Amber 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 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 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 service promoted an open and transparent approach to safety and staff were encouraged to raise concerns. One member of staff told us, “If one of our colleagues was doing something wrong, it’s my duty to inform a senior.”

Learning from incidents, accidents and safeguarding matters was used to strengthen practice and support continuous improvement. The registered manager explained, “Any incident is reported and recorded and safeguarding is raised.” In addition, the registered manager and deputy manager ensured learning was shared with staff so that positive outcomes for people could be maintained and developed further.

Information was communicated effectively through regular handovers, supervisions and staff meetings, ensuring staff remained well informed. Clear communication systems were also used to update staff about changes, including updates to care plans, visits or appointments.

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 told us that care plans were detailed and contained all of the information they needed. One member of staff explained, “Care plans are clear. That is how we understand people. Same as risk assessments.”

People and relatives shared that they were satisfied with how the transition into the service and admission process had been managed. One relative said, “[Relative] came into the home end of [month] last year. I feel they look after [relative] very well; and are very kind and caring to [relative].” One person told us, “I have been here about 5 weeks now. All I can say is the staff are wonderful to me. They are very kind and caring.”

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 were able to explain how to identify indicators of abuse and clearly described the steps they would take to protect people. This included escalating concerns and contacting relevant external agencies if they felt appropriate action was not being taken. One staff member told us, “I’d report to my senior. After that if it’s not controlled by them, I’d report to CQC directly.”

We received positive feedback from people and relatives. One relative told us, “Yes, we feel [relative] is very safe there, 100% no worries whatsoever.” Another relative said, “[Relative] is very safe, they take good care of [them].”

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.

Care plans and risk assessments were personalised and detailed to provide positive outcomes for people whilst maintaining their choice and independence. Risk assessments contained mitigation plans and care workers explained that they were able to implement risk management when caring for people. For example, one member of staff explained, “We assess all risks before accidents can happen. We try to assess risks to minimise harm to people and put precautions in place.”

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 environment was adapted to meet people’s needs. There were spacious communal areas that enabled people to relax and take part in activities, as well as access to outdoor space and gardens. People had their own bedrooms, and specialist equipment was available where required. The premises were well maintained and safe, with a dedicated maintenance employee. Systems ensured maintenance issues were recorded and addressed promptly, and records of equipment and premises checks were up to date. A relative told us, “It’s a very clean home, what I notice more than anything is there is no smells there.”

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.

The registered manager had processes in place to ensure all staff received an induction and staff we spoke with told us they had an extensive induction when they started. The registered manager told us about the recruitment process and said, “Interviews are very important. Most staff, if they don’t have the relevant qualifications we do the Care Certificate and we have a lot of staff that have equivalent. [Deputy manager] is very experienced clinically.” The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.

Appropriate checks were in place before staff started work including providing full work histories, references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

Care workers told us there were always enough staff on shift and that the rota was managed well. People and their relatives also told us that there were sufficient staffing numbers, for example one person said, “If I press my buzzer, I don’t wait long for anyone to come.”

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 had received training in infection prevention and control, and there were clear policies in place. Cleaning schedules were in place and followed, and staff had access to appropriate personal protective equipment (PPE). An infection prevention and control champion monitored cleaning arrangement, ensured PPE was used correctly, and that the Control of Substances Hazardous to Health (COSHH) products were stored safely and in sufficient supply. COSHH refers to the regulations that require employers to identify hazardous substances, assess the risks they pose, and implement appropriate control measures to protect employees’ health.

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 robust systems in place to safely manage medicines including refreshing medicine training and competency checks. Audits were very thorough to check whether medicines were being managed safely and records confirmed this.