Tallington 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.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

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. The processes in place at the service showed people were being protected from the risk of abuse. People we spoke with told us they felt safe at the service. Staff had a good understanding of the different types of abuse people could be exposed to, and what they should do if they saw any practices they were unhappy with. Numerous staff told us they would speak to whoever was in charge at the time of the event and they had confidence any issues they raised would be investigated thoroughly. This was supported by our review of records relating to safeguarding events at the service and how the managers had responded to them. There was clear evidence of any concerns being taken seriously, investigated and outcomes shared with people. When the provider had found errors that could impact on the safety of people in their care they had raised safeguarding alerts to the local authority team and ourselves at CQC, and worked in an open way to ensure any issues were addressed and lessons were learned from them.

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. The risks to people’s safety had been individually assessed and measures were in place to reduce those risks. For example, when people were at risk of skin tissue damage there was guidance in the care plans on how often staff should support them to reposition themselves We saw records to show the support had been given. Where people needed pressure relieving equipment we saw this was in place. Where people were at risk of falls there were appropriate measures in place to try to reduce the risk. Some people had bed rails in place to prevent them from falling out of bed. There were appropriate consent records to show people had been asked if they would agree to the use of bed rails in place. Where people lacked the mental capacity to make the decision the correct processes had been followed to assess the person’s need using the best interest decision framework. These records were accompanied by risk assessments and where it was noted a person had in the past attempted to climb over their bedrails, alternative methods to support them were used, such as the lowering of their bed and a cushioned crash mat with a sensor mat in place. All equipment used to support people had been regularly serviced and was in good working order. The provider had a dedicated maintenance team who oversaw this. Staff told us the information they needed to support them to provide safe care for people was found in their care plans which staff could access whenever they needed to, via the provider’s electronic care planning system.

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 lived in a safe environment. There were comprehensive maintenance and refurbishing plans in place. These were overseen by the provider’s overall maintenance manager. Throughout our visit we saw the environment was clean and well maintained. The provider had a dedicated maintenance team for all their services and this group of staff were supported by the provider’s Health and Safety compliance team. There were strong processes in place to show when issues had been reported or highlighted to the team by either staff at the service or via auditing processes. The provider could keep track of them and ensure work was carried out in a timely and safe way.

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. Staff worked well together to provide safe care that met people’s individual needs. Our observations whilst visiting the service, and feedback from relatives supported this. A comment shared by a relative whose loved one was cared for in their room, “They [staff] check in on [relative] and make sure [relative] is comfortable.” The provider made sure there were enough qualified and skilled staff. Records showed staff received an induction and regular supervision as part of their role to ensure staff could meet the needs of people using the service. Staff had completed nationally recognised qualifications in health and social care, including the Care Certificate, which encouraged them to provide safe and compassionate care. Staffing rotas were developed to ensure there was the right skill mix and experience on each shift and there was always a trained staff member to give people their medicines. We saw staff had time to check on people, chat with them and respond to their requests promptly. A member of staff told us, “They [provider] really look after you and treat you equally. Where I worked before, they treated me differently because I am not from this country. Everyone [staff] gets on with each other.” The same staff member then went on to tell us, “Our manager is very good and we work very well as a team here.” Staff files contained evidence of recruitment checks including application forms, interview records, employment references, enhanced Disclosure and Barring Service checks (DBS)/Police checks, right to work and identity checks. The information helps employers make safer recruitment decisions. Where required, risk assessments were in place for staff where there had been delays in DBS checks. We reviewed records and noted this for a small number of staff who had a Certificate of Sponsorship (CoS) issued by the Home Office which allowed them to work in England at CQC regulated services.

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.

Throughout our visit we saw staff undertook safe infection prevention practices. They wore appropriate personal protective equipment (PPE) when providing hands on care to people and used safe methods to dispose of it when they had finished.

The housekeeping staff followed safe practices when using chemicals which may be hazardous to people’s health, following COSHH standards (Control of Substances Hazardous to Health). When not in use these chemicals were locked away and when staff were using them they ensured they were within their sight at all times.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People’s medicines were not always well managed by staff administering them. Medicines stocks and recorded balances were not always accurate. We found instances where medicines administration records did not balance with medicine stock counts. We highlighted the issue to the senior management team who responded straightaway to address the issue. On the second day of our visit we saw a full comprehensive audit had been carried out by the provider’s medicines team. They had also put in processes to support staff learning from this. This was done by supporting all staff administering medicines with update training, supervisions and spot checks on practice. The home manager also attended handover meetings to ensure staff were aware of the need to address the issue and they also added updates to their electronic communication system ensuring staff had to record they had read the update.