Apex Prime Care - Nightingale 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.

This is the first assessment for this newly registered service. This key question has been rated 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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had processes in place for staff to report incidents and near misses. This included reviewing and learning from incidents and adjusting people’s care accordingly to keep them safe. Staff confirmed they would report any concerns to the office straight away and that prompt action would be taken to keep people safe.

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. This included completing a comprehensive initial assessment with the person and their representatives. This ensured information regarding all health and social care professionals involved in people’s care was up to date and routinely reviewed. People were supported to move into the service including from hospital and kept in contact with health professionals to support people safely back to their home. One person told us, “The district nurse comes in to see me, so I feel very safe living in my own space. Something I haven’t been able to do for a good while. I love it [here].” One relative told us, “After 2 recent unsafe discharges from [name of hospital] and being denied a hospital bed for my now bed-bound father, everyone at Apex has stepped up to make sure he is safe and well looked after going forwards.” Another relative told us, “Mum started having nosebleeds and the registered manager worked with the GP to identify which medication might be involved, reducing the dose over time until the bleeding stopped. They are a godsend.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. Staff and the registered manager knew how to recognise the signs and what to do if they suspected someone was at risk of abuse or neglect. Staff had access to an application on their phone to share any concerns quickly, this was closely monitored. Records showed the provider had reported safeguarding concerns to the relevant authorities and cooperated with investigations. One relative told us, “She is safer there than anywhere I think.” Another relative said, “We have peace of mind that she is safe there and that there is always someone around to support her 24/7.”

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. Assessments were undertaken to identify risks to people and to the care staff who supported them. Areas covered by these assessments included risks associated with the environment, personal care and moving and handling. Staff knew people well and could identify risks to people and knew what support was needed to keep people safe.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider carried out assessments of people’s home environments to identify and reduce any risks related to the delivery of care. The registered manager understood who to contact should they feel people may benefit from additional aids or equipment. There were clear instructions for staff, outlining the safe use of any care related equipment. Staff were trained and routinely observed when using equipment which helped to ensure it was used appropriately. One relative told us, “Mum and dad are safer there than they were living independently in their own home, it really is the next best thing, and help is only a buzzer away. Day or night.”

The service 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 they received support from consistent staff at the agreed times and staff were well trained and competent in their role. Staff received training relevant to their role and systems were in place to promote their ongoing learning and development, including regular supervision, checks of their competency and shared learning through team meetings. Staff were recruited safely. One relative told us, “Nothing is too much trouble and there are always enough staff.” Another relative said, “Nobody rushes mum, and they let her go at her own speed.”

The provider thoroughly assessed and managed the risk of infection. They always quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly. There was a recent outbreak of Nora Virus and everyone we spoke with told us how well the situation was handled and really praised the service on how they managed this. One person told us, “The outbreak of Noro Virus was handled really well, and I am happy to say I never got it.” Staff were provided with appropriate personal protective equipment (PPE) whilst they were providing care. One person told us, “The carers do wear gloves and aprons. If they make me a cup of tea after personal care, they change the gloves again.” The provider had effective infection control policies and procedures in place.

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. The provider had policies and procedures developed in line with national guidance, to help ensure staff were following best practice. People’s care plans detailed the support people needed to manage their medicines and the support they required. Records showed people received their medicines safely as prescribed. Staff had a good understanding of best practice in medicines administration. The service worked closely with a local pharmacy to provide medicines to people. The pharmacy told us, “I find the management are very swift in reacting to the needs of the residents. If someone is prescribed a new medicine or are running low on a particular medicine, they will inform me immediately and will follow up to make sure I have received from the surgery what was requested and will deliver in good time.” One relative told us, “The carers deal with all the medication and there have never been any problems.” Another relative said, “Since they moved to Nightingale Lodge and they took over their medication, she is a different person. Much more stable and happier.”