Scarborough Hall and 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 good. At this assessment the rating has remained 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.

Clear policies were in place and followed by staff in the event of any accidents or incidents. A staff member said, “If I notice a bruise or skin tear, I let the senior know, they will call the District Nurses, get them to have a look, body map and put in their care plan.” Processes were in place to ensure these were then reviewed, outcomes were monitored and analysed for themes and trends. These were used to support learning and improve safety and care across the service. These were regularly reviewed by the provider and used to identify any additional training required.

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, and their relatives where appropriate, were asked prior to joining the home about their needs. These were used to plan their care. Systems were in place to share relevant information, for example, when people went to hospital.

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.

Staff had been trained about how to recognise the signs of abuse and felt confident to raise concerns, and that these would be dealt with appropriately by managers. Care plans contained information about people’s mental capacity and appropriate decisions had been made and recorded where people did not have capacity. Staff understood about the Mental Capacity Act (MCA) and knew whether people had restrictions placed on them, such as Deprivation of Liberty Safeguards (DoLS).

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. However, we identified there were some instances in which documentation was not always clear or had not been updated in a timely manner. When these were brought to the registered manager’s attention immediate action was taken.

For example, a bed rails assessment had not accurately recorded when someone had been found on the floor, and records of one person who was resistant to personal care did not accurately describe to staff how to care for them. People at risk of malnutrition were regularly monitored and appropriate action taken. However, we found one example where a change had not been shared with the kitchen. We were told there had been a delay in updating and this was actioned immediately when brought to the attention of the service.

Individual, person-centred risk assessments for people had taken place. These were recorded and regularly reviewed. Staff were directed by clear and up-to-date information about people’s risks and how these should be mitigated. Where people were at risk of falls, clear guidance was contained in their care plans about the actions staff should take if the person did suffer a fall.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were cared for in a safe environment, which was designed and adapted to meet their needs. Dementia friendly signage and the use of pictures on people’s doors supported people who live with dementia to navigate the environment. Appropriate checks took place on both the environment and the equipment the service used. These checks ensured the equipment was safe for both people and staff. Appropriate fire checks and simulated evacuations had taken place.

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.

Care was observed to be unhurried. Staff supported people in a timely manner. One person told us, “I know all the girls (staff), they’re always plenty around. I just have to raise my hand when I need help to go to the toilet. They are all my friends they help you if they can.” A relative said, “[Name] definitely gets the support [name] needs.”

People told us there was enough staff. Staff told us they felt supported. A staff member told us their manager “does a really good job, is open to suggestions and is one of the reasons I stay”.

A staff member commented about staffing numbers, “Yes, we are alright with staff.”

Staff members were supported to develop. A staff member explained, “[Name of team leader] is good at listening. She would support me to be a senior.”

Staff were recruited safely with appropriate checks in place.

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.

Appropriate cleaning schedules were in place. Cleaning staff were knowledgeable about infection prevention and control. Staff used PPE appropriately. However, we observed some staff were not ‘bare below the elbow’. We discussed this with the registered manager, who told us immediate action had been taken, and staff would receive further refresher training as a result. The home was very clean and odour-free.

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 stored securely with access restricted. Staff had completed medicines training and competency assessments. Medicines fridge and room temperatures were recorded daily and were within range. People were receiving medicines as prescribed, front sheets were in place which were used to identify residents at the point of administration. These included person-centred information including a photo, allergy information and how medicines were taken. The home had processes in place to ensure adequate stocks of medicines, so people did not run out. There was a system in place for the disposal of medicines. Care plans and protocols for medicines prescribed as ‘when required’ were in place to support staff safely administer them. Where changes were made to how people’s medicines were administered, for example, changes from tablets to crushed or liquids, we found care plans required updating in a more timely manner. Body maps and records were available for medicines applied to the skin including topical medicines and patches. Governance processes were in place to monitor medicines use and the arrangements for medicines management.