Acquah Lodge- 60 Dalkeith Grove

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 69 (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.

A system was in place to report, record and monitor incidents and to help support people safely. Accident/incident forms detailed the action taken following an accident/incident but there was a lack of detail around lessons learnt. We raised this with the registered manager who said that they would amend the form to include this and in future this would be documented.

Staff were able to raise concerns outside of the management team to help prevent the development of a closed culture.

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.

People’s needs were assessed before they started using the service to ensure staff were able to effectively meet them. People and their relatives were involved in the assessment process so that their views and wishes were taken into account when planning their care and support.

Staff told us there were handover systems and information was shared amongst staff promptly so that people continuously received care and support that met their individual needs. A member of staff told us, “Communication is really good. We pass information to each other. We have handovers and have regular meetings.”

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.

Procedures were in place to help safeguard people from abuse and improper treatment. Staff were able to recognise signs and symptoms of abuse and received training to help ensure they were up to date with best practice guidance. Staff told us they felt confident raising concerns and were confident that management would respond promptly to any concerns.

People told us they were confident they were safe in the presence of care staff and were well looked after. When asked if they felt safe, a person said, “I feel safe in my home.” Another person told us, “I am safe.” Relatives we spoke with told us their family members were safe. A relative told us, “[My family member] is safe and well looked after.” Another relative said, “I am happy with the care. I am confident that [my family member] is safe.”

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.

People were involved in decisions about their care and risk management. Risk assessments were comprehensive and contained clear instructions for staff about how to support people to minimise and manage risks to help keep people safe. These informed staff of what actions they needed to take to help keep people safe and help reduce the risk of harm. Staff encouraged people to remain independent as far as possible whilst mitigating risks.

Information about people's mobility and medical conditions that could impact on their ability to leave the premises in the event of an emergency were documented. This included guidance on how staff should support them.

The provider did not always detect and control potential risks in the care environment. During the site visit we found that some windows did not have a fully operational window restrictor in place and this was a potential risk to people in the service. We raised this with the registered manager who took immediate action and checked all windows to ensure that operational window restrictors we in place. This helped to ensure risk was managed in a safe way and the environment was safe.

Relatives spoke positively about the premises. A relative said, “The home is a normal house and not institution. I like that about it.” Another relative told us, “There is a homely environment.”

The provider made sure there were enough qualified, skilled and experienced staff. However, records relating to the provider’s recruitment practices needed to improve. Recruitment practices were not always robust. We looked at staff files and found that 2 references were not always obtained for care staff. There was also a lack of evidence to confirm that references had been verified to check their authenticity. Following the site visit, the registered manager obtained the outstanding references for staff and provided evidence of this.

Care and support was provided by a stable and regular workforce that people and relatives were familiar with. People and relatives spoke positively about this. A relative said, “They have the same staff. There is very little turnover and there is consistency. That really helps with [my family member] because [they] have the continuity of the same staff caring for [them].”

Systems were in place to help ensure staff received training suitable for their role and that they have the required qualifications. Staff received supervisions and their practice and competencies were checked. This enabled management to monitor and discuss care staff’s role, performance and development.

The provider assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading and were aware of the procedures to follow if any concerns had to be shared.

Staff followed infection control processes, including washing their hands, keeping people’s home’s clean and wearing personal protective equipment (PPE) where appropriate.

Staff had completed training about infection prevention and control. Staff said they had enough PPE.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Medicines management systems were in place.

Medicine Administration Records (MARs) were completed by staff. We looked at a sample of these and found these were completed indicating medicines were administered as prescribed.

Staff received training to administer medicines to help ensure they had the appropriate knowledge and skills.

Where people were prescribed medicines on a when required basis (PRN), there were appropriate protocols in place. These protocols advised staff about which circumstances and how to give these medicines.