Barton 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 requires improvement. At this assessment the rating has changed to 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. For example, since our last inspection, the registered manager had introduced several additional audits and checks, for example in relation to bedrails and repositioning. These had identified areas where further improvements could be made through staff training and record keeping, leading to positive outcomes for people.

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. Where required, the provider ensured an escort was available to support people to medical appointments and ensured information could be shared effectively.

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 a good understanding of their responsibilities to keep people safe. One staff member said, “If I witnessed anything, I would raise it straight away to the manager, I know I could go to the local authority if I needed to.” The provider had effective systems in place to recognise, record and respond to information of concern.

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. For example, where people experience emotional distress, care plans contained clear guidance for staff to follow. People told us they felt safe, one person said, “I do feel very safe here.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. For example, the provider had several regular checks to ensure the environment and equipment was safe and suitable. People were happy with the environment, one person said, “The place is lovely, clean, rooms are big and comfortable, good furniture and I have my shower room.”

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.

We received mixed feedback about staffing. A relative said, “Sometimes there seems to be enough staff and other times there seems to be not enough, in the lounge there are enough staff, sometimes a bit up and down. Mostly enough.” And “I think they need more staff at nights and weekends.” Another said, “I think there are enough, not seeing anything otherwise.” During our assessment visits, we observed enough staff to be responsive to people’s needs.

Staff confirmed they had received additional training workshops in relation to record keeping and person-centred care following improvements that were noted during our last inspection. Staff told us they attended regular supervision.

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. We observed the environment was clean, there were appropriate amounts of personal protective equipment available, and food was stored safely. A relative said, “It is clean, and it is a safe environment.”

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.

We observed staff supported people to take their medicines safely and in a kind and respectful way. Medicines, including controlled drugs (medicines requiring additional control due to the potential for misuse), were stored securely, and administration records showed people received their prescribed medicines as intended.Medicines audits were carried out routinely to check that systems were safe. Staff had received training, and their competence was assessed regularly. Staff engaged with other healthcare professionals and took part in regular multidisciplinary meetings to review people’s medicines.Topical medicines, including patches, were recorded appropriately, with clear body maps in place to support application and site rotation. Where people received medicines via an enteral feeding tube, records showed care was delivered safely in line with clear instructions.Person centred guidance was in place for 'when required' (PRN) medicines, such as pain relief and medicines for agitation. While staff usually recorded the reason for giving the medicine, they did not always document what non-medical or calming strategies they tried before giving medicines for agitation.