Skirbeck 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 newly registered service. This key question has been rated as good, meaning people were safe and protected from avoidable harm

This service scored 81 (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 developed a philosophy of care that promoted a culture of honesty, understanding and responsibility. Daily and weekly mangers meetings were held to discuss topics such as visitors to the service and scheduled appointments for people. Staff were given opportunities to identify risks and reflect and learn when things went wrong. They used a ‘no-blame’ approach which offered support and reassurance.

An annual staff survey and monthly supervisions ensured staff felt listened to and had opportunities to discuss well-being concerns, which the provider then acted upon. The staff team shared information and best practice with local services such as the community forensic team to minimise the risk of developing a closed culture. This practice helped to better support people by working collaboratively to minimise risks and try to keep people safe.

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 happy with the transition process when they moved. The provider worked with the Lincolnshire Partnership Foundation Trust (LPFT), the Lincolnshire Integrated Care Boards (ICB) and Community Forensic Team (CFT) as part of the step to assess pilot with collaboration from the ministry of justice. This ensured they had good oversight and promoted open, partnership working when planning and delivering care centred around people's needs in line with their existing conditions and restrictions.

A healthcare professional told us, " The placement is well adapted to meet each individuals needs including consideration around placement of rooms in accordance to risk mitigation measures.” And “Time was taken to understand the risk and formulation of individuals highlighted for Skirbeck Lodge. Staff attended training workshops provided by CFT.”

There were processes in place to ensure people's needs were assessed before being admitted to the service, with training provided to the staff on each person including their conditions and restrictions.[TF1] People were supported to understand risks and restrictions before moving into Skirbeck Lodge. They were fully involved in all assessments and supported to have a voice about how any risks could be reduced. Staff promoted people’s rights by educating people about how to stay safe.

Skirbeck Lodge monitored various aspects of the service quality and outcomes electronically. This data allowed the management to have oversight on all aspects of the service and allowed them to manage risk and promote well-being.

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.

Staff demonstrated how they would identify and raise a safeguarding issue and had a good understanding about the importance of protecting people from the risk of harm, abuse or discrimination. They were able to identify different forms of abuse how and to whom it could be reported. There were procedures for staff to follow if they had any concerns about abuse including an anonymous email account for sharing concerns.

Staff worked effectively with people in the community in line with their legal restrictions, focusing on reflective practices that aided peoples understanding on how they can live safely in the community. Through virtual ward rounds with external professional teams, staff were able to work together with the hopes to review and reduce legal conditions and restrictions in the future

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 told us they felt safe. Their comments included, "I feel safe, and I know how to get help if I need it. The staff are always around to help me.” Staff supported people to live a less restrictive lifestyle. This was achieved by having processes in place to promote a healthy lifestyle while working to minimise the potential risks involved.

Each person’s support plan allowed staff to identify individual needs, the agreed goal to be achieved and the interventions required to achieve the goals. The management and support team kept oversight of risks linked to people's care though the regular review of care plans and risk assessments with collaboration from the Lincoln Partnership Foundation Trust.

Staff provided people with accountability and empowerment by allowing them to take positive risks, whilst at the same time remaining safe. An example involved allowing a person to make the decision to drink alcohol with lunch. Staff made the person aware of the risks involved drinking excessive alcohol and the effects it could have on their behaviour and actions, resulting in potential serious outcomes as a result. Staff ensured that support plans and risk assessments were completed with actions to be taken if serious incidents did occur.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

People were cared for in a safe environment that was purposely adapted to meet their needs. The facilities were all on one level which enabled all people to move around freely without any problems.

The facilities were well maintained, and technology was used appropriately to gain access to areas not used by people.

People had access to a communal space as well as their own lounge areas should they need it. We observed the communal space being used throughout the day by people who seemed to enjoy each other’s company. Staff were also visibly present in these areas but not getting in people’s way when they needed to be on their own.

The environment was safe for staff to work in. The provider has a good relationship with the landlord which enabled effective arrangements to monitor the safety and upkeep of the premises, bringing in professionally qualified people to complete the necessary environmental and equipment checks where needed.

The safety of the premises, communal and personal spaces (such as bedrooms), and the living environment were checked and managed to support people to stay safe.

We observed a calm and welcoming environment that supported people’s safety and mental health. For example, on person told us how they really enjoyed the garden and had taken part in an environmental study of birds and had been supported to submit their findings.

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.

People shared positive feedback about staff numbers and how responsive staff were to their needs. People stated they were able to have support anytime they needed, and activities and plans were never delayed or cancelled due to staffing numbers.

Skirbeck Lodge incorporated a robust recruitment process to ensure that fit and proper persons were employed. This included DBS checks, previous employment history and information related to an individual’s physical or mental health conditions which are relevant to the person's capability, after reasonable adjustments were made.

Staff said that they felt supported and safe to do their duty. They received mandatory training relating to learning disabilities including The Oliver McGowan Mandatory Training and sexual health relationships in learning disabilities. Staff training would be reviewed annually with additional support provided if requested by staff or observed through staff supervisions with management.

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 did not receive concerns from people and staff in relation to infection prevention and control. The environment was clean and tidy with personal protective equipment such as disposable gloves and aprons available for staff use. Infection prevention control audits were in place and staff were alerted to daily cleaning and environmental tasks monitored by an electronic system.

The management team completed regular checks on staff's practice around infection and prevention, which included hand washing, cleanliness of the environment and laundry. Colour coded mop buckets and mops for specific cleaning tasks were provided.

People were supported and encouraged to promote their independence to help with light cleaning duties which included their own bedrooms and laundry.

Posters were visible regarding washing hands and colour coded chopping boards and utensils were used to prevent cross contamination in the kitchen.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in ordering and collecting their medication from the local pharmacy. Staff discussed the processes involved and used this as an opportunity for people to learn new skills within the community. People were informed and updated when medication changes occurred, staff supported people to be aware of and understand potential side effects and changes to medication times.

Medicines were administered safely via a pre-packaged dosset box dispensed by the local pharmacy. People received their medicines at the correct times in a way that was best suited them. Staff followed the “6 Rs” Right Person, Right Medicine, Right Dose, Right Route, Right Time and the Right to refuse.

The service had safe systems for appropriate and safe handling of medicines. Staff were competent in administering medicines with procedures in place such as providing a dedicated private room where people could take their medication in their own time and allowing privacy.

One person told us “I am taking my medication daily. The staff help me with this and explain what the medication is for and if there any side effects. I don’t have a problem with taking my medication as I know it’s good for me.”