Aspen Lodge 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. This is the first assessment for this newly registered provider. At our last assessment under a previous provider, we rated this key question requires improvement. Under the new provider, at this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

Under the previous provider, the service was in breach of legal regulation in relation to people’s safe care and treatment and safe staffing. Under the new current provider, improvements were found at this assessment and the provider was no longer in breach of these regulations.

This service scored 66 (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. People told us they felt safe, and they were encouraged to raise concerns and felt confident to do so. The manager sampled all records and observed practice in order to offer feedback to staff where this could be improved. This proactive approach meant there was consistent learning to help reduce future risks without a sense of blame. Professionals spoke positively about the care being delivered and how staff worked to improve care when things went wrong. A professional told us, “There are no concerns regarding the quality of care that is being given in the home, the management team are very responsive with any documentation that is required, and this is always delivered in detail and promptly.”

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 and staff team worked hard to ensure people’s needs were assessed and developed relationships with relevant external professionals. They made referrals to various teams including district nurses and speech and language therapists (SALT). They worked with hospital staff to ensure safe discharges and admission for people using hospital passports to share key information. A professional said, “From a quality monitoring prospective, we have not received any poor practise concerns. Our case managers report a friendly welcoming environment where the manager is approachable and supportive. Our community nurse colleagues have also reported a positive working relationship.”

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 aware of the provider’s whistle blowing policy and had a good understanding of how to keep people safe and what various forms of abuse might look like. They knew how to report concerns both to their own managers and to other organisations where needed, such as CQC and the local safeguarding team.

Some people had restrictions in place to keep them safe, such as giving medicines covertly or not being able to leave the home without staff support. Where restrictions were in place, the manager had followed the principles of the Mental Capacity Act 2005 (MCA) and ensured a best interest process was followed and people and those closest to them were involved in the decision-making process. For those who required it, the manager had applied for Deprivation of Liberty Safeguard (DoLS) authorisation. These were monitored and reviewed.

People told us they felt safe and were happy with the care. One person said, “This is my home now. I asked to come here, and it is as good as I had hoped.” A relative told us, “It is very safe. [Staff] use a hoist to get my [family member] out of bed. We have seen them use it; there are no issues at all.” Another relative said, “It is very safe, my [family member] is happy since they have gone there. A lot of their stress has gone.”

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks were reviewed monthly or when a concern was raised however, updated information was not always transferred to people’s main care plans. Subsequently, some risk assessments did not contain current information, and 1 person did not have a risk assessment in place for their epilepsy. No-one had come to harm because of this but it placed people at risk of harm as staff were unclear on how to respond if the person had a seizure. The manager and clinical lead acted quickly and put the risk assessment in place before the end of the inspection and booked staff on refresher training in this area.

Despite our findings, people and professionals were happy with how risks were managed to ensure people were supported safely. A relative told us their view of how staff managed mobility risks for their family member. They said, “From what I’ve seen, [staff] are very well trained. No concerns whatsoever. My [family member] gets panicky, but they reassure them.” A professional told us, “During any visits, residents always speak highly of the care that is being delivered and how the carers are kind and considerate. Risk management has not been a concern with Aspen Lodge.”

The provider made sure equipment, facilities and technology supported the delivery of safe care by arranging servicing checks as required. The manager conducted various environmental audits to continually monitor areas for improvement. However, there were areas of the home that required repair or redecoration on walls, doors and floors. The manager had an improvement plan in place for addressing this.

The home was not currently designed or decorated in ways that supported people living with dementia to orientate around the home, find their bedrooms and prevent falls risks. The manager shared with us a detailed plan that focused on introducing new signage, tools and décor to help people living with dementia find their way around and reduce risks of injury from falls and aimed to decrease risks that caused people to become distressed.

People and relatives gave mixed feedback about the environment, most were happy with the home, but some felt the decoration could be refreshed. A relative told us, “I think [staff] do try their best for people. The new manager had done changes, it’s more homely. All rooms have been decorated. It’s a lot more of a homely feel now and [the manager] is always approachable.” Another relative said, “It does need a bit of TLC. [Staff] are doing that gradually. When they do change a room, people are getting choice of wallpaper and carpet.”

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 provider had safe recruitment procedures in place to assure themselves of staff’s suitability for their roles. This included checking work history. There were sufficient staffing levels in place to meet people’s needs, although some staff and relatives felt the service would benefit from additional staff to support meaningful engagement. Other relatives told us there was enough staff. One relative said, “There is always someone around, I don’t have to look very far to find someone. The office staff are lovely and very helpful. I can’t fault the clerical staff or the manager. I’ve heard them say they consider the people as family.” Staff told us they received a thorough induction which included shadowing more experienced staff and completing multiple training courses relevant to their role. Training was followed up with checks on staff competency. Staff were encouraged to complete care qualifications and told us they felt supported and could ask for further training when needed. People felt staff were well trained. One person told us. “We have seen them train [staff]; they seem to train them really well.”

The provider had audits and checks in place for minimising risks in relation to the control and prevention of infection (IPC). However, we found some areas such as bathrooms, laundry rooms and the kitchen where the cleanliness or damage to sealed edges meant they did not always manage the risk of infection effectively. Some equipment in the kitchen required deep cleaning. One area of the home had a strong smell of urine and required a review of the flooring type to ensure it was the most appropriate for the needs of the people in that area to help maintain a clean and odour free environment.

Staff received training on IPC and understood the risks of infection and how to prevent infection spreading. They also wore personal protective equipment (PPE), such as disposable gloves and aprons where required. Staff used colour coded chopping boards and cleaning equipment to minimising the risk of cross contamination.

Despite our findings, visiting professionals had given positive outcomes on IPC inspections and people and relatives were happy with how clean the home was. A relative told us, “[Staff] wear gloves. Never had any concerns with that, the home or my [family member’s] room.” Another relative said, “There is never any smell in the care home at all. It’s clean. There are always 2 or 3 [housekeeping staff] there.”

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. Systems were in place to safely administer and store medicines. We reviewed people’s electronic medicines administration records (MAR) which showed they were receiving their regular and time sensitive medicines as prescribed. However, when people were prescribed topical creams, they were not always recorded on the MAR system. As a result, people did not have these consistently applied as prescribed. The service made improvements regarding this following the inspection.

Care plans mostly contained comprehensive information for staff when supporting people with their complex needs. However, some specific risks, such as those associated with anticoagulants were not always documented. Despite this, staff we spoke with, had a good understanding of these risks and knew how to escalate concerns. Staff completed medicines training, and their competency was regularly assessed.

Person centred information was available to support staff when administering ‘as and when required’ (PRN) medicines. The effectiveness and outcomes were recorded. Staff used pain assessment tools for people who were unable to verbally communicate, to help identify when they may be in pain.

We reviewed the records for 1 person who was prescribed medicines to be given covertly (disguised in food and drink). Although, GP authorisation was in place to administer the medicines in that way, there was no best interest decision meeting or mental capacity assessment conducted to support the decision. Following our inspection, the service was responsive to our feedback and put this in place.

Staff understood the processes to report incidents and these were appropriately investigated. The service had good oversight of medicines management and conducted regular audits and acted on issues identified.

Relatives told us they were happy with how their family member’s medicine was managed. A relative said, “[Staff] manage my [family member’s] medication, no issues. I can’t say anything bad about them. My [family member] seems happier now they have got all those people around them. They like it there.” Another relative told us, “My [family member’s] medication is managed well which I’m delighted with it.”