “I feel at home here.” Another family member said, “[Relative] has got a lovely downstairs room, everyone says how well they look.” A third family member said, “For a big home it’s remarkably quiet. Our only concern was that [relative] would be safe – and they are.”

Throughout the assessment we observed the environment in all units to be safe, clean and welcoming. The environment was purpose built to meet the needs of people living there. People’s bedrooms were personalised to their taste with ornaments and family photographs. Bedroom doors were individualised with pictures of people’s choice.

The gardens were well tendered, and people made good use of them. Maintenance staff were employed to ensure the premises were well-maintained and safe. There were systems in place to ensure any maintenance needed was responded to promptly.

There were effective fire safety procedures in place. Fire safety checks and fire drills were undertaken and people had up to date personal emergency evacuation plans in place. These detailed the support people required in the event of an emergency. Health and safety checks were undertaken, and records showed the kitchens and laundry facilities, equipment, maintenance and all aspects of the premises were safe and comfortable for people who lived and worked at Loganberry Lodge.

Staff used equipment safely to support people. We saw staff assisting people with their frames and using a hoist to transfer people from armchair to wheelchair. Staff communicated with people clearly and gently and were caring and professional. A person told us, “I use a hoist, they know what I am doing. I do feel safe. It is alright.” Another person said, “The staff understand the help I need. They know I use a frame but sometimes need a wheelchair.”

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.

People told us that staff were available to support them when needed. Staff were visible during our visit and were prompt when people requested support. A person said, “It is very good they look after us well. Staff are lovely and they come quickly when I ring my bell.” Another person told us, “If I press my buzzer, staff and the night staff do attend promptly. I feel safe here, I like it here.” People and family members acknowledged that there were times when staff were busier than others and they might have to wait. A person told us, “There are times when they are busy, but they will come to me and say they will come back and they do.” A family member said, “[Relative] is always clean, tidy and comfortable no matter what time we visit. Staff work together as a team, and we are happy there is continuity of staff for our [relative].”

The deployment of staff across the units had improved. Staffing levels and skill mix were monitored to make sure people received consistently safe, good quality care that meets their needs. However, there were two areas where we found staffing needed to be reviewed. One was the amount of night staff available on one unit to care for people safely. The provider told us they were aware of this and confirmed during the assessment they had added additional staff to the rota for a night and day shift and would monitor the outcomes of this. The other was the availability of staff (lifestyle coordinators) to provide activities and one to one time with people. Following our feedback, the provider informed us they had adjusted the rota and allocated additional time every day for lifestyle coordinators to spend with people.

People experienced continuity of care, for example being supported by a regular staff team, and care being delivered through an agreed routine. Staff told us they usually worked on the same unit and were only moved to another unit when needed, or working overtime. A staff member said, Staffing on my unit works well because we are an experienced team and we’ve been together for a long time. We know each other’s routines and strengths.” Another staff member said, “Of course there is always space for more staff, but when we all work together the job gets done and we still have time to spend with people.” A third staff member told us, “I think the staffing is fair, even if it’s a particular busy day I ensure I spend 1 to 1 time with the residents, even if it’s just for a chat, or painting my ladies nails, I know this can make all the difference to them and how they feel.”

Staff had the right qualifications, skills, knowledge and experience to deliver safe and effective care. Staff received training appropriate and relevant to their role, and this was embedded into practice, with their competency assessed. Training was refreshed at regular intervals to maintain knowledge and skills in line with best practice. A staff member said, “Managers make sure we have all the knowledge we need, and we have all the on line and face to face training, plus the chance to progress in our career. This helps us feel more confident and safer in our work.”

Staff told us they received the support they needed to deliver safe care. This included induction, supervision and an annual appraisal. Comments included, “We have regular supervisions and competency checks, and I find them helpful” and “I have regular supervisions and management who supervise me are always willing to listen and offer help and advice if needed” and “My supervision and competency is checked every 2 months but every time when I have a concern or something to say the doors of the managers are open and I receive all the support I need.”

There were robust and safe recruitment practices to make sure that all staff, were suitably experienced, competent and able to carry out their role.

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.

People were protected as much as possible from the risk of infection as the premises and equipment were kept clean and hygienic. People were supported to maintain their own personal hygiene in line with their needs and preferences.

All areas of the service were seen to be clean and uncluttered. This included the kitchen, laundry and hairdressing salon. People and relatives were very positive about the cleanliness in the service. A person told us, “The place is really clean and very safe. Staff know what they’re doing.” A family member told us, “Everything is so clean and tidy, that goes for everything, you can’t fault it.”

Staff were aware of the current guidance for the use of personal protective equipment (PPE) and were observed using this appropriately. A family member said, “They always wear PPE when doing personal things and ask permission first.”

Infection prevention and control processes were in place and seen to be followed. Staff had received training in infection control and were aware of the policies and procedures in place. Housekeeping staff told us they had enough cleaning provisions. They had a daily and deep cleaning schedule to follow. A staff member said, “My aim is hygiene, and I like to do a good job and leave everything clean and hygienic.”

Staff understood the importance of food safety, including hygiene, when preparing or handling food. They followed the required standards and practice.

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.

People were satisfied with the way they were given their medicines. A person told us, “I get my medicines when I should and on time.” A family member told us, “My [relative] is very aware of what they should be taking and counts their tablets out.” Another family member said, “[Relative] used to get very confused with their medicines at home and for us it’s been a relief to know they are getting the right drugs at the right time.”

Systems were in place to safely store, give and record the administration of medicines. Medicines administration was being recorded on medicine administration record (MAR) charts and there were no gaps in recording which meant people were receiving their medicines safely.

For medicines that could be given when required, there was always a current protocol in place to assist staff. Most protocols were clear and comprehensive but a few lacked information. For example, details about when to administer an ‘as required’ (PRN) sedative medicines were not always clear. Staff were trained to be able to respond to episodes of hypoglycaemia (low blood glucose) in people who were wearing a continuous blood glucose monitoring system, but it wasn’t always clear from the PRN protocol what blood glucose reading would require the administration of glucose. These were immediately updated during the assessment in line with the care plans to give clear guidance to staff.

Some of the tablet crushers and cutters found were not clean and contained tablet residue. Action was immediately taken by the registered manager, and they assured us this would not reoccur by ordering individual pill crushers for people and requesting the pharmacy supply these precut where possible. Medicines that were administered by a topical patch were always recorded and rotated appropriately but there was no daily check documented to ensure the patch remained in place. A daily check was immediately put in place by the provider. Care plans were in place for medicines including people on anticoagulants, however, falls risk assessments did not contain details of the increased risk of bleeding when taking these medicines. These were amended by the provider as requested.

Staff were trained in medicines administration and had completed competencies. We observed staff administering people’s medicines competently and treated them with care and dignity. People who were having their medicines covertly (hidden in food or drink) had all the necessary information in place which showed us that decisions had been made in their best interests. The provider was ensuring that people on antipsychotic medicines were being reviewed regularly.

Medicines that needed to be given at specific times were being administered consistently at those times which was outside of the medicines administration rounds. These times took into consideration the views of people who did not wish to be disturbed early in the morning. Medicines which required specific storage were stored, recorded and checked appropriately. People’s allergies were clearly documented so staff were aware.

The provider encouraged people to maintain their independence by allowing them to self-administer their medicines if they so wished. A person told us they were pleased that they were able to manage their own medicines. Risk assessments had been completed, and the process was audited by the provider.

Incidents were being reported and investigated. Medicine audits were being completed both by the provider and by the supplying pharmacy, and action was taken to address any issues.