Joseph 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 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. The provider and manager understood their responsibility to provide a safe and supportive environment for people and staff. There was a focus on learning and getting to the root cause of any safety events to mitigate against these happening again. The provider and manager understood their responsibility under duty of candour to be open and honest, to share information with relevant stakeholders about safety concerns. Lessons were learnt to continually identify and embed good practice. The manager and provider fully investigated any concerns including safeguarding, accident, incidents and complaints to share learning from these events and mitigate future risks. Where themes were identified the manager took action to change practice to increase safety for people. For example, where it was identified a pattern of falls happening at a certain time of day, staffing rotas were changed to provide additional staff support during these times. Lessons learned from investigations were shared with staff through meetings and supervisions sessions. A log was kept of learning and any changes to people’s clinical needs for staff to reference when they needed to.

The provider and manager 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. Before people moved into the service a full assessment of their needs was completed to ensure they could be met by the service. A care plan was put in place and shared with staff so that they had all the information they needed to support people safely. Staff told us they had time to get to know people and understand how they preferred to be supported. The manager told us they had good communication with other health professionals to ensure there was continuity of care being provided.

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 had received training in safeguarding and knew how to raise concerns to safeguard people. The manager discussed safeguarding with staff during supervision and meetings to ensure they felt supported to raise concerns or had access to ‘whistle blowing’. Staff had information displayed and telephone numbers to call should they wish to directly raise a concern. One member of staff said, “I have received level 2 safeguarding training and would confront any poor practice. I would report to my line manager and if they did not address it, I would go to the local authority safeguarding team.” The provider and manager shared concerns quickly and appropriately with the relevant authorities and worked with them to investigate these to keep people safe.

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. Staff identified risks to people and put safeguards in place to mitigate these risks. For example, if a person was at risk of pressure ulcers staff ensured they had all the correct equipment in place to minimise this risk. Where people were at risk of falls the manager worked with them to understand the risks and what were the best ways to reduce this risk. Whether that was using the correct walking aid, wearing correct fitting shoes or using technologies to help alert staff when they were at greater risk of falls. The manager worked with people and their families to problem solve what the issues were and come up with solutions to lessons risks to people. Staff were aware of preventative measures they could promote, such as encouraging people to stay well hydrate and nourished to minimise the risks of infections or pressure ulcers. Staff supported people to take part in gentle exercise to maintain use of muscles to help them keep active and prevent physical decline. People were supported to live full lives and this included going out into the community safely either independently or with staff and relatives.

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 provider employed maintenance staff who completed environmental checks at the service and ensured equipment in use was in good order and regularly serviced. Safety certificates were up to date for gas safety, legionella, water temperature testing, hoists, lift and fire equipment testing.

Staff had received training in fire safety, and each person had a fire evacuation plan in place to safely evacuate them from the building. The manager was following up on recommendations from the fire safety checks that had been completed to ensure the service met all fire safety requirements.

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 manager continued to actively recruit new staff to work at the service with the aim of reducing the amount of agency hours they currently used. The manager had been successful in reducing the amount of agency hours used and were recruiting more staff as the service expanded.

Recruitment checks included applicants providing a legal right to work, full working history, references and undertook a disclosure and disbarring check (DBS). DBS provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

The manager told us they had involved people in the recruitment process giving them the opportunity to ask questions and interview potential new members of staff. People told us they had good relationships with staff, and we observed staff were very attentive to people’s needs.

When staff first started working at the service, they underwent an induction, which included shadowing more experienced staff who could mentor them. Staff completed training both on-line and face to face. Staff new to care completed the Care Certificate, a national recognised set of care standards to provide staff with the skills and knowledge they need to work in the care industry. The manager monitored new staff during their probation period and met with them regularly to see how they were progressing. There was a system in place for staff to have regular supervision and meetings to share updates and discuss the general running of the service.

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 (IPC) and were able to demonstrate how they safely managed the risks of infections. Staff knew how to use and dispose of personal protection equipment (PPE) appropriately. We observed good hygiene practices amongst staff during the inspection. IPC audits were completed by the manager to ensure IPC was being implemented correctly to prevent the risk of the spread of infections.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were supported to have their medicines by staff who were suitably trained and skilled to administer medicines. Staff had their competency checked regularly to ensure they were using safe practices. Medicines policies were in place to support the safe administration of medicines, and the medication records we reviewed were in good order. Where medication errors had occurred, these had been fully investigated and action taken to learn from events to prevent these from happening again.