Cera Castleham 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 improved to Good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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.

Lessons had been learnt from the turnover of staff and managers. The new manager was well supported by the regional manager, and they understood the continuing frustrations that had arisen over time from people and staff within the scheme.

People and staff said the management cover arrangements had previously been piecemeal over a period of months and resulted in poor communication and inconsistent leadership. There was now a new managerand regional manager in post and support from other Cera services. One person said, “The office staff are nice, I go down and they can help me.” An on-call system at Cera Headquarters was available and staff knew how to call an out of hours manager. The regional manager was informing staff about how the service worked and what was expected of them. There was a management training course which they had attended over some weeks. This meant there was a consistent message shared with people and staff.

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.

Communication had been improved between people and staff and external health professionals. The new manager had a role on the commissioning panel for new admissions to ensure they could meet peoples’ needs prior to their arrival. There had been no new admissions since the last inspection to enable assessment improvements to be made. Many people in the building did not receive care from Cera Castleham Lodgebut used the Peace of Mind service. Cera Castleham Lodgehad ensured they had pen pictures and hospital passports about these people, so they had some information when they answered their call bells.

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.

People said they felt safe with the staff group and were pleased there was a more stable team. One person said, “I have nothing negative to say about the staff just the waiting.” Staff were up to date with safeguarding training and were aware of how to raise any concerns. They knew how to record and make a referral and notify external agencies and CQC.

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 said they had sufficient information to support people safe. For example, risk assessments were completed for all known risks and had been recently reviewed. Staff had the necessary guidance to deliver safe and appropriate care. There was enough detailed information so staff could identify when people were not well so they could take appropriate prompt action. One example showed excellent emergency support for one person with a successful outcome. The new manager had supported staff and acknowledged how well staff had reacted.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

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 acknowledged there were frustrations about how the Peace of Mind scheme was used and the impact it could have on personal care visits.

Staff now received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs but were also frustrated by the structure of the Peace of Mind scheme.

The management team was more stable, and the regional manager was consistent and supportive. Permanent care staff had been recruited to cover the domiciliary care visits. Staff training had improved and was up to date. Supervisions and face to face discussions had been completed and were booked regularly. Agency staff were no longer being used but there was an agency induction pack should they be required again, which was good practice.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People generally managed their own medicines and had no concerns. Medicines audits and reviews had been carried out with the newmanager. They had looked at optimisationof medicines for each person who had support with medicines with their GP. This ensured they were on the correct effective medicine.

There was now good oversight of medicines to ensure people were safe.