Heath 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 the last inspection, we rated this key question as good. At thisinspectionthis key question hasremainedthe same. 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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Learning from accidents, complaints and inspections was taken and shared with the staff team. This was discussed at handovers, team meetings and as part of day-to-day discussions.

We saw when incidents, accidents and events happened which negatively impacted people, action was taken to address this. For example,staff were provided with a lessons learned tool which they needed to read and sign. This described the incident, explained what action had been taken to reduce the risk of a recurrence and what staff needed to follow going forward. This included training, spot checks,referral sand changes to equipment.

People and relatives told us the management and staff team asked for their views and took any action that may be needed.

Staff told us learning from events, complaints and updates was shared through meetings and had a learning tool.A staff member said, “We have a learning tool to sign to get shared information about any[lessons]learning from complaints and we discuss outcomes and actions during meetings.”

The provider worked with people and healthcare partners toestablishand maintain safe systems of care, in which safety was managed ormonitored. They made sure there was continuity of care, including when people moved between different services.

People and relatives felt the move into the service had been good. They told us the team had ensured the move was as easyas possible and they felt supported.

There was positive feedback from visiting professionals.A visiting professional said, “The seniors have had good knowledge of their residents when I have asked about them.”

People received arobustpreadmission assessment prior to moving into the service. Records were held on file and information was to be shared with healthcare professionals as needed.This was used to help inform the care planning process.A staff member said, “We receive care plans, risk assessments and handovers before supporting someone.”

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, avoidableharmand neglect. The provider shared concerns quickly and appropriately.

Safeguarding concerns were processed,reportedand recorded appropriately.Where people had suffered unexplained injuries, an internal investigation was carried out toascertainthe cause and take any required action.

People told us they felt safe living at the service.A person said, “I feel safe and happy to speak up. I have no worries.”Relatives felt their family members were safe.A relative said, “We feel our[person’s]needs are met and thatthey arekept safe by staff.”

Staff told us they knew how to recognise, and respond to, abuse. Staff told us they would speak upand report concernswhen needed.A staff member said, “If Iwasworried about someone’s safety, I would report itimmediatelyto the manager or safeguarding lead and document it.I understand whistleblowing procedures and would escalate concerns if needed.”Staff wereobservedbeing kind in their approach and gentle when supporting people. People were relaxed when interacting with staff whichindicatedthey were comfortable with staff.

Staff received training in relation to safeguarding people from the risk of abuse and information was displayed around the home.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe,supportiveand enabled people to do the things that mattered to them.

People had individual risk assessments, and these gave guidance to help ensure staff supported people safely and were regularly reviewed. These included pressure care management, falls safety and choking prevention.Records reviewed showed care was being deliveredinaccordancewithpeople’splanned needs and risk assessments. For example, regularrepositioning.

People and their relatives told us they felt staff supported them safely.A relative said, “[Person] hashad a couple offalls,so they put a falls mat bytheirbed.”

Staff told us about risks to people and the action they took to help reduce those risks. For example, in relation to falls, dietary needs, changes in health needs and supporting people when they felt anxious or distressed.

We saw staff supporting people to move around safely, respond to calls forassistanceand carry out regular checks. Staff ensured people were sat up when eating and drinking. There were sensor mats and call bells accessible for those who were able to use one.

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 had access to call bells and for those who were at risk of falls had sensor mats to alert staff to their need ofassistance. Relatives were positiveabout the environment.

Staff were aware of hazards and how to reduce these.Staff had attended fire drills, there were regular drillscarried out,and people had individual evacuation plans.A staff member said, “I have taken part in fire drills. I know the evacuation procedure, where the fire exits are, the assembly point, and how to support people with PEEPs (Personal Emergency Evacuation Plans). Fire safety equipment is checked regularly.”

There was firefighting and evacuation equipment in place.Routine checks were being carried out on the environment asrequired.

The building had various sitting areas and people could choose where they wanted to sit and spend their day. Weobservedpeople moving around the home and staff helping to reorientate them as needed.

There were regular checks carried out on the environment and equipment to help ensure theappropriate servicingwas carried out and everything was in working order.

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.

People told us there were enough staff to meet their needs. A person said, “They come quickly and are happy to do it.”

Relatives said they felt there were enough staff most of the time, and staff were trained for their role.A relative said, “Currently they have enough staff certainly during the week, however sometimes they do seem to be a tad stretched at the weekends,especially when inundated with relatives.”Another relative said, “I feel there's enough staff to care for[person]and haven't had any cause for concern in the years they’ve been there.”

Staff said there were enough of them to meet people’s needs in a person centred and timely way. A staff member said, “There are generally enough staff to meet people’s needs safely. Care is not usually late or missed. If someone calls in sick, agency or bank staff are used to ensure safe staffing levels.”

During our visit, staff were visible and prompt when people requested support. Staff were taking their time when supporting people and carrying out regular checks.

Staff told us they received enough training and support to carry out their role.A staff member said, “I feel I have the training and support needed to carry out my role safely and effectively. I completed a full induction including the Care Certificate and mandatory training (moving handling, safeguarding, infection control, MCA, first aid, fire safety). My competencies are checked regularly through observations and spot checks. I have supervision with my line manager every 6–8 weeks and an annual appraisal. I feel supported and can approach management at any time.”

We reviewed the training provided and saw this covered all mandatory subjects.Training was over 98% in most subjects.

Recruitment followed a process carrying out checks to help ensure staff were suitable to work in a care setting. These checks included criminal record checks, verifying applicants’ identities and written references. Full employment history was also checked with any gaps needing to be explained and documented.

There was a checklist to be completed to ensure all required information was in place and verified.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns withappropriate agenciespromptlyif and whenneeded.

People’s bedrooms and communal areas were kept clean.Staff were practicinginfection prevention and control (IPC)in their day-to-day roles. Weobservedcorrect handwashing and use of personal protective equipment (PPE).

Staff knew how to practice goodIPC. A staff member said, “I’vecompleted infection control training. I follow hand hygiene, use PPE appropriately, clean equipment, and follow isolation procedures whererequired.”

There were IPC audits and checks in place.

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

Medicines systems had clear records and processes. There was a log of staff signatures and competencies. Daily counts for all medicines were in place. Each person had a detailed cover profile which included alerting staff to instructions for administration and allergies.

Body maps completed to support the administration of pain relief patches were completed consistently.

People received their medicinesin accordance withtheir needs and as the prescriber intended. Staff were carrying out administration tasks safely andin a timely manner.

Staff responsible for managing medicines were aware of safe practice.Following 2 pointsidentifiedduring the inspection, areminder was to be shared with staff to ensure they alwaysfollowed the procedureregardingfridge temperatures and ensuring they physically count medicines ondaily reconciliation counts.

We reviewed a sample of audits and found these were checking theappropriate elements, such as quantities,entriesand storage of medicines. Actions were in place were shortfallsidentifiedand these were signed off when completed.