Sagecare (Chesil 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 inspection this key question was rated good. At this assessment the rating remains 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.

People told us staff were responsive when incidents or accidents occurred. They said staff were very competent in recognising when they were unwell or needed additional support.

The provider had systems to learn and implement changes when things went wrong. They investigated all incidents and reviewed records to help identify any trends or ways to reduce the risk of recurrence. Senior staff followed up incidents with people and stakeholders as appropriate, ensuring people’s care needs were reviewed and updated in response. Staff had a good understanding of reporting and recording safety incidents. They said they were supported in reflective practice to help promote learning from incidents. Senior management had insight and oversight of the learning culture at the service, with both input in response to individual incidents and wider, in-depth support to address thematic issues related to care delivery.

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 manager worked with stakeholders to identify whether prospective tenants were suitable for the model of care at the service. They were clear about the breadth of needs they could accommodate, considering people’s personal abilities to manage risks and the effect their admission would have on the wider population at the service.

When people’s care services commenced, senior staff maintained regular oversight, to help monitor and review whether people’s commissioned hours were still appropriate in meeting their needs. The manager told us people’s care needs often changed when they moved into new settings, so they worked pro-actively to adjust the levels of care provided accordingly.

The service provided a dedicated short stay flat for people requiring a period of focused and structured support. For example, after hospital admission, or when struggling at home. The aim was to stabilise their health and well-being, build confidence, and enable the transition back into more independent living arrangements. There had been several successful placements using this model, which enabled people to access the short term help they needed to aid their recovery, health and wellbeing.

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 with professionals.

People told us they felt safe and knew who to contact if they had concerns about their care or safety. They said they felt comfortable raising issues with the provider and they had built trusting relationships with staff. The provider had developed safeguarding policies and procedures in line with statutory guidance and local best practice.

The manager and staff understood their responsibilities to recognise and report safeguarding concerns to the local authority and other stakeholders as required. They had completed safeguarding training relevant to their role. Records of safeguarding incidents reflected that the provider was pro-active in raising safeguarding alerts. The majority of these referrals were around self-neglect, with early intervention helping to ensure people received the additional support they required. One staff member told us, “If I have any concern, even a small one, I report it straight away to the senior or manager. I’d rather speak up early because safeguarding is everyone’s responsibility”.

The provider had policies and processes to promote people’s personal safety and home security. This included non-entry policies, procedures around handling people’s money and responding to instances of self-neglect. This helped ensure staff were following guidance in their everyday practice that promoted people’s safety.

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us that staff were competent in helping them manage everyday risks related to their care. This included risks around medical conditions, skin integrity and moving and handling.

People had care plans outlining how to reduce risks related to medical conditions, health and care needs. This included risks around epilepsy, catheter care and skin integrity. For example, one person had guidance for staff to follow in the seizure they suffered a seizure. Staff had a good knowledge of supporting people in managing and reducing known risks.

There were business continuity plans, which identified how the service would respond to risks related to extreme circumstances, such as severe weather. People’s care needs had been assessed and prioritised in the event of an emergency. This helped to ensure those most at need would receive support first. There were provisions to source alternative staff from the provider’s other local services in the event of a staff shortage. This helped to reduce risks related to short term staff sickness or absence.

The provider was responsible for responding to emergency call bell requests and senior staff operated an out of hours telephone based ‘on call system’. People told us there was always a senior member of staff available to contact in the event of an emergency. One relative told us “(My relative) is very prone to falling and he wears a lifeline. If needed the carers answer this pretty quickly.” The provider kept records of emergency requests to monitor response times and identify changing needs. For example, in response to increased emergency requests, one person had additional calls scheduled overnight to support them with their continence, which helped to reduce the risk of falls.

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

The provider assessed people’s home environments, considering risks around, falls, home safety, and care equipment. People told us they had the right equipment and that staff used it safely. Staff routinely checked care equipment to ensure it was in a good state of repair and safe to use. Where people used mobility aids, there were clear instructions for staff to follow. For example, there were step-by-step instructions for staff when supporting people to use mobility aids.

The provider promoted safe storage of care equipment. Staff helped people store mobility vehicles in designated ground-floor areas, reducing clutter and fire risks associated with charging this equipment.

The provider helped people raise housing or tenancy issues and met regularly with the housing provider to help resolve them.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

People told us there were suitable numbers of staff and they were happy with their care arrangements. They told us staff were competent and trained to a good standard.

Staff’s training induction was in line with The Care Certificate, which is the recognised standard in health and social care settings. Staff have also received training in supporting people with a learning disability and autistic people, which was in line with best practice requirements. The provider had resources to deliver specialist training when needed. For example, for delegated clinical tasks such as nebulisers, suction machines and seizure management. Staff received regular training updates to help ensure they were following best practice in their role.

Leaders provided ongoing support to staff through structured induction, supervision meetings, spot checks and competency assessments in key areas of their role, such as medicines administration. Staff told us they were happy with the quality of training and support they received. One staff member told us, “The training really helps me feel confident in what I do. It refreshes my knowledge and reminds me of best practice. And if there’s something I’m not fully sure about, I know I can ask for more support or extra training.”

The provider completed pre-employment checks for new staff to help ensure they were qualified and suitable to work with people.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading.

People told us staff followed good infection control practices, wearing personal protective equipment, such as gloves and aprons during support with personal care. Staff received infection prevention and control training and understood how to promote good hygiene and reduce infection risks. The provider had developed infection prevention and control policies and procedures based on best practice. Leaders completed observations of staff whilst working; to help ensure they were following guidance set out in the provider’s policy. This helped to reduce the risk of infections spreading.

The provider made sure that medicines and treatments were safe and met people’s needs.

People told us they were supported to take their medicines as prescribed. They told us that staff had a good knowledge around their needs in relation to medicines administration. People told us they received medicines at their prescribed times, and they had not experienced medicines errors related to staff support.

People’s care plans documented the level of support they needed in the management of their prescribed medicines. The provider had effective systems to monitor medicines administration using the providers electronic care planning system. Staff had a good knowledge of best practice in medicines administration. They told us how they completed checks prior to administration to help reduce the risk around medicines errors. There were safe procedures to ensure medicines care plans were kept up to date and reflected the most current prescriptions.

The provider had effective procedures around the ordering, delivery and disposal of medicines. People’s specific arrangements were documented in their care plans. This helped to ensure it was clear who was responsible for these tasks and who the provider should contact if there were concerns related to the supply of medicines. Where the provider took responsibility for the ordering of medicines, there were additional systems and checks to ensure people had the appropriate medicines available.

The provider had developed medicines policies in line with best practice guidance. This included policies around topical creams, homely remedies, time sensitive medicines and As Required (PRN) medicines. This helped to ensure medicines were managed safely.