Earls 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 56 (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 based on openness and people’s safety. There was a system in place to report and record accidents and incidents which staff followed. When concerns arose, staff took action to ensure people were safe. Accidents and incidents were reviewed by the senior management team with clear actions to reduce further risks to people were set and completed. A monthly incident audit was completed; however, we found there was an emphasis on learning from falls incidents compared to other incidents that happened within the service. A system was in place to share learning from complaints, however several recuring issues indicated that the process for learning from complaints was not always effective.

The provider did not always work with people to establish an effective system of transition and continuity.Processes were in place to support admissions into the service where staff worked with people and their health professionals, during the process. We received positive feedback from relatives that professionals were involved where needed. One relative said, “Since [person] came here, [staff] have been very helpful. They have made a lot of arrangements for [person] to see people to help [person] get better.” The provider used an electronic care recording system, however, there were gaps in some people’s records which meant we could not be assured all relevant information was consistently being used to support people’s safe transition into the service. We reviewed 1 person’s care plan who had recently moved in and found not all sections of their care plan had been completed; this was completed following our visit. We also found there were gaps in care records around planning for the future such as end-of-life care for people which could mean people’s wishes would not be supported during a difficult time.

The provider did work with people and healthcare partners to understand what being safe meant to them and how to achieve that.People and relatives, we spoke with felt safe at Earls Lodge Care Home. One person said, “I feel safe here. I am very happy. If you ask for anything [staff] will get I for you. [Staff] are very good.” Staff also had good knowledge of how to keep people safe and raised no safeguarding concerns about people. One staff member said, “We look after everyone in the home, ensure their needs are met, they feel safe and wanted and welcomed.” We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA) and how they managed Deprivation of Liberty Safeguards (DoLS) within the service. We found assessments of people’s capacity, and Deprivation of Liberty Safeguards (DoLS) applications had been made where required. People who had conditions as part of the DoLS were being met, but it was identified recording could be improved to evidence this. The registered manager assured us they would address this. We also found concerns with window restrictors on the first floor and security for the building, even though we had not been made aware of any people leaving the service unauthorised there was a risk this could happen. We informed the provider of this who addressed this promptly.

The provider worked with people to understand and manage their risks. We found where people had risks to their health and wellbeing, a risk assessment had been completed to support staff to mitigate the risk. Where people required equipment to further mitigate their risk, this was in place. One relative said, “In the early days, [person] had a walker and had falls. They are now taking [person] in a wheelchair, so there are less risks of them falling.” Staff also knew which equipment was needed for people to support them safely. As part of our assessments, we also reviewed each person’s Personal Emergency Evacuation Plan (PEEP) and the service’s fire evacuation plan. We found the PEEPs did not include sufficient detail around evacuating people safely and the fire evacuation plan was not clear. The provider assured us these would be reviewed and updated.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Decoration within the service was clean and fresh and the environment was free from obvious hazards. People’s bedrooms were decorated and personalised. Photographs and items of importance and interest to people were present. One person told us, “I really like my room, it’s warm and cosy. I have all my things around me, and I like coming in here.” People had sensors and alarms in their rooms to maintain their safety. The provider ensured equipment was serviced and checked to help maintain its safety. For example, fire equipment, lifting equipment and electrical safety checks were completed as required by regulation.

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 staffed the service in line with their dependency tool. During our observations, we found staff to be present and supporting people throughout the service. Managers reported no concerns with staffing levels and told us staff picked up additional shifts to support in periods of sickness and leave. We received positive feedback about the staff working at the service from people and relatives. Comments included, “I am safe here. The staff are nice and friendly” and “They are nice and good carers. They do know what they are doing.” The provider was also completing recruitment checks when they recruited new staff. Staff were also completing required training for their role.

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 were supported in an environment that was clean and hygienic. No one reported any concerns about the environment within the home. One person said, “[Staff] are always coming around cleaning.”There was Personal Protective Equipment (PPE) stations around the building and during our observations we observed people using PPE when supporting people.

The provider did not always make sure that medicines were managed safely. Upon review of Medication Administration Records (MAR), we found there were some gaps in people’s records where medication should have been signed for when administered. We also found that medication that had to returned to the pharmacy was not being stored securely, as well as the medication fridge not being locked. reams and eye drops were not consistently marked with the date opened so staff would not know when they would have to discard of the items. We did find the treatment room was clean and staff demonstrated knowledge of people's medicines needs. Those staff who administered medicines had completed medicines competencies and relevant training. We also received no concerns from people or relatives about medicines administration. One person said, “I get my medication in the morning and evening time. I get it on time, and they never miss any. They are very good.”