Dalton 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 69 (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.

Systems were in place to dealing with incidents and accidents, including learning from these. Accidents and incidents were recorded, monitored and analysed to reduce the risk of reoccurrence. For example, falls prevention equipment had been installed to reduce the risks of a fall. However, we identified some areas in how accidents and incidents were analysed and learning from them recorded that could be improved. For example, where the audit asked for areas of practice to be evaluated or the tools used, the response simply stated "medication," which lacked detail of what was the identified concern. This did not provide sufficient information about what went wrong and the actions taken. The home manager took this on board and said they would implement the necessary changes to ensure actions taken and learning were clearly reflected in records.

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’s needs were assessed before they started using the service. People and most relatives confirmed there was responsive action if people became unwell. Comments included, “They were straight onto it and always inform me straight away about stuff, the communication is very good.” Records confirmed this, including involvement from, for example, the community district nurse, occupational therapist and GP practice.

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.

Safeguarding procedures were in place to safeguard people from abuse and staff completed appropriate training.

Staff supported people to keep them safe. A relative told us, “[Relative] is safe, and I am happy with the staff. The management and carers keep me up to date.” Another relative commented, “Yes, [person] is [safe], it has taken so much stress off myself and the whole family. I never knew it could be like this.”

Staff knew people well, had completed appropriate training and were aware of how to report any safeguarding issues or concerns. A staff member told us the action they would take if they witnessed abuse, “If I saw anything concerning, I'd report it straight away. Our manager takes these things very seriously - we've had training on exactly what to look for and who to tell."

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’s care records contained detailed risk assessments which supported staff to meet people’s needs whilst minimising the risks.

Risks to people were assessed and reviewed. We found comprehensive risk assessments covering falls, skin integrity, and choking. Effective monitoring systems for weight, fluid intake, and repositioning where needed. Evidence-based tools were used for pressure care and nutrition assessment. Clear documentation of pressure-relieving equipment settings and monitoring was in place. Some areas of risk required more detail, such as an epilepsy seizure plan for one person. We informed the home manager who told us they would put this in place.

Staff assessed and managed risks to people’s health, safety and wellbeing effectively. A relative told us, “Staff encourage [person]. [They] have an alarm mat by [their] bed as [they] are at high risk of falls.”

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 premises were safe. There were environmental risk assessments in place including for fire, and regular checks and testing of the premises and equipment.

People had personal emergency evacuation plans in place that reflected their needs and ensured they could leave the building safely if required.

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. However, we during medicines administration and at busier times staff deployment was not always sufficient. A staff member told us, “I feel supported here, but sometimes we are short staffed, and I think we need more staff.”

The home manager used a dependency tool to determine staffing levels required in the home which took into consideration their dependency needs around all aspects of their care.

During our visit we saw on the whole staffing levels were sufficient to meet people’s individual needs. Relatives were positive about staff presence and visibility when they visit their loved ones. A relative told us, “We have seen enough staff there when we have been, when we press the bell people come.” Another relative said, “Staff come as quickly as possible, and they know them. They have the notification on their tablets. Staffing levels is very good.”

Safe recruitment procedures were in place and necessary checks conducted. Records confirmed staff had received up to date training and regular supervisions. The home manager monitored this to ensure staff received support and regular supervision to assist them to effectively carry out their role. This was confirmed by staff who told us they received supervision and were supported in their role. New starters completed an induction, this included shadowing more experienced staff.

Staff received mandatory training in various areas. Staff confirmed to us that they had completed various training and found it effective.

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.

People spoke positively about the cleanliness of the home. A relative told us, “The place is spotless, and it does not smell. The staff clean as they go. [person’s] room is always clean, nice room.” Another relative said, “Rooms are quite small, lovely and clean, no odours.”

Staff wore appropriate personal protective equipment (PPE) and followed infection prevention and control guidance when supporting people. Infection prevention and control measures remained robust. Staff demonstrated consistent use of PPE and followed current guidance on infection control. The home was clean and tidy, well-maintained, and regular environmental checks ensured all areas remained safe for residents. Domestic staff were visible throughout the home, frequently cleaning, including regularly touched areas. The home manager carried out a daily walk around to check staff were following infection control procedures.

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.

Medicines were administered and managed safely. The service demonstrated safe and effective management of medicines, with systems in place to ensure residents receive their medicines as prescribed. The home is picking up on their errors, with ongoing monitoring and staff training helping to maintain standards of care.

Procedures were in place to manage medicines. Medicines errors were identified through audits and lessons learnt followed up with staff. However, the action plans in response to these errors were not sufficiently robust. For example, where the audit asked for areas of practice to be evaluated or tools used, the response simply stated "medication," which lacked detail. During our site visit we observed the medicines trolley was left unattended, although locked. The staff member who was also administering medicines was caring for 5 people. We discussed this with the home manager who took immediate action to resolve this matter.

Medicines were stored securely in locked cupboards and the medicines trolleys, in line with national guidance. Controlled drugs were kept in a separate, double-locked cabinet, and the keys were held by senior staff. The medication room was clean, organised, and maintained at an appropriate temperature, with daily temperature checks recorded.

Staff had received up to date medicines training and regularly had their competence assessed. Regular medicine checks and audits were carried out to identify any errors and take appropriate action.