Rivendale Lodge EMI 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 remained 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.

The provider had systems in place to identify any areas of improvement required. For example, following safeguarding concerns changes had been implemented to prevent these re occurring. When accidents or incidents occurred, these were looked at and reviewed by the registered manager to identify any trends and themes. Any findings were fed back to staff and if required changes were made to peoples care plans and risk assessments.

Relatives felt people were safe and well cared for. One told us, “I can leave here and know she is safe and well looked after, I am not local, so it's so reassuring to know she is so well looked after.”

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 were assessed before they moved into the home. When people came to Rivendale for a short period of respite care, or to live permanently families were asked for information about the person and their needs.

The registered manager and staff worked with other health care professionals to ensure people’s physical and mental health needs were assessed regularly. Care documentation was kept updated and accessible to ensure appropriate information could be shared with other professionals when required. Feedback from other health professionals was positive. One told us, “Any changes, new diagnosis or concerns are reported to staff and staff have acted without delay. Staff follow my professional advice and are proactive in supporting resident’s health. Additionally, if staff have any concerns with a resident’s health, they quickly report it for review.”
 

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.

Staff had received safeguarding training and were able to tell us the actions they would take if they had a safeguarding concern. Staff demonstrated a good understanding around how to protect people from the risk of abuse and told us if they had any safeguarding concerns, they would raise these with the deputy or registered manager. We saw examples where concerns had been raised to the local authority and CQC.

People’s mental capacity had been considered. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We saw best interest meetings had taken place to involve relatives and relevant health professionals in decisions about people’s care.

The service was working within the principles of the MCA and if needed, DoLS authorisations were in place to deprive a person of their liberty.

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 had up to date and detailed care plans and associated risk assessments in place. These were reviewed regularly and updated following any changes. This meant staff were well informed regarding any particular risks for people which could impact on their health and safety whilst living at the home.

Relatives were kept updated and referrals were completed to health specialists when required. For example, people with swallowing concerns had been referred to Speech and Language Therapist (SALT) teams for reviews. If a person had experienced recent falls, then appropriate equipment had been put in place, including pressure mats and sensors in bedrooms to alert staff and referrals completed to the falls team for review.

People had Personal Emergency Evacuation Plans (PEEPs) in place to inform staff and emergency services in the event of an evacuation being required.

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 was kept nicely decorated and clean whilst maintaining a homely feel for people.

Equipment in place, including electronic hoists, wheelchairs and stair lift were checked and serviced regularly. The home had an onsite maintenance person who was responsible for maintaining the home, with external companies used for specialised work. Any issues were reported to the maintenance person and these were addressed promptly.

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.

There were clear and robust recruitment processes in place, this included relevant checks completed before people started working at the home.

Staff received training and regular one to one supervision. Staff felt they received the training they needed to provide care to people and meet their needs. This included dementia training to support them in providing appropriate and supportive care for people living with a dementia type illness. During the first day of the inspection, face to face moving and handling training was taking place in the home. Staff told us they found face to face training very helpful. The trainer confirmed staff were very receptive to learning, communicated well during training sessions and were really keen to learn and improve asking lots of relevant questions to aid their understanding.

Although new staff completed initial new starter checks as part of their induction to the home no formal induction programme was recorded. The registered manager told us how new staff worked alongside experienced staff and received regular supervision to identify any specific areas of further training required during their probationary period, before they worked alone. However, this was not documented. We signposted the registered manager to information in relation to induction and they confirmed induction processes would now be documented.

Safe levels of staffing were in place to meet peoples needs. Staff confirmed they felt that staffing levels were appropriate. Staff worked well together as a team, with many having worked at the home for many years. Staff spoke highly of the registered manager and the support they provided.

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.

Relatives told us, “I consistently found Rivendale Lodge to be clean, tidy, and well-maintained. The environment was always welcoming and comfortable for both the residents and visitors.”

The home was clean and tidy. Staff had completed infection control training. Personal protective equipment (PPE) was available throughout the home and we saw staff used PPE as required.

There were designated housekeeping staff who ensured a high standard of cleanliness was maintained throughout the home.

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.

Safe medicine processes were in place to ensure people received their medicines as prescribed. Staff administering medicines received training and had their competencies assessed to ensure best practice was being maintained.

Systems were in place to record when medicines were given. This included PRN or ‘as required’ medicines. PRN medicines had protocols in place to inform staff how and when this could be safely given. If a person required PRN medicines regularly the GP was informed to assess whether this medicine needed to be prescribed regularly rather than PRN. Staff told us, “We record time and effectiveness of medicines, to look for themes, and if things need to be reviewed and referred. If medicines prescribed for people (who may became anxious or upset) are required regularly we inform the mental health team to make these permanent or to review an alternative.”