Gallimore 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 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. The service had systems in place to investigate incidents or accidents when they occurred. The registered manager listened to concerns about safety and investigated and reported safety events appropriately.

The provider reviewed incidents and accidents regularly and identified opportunity to learn and improve. When an incident happened, the service was transparent with people, their loved ones, and staff. Lessons were learnt to continually identify and embed good practice. Staff confirmed the registered manager would discuss lessons learned with them during staff meetings. The registered manager shared records of actions from lessons learned with staff following discussions about those events.

Staff knew how to report risks and understood their role in keeping people safe. Staff were encouraged and supported to raise any concerns about safety risks. Staff felt assured that the registered manager would take action to ensure people’s safety.

People were registered with local health services and had access to a range of community health services. The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The service worked well with other professionals. The nurse from the GP surgery visited people at the service on a weekly basis and people were referred to specialist services if needed, such as speech and language therapy (SALT), dietitian and district nurses.

The provider worked well with people and healthcare partners to understand what being safe meant to them and the best way to achieve it and shared concerns quickly and appropriately. 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. Loved ones felt that their relatives were treated well by staff. One relative said, “Staff make sure people are safe.” People were comfortable with staff and staff knew people well.

There were clear safeguarding systems, processes, and practices to help protect people from abuse, neglect, and harassment. The provider displayed posters and leaflets for people, staff and visitors, offering guidance on how to access support and recognise signs of abuse to help safeguard others.

Safeguarding systems were in place to safeguard people from abuse. The provider had safeguarding policies and procedures in place, and the registered manager was aware of reporting procedures.

Staff understood how to identify and monitor people for signs of abuse and escalate their concerns if they had them. Staff felt comfortable and able to raise concerns to the registered manager but also knew other avenues to raise concerns if they had them. One member of staff told us, “If I had safeguarding concerns I would go straight to the manager and tell them the concerns. If I ever saw anything I would want to protect people. If the manager did not act, I would take it higher.”

Staff had received safeguarding training and safeguarding was discussed in staff meetings and supervisions to ensure staff understood their role in keeping people safe. One member of staff said, “We discuss safeguarding in our supervisions.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the registered manager understood their responsibility to make DoLS application when required and did this in conjunction with people, relatives and advocates.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe and supportive. Risks relating to people had been identified and assessments were in place to manage these risks appropriately. Risk assessments gave staff clear instructions on how to keep people safe. Staff received training to help them manage risks including training for supporting people with difficulty swallowing and other health conditions as such as epilepsy. When people could not participate in their risk assessments people’s relatives and advocates were invited to be involved in decisions about potential risks and how to best mitigate them. The service took a balanced and proportionate approach to managing risk, supporting people in a holistic way. For example, when 1 individual experienced a fall, staff helped them purchase suitable trousers and footwear to improve mobility while reducing the risk of further incidents.

The provider detected and controlled potential risks in the care environment. They had taken action to ensure the environment was safe for people and staff and made sure equipment, facilities and technology supported the delivery of safe care.

People were cared for in a safe environment that met their needs. There were effective systems in place to monitor the safety and maintenance of the premises. Staff and management could report repairs, which were then addressed appropriately. In addition, the provider arranged for professionally qualified individuals to carry out required environmental and equipment checks. Safety certificates were up to date for gas safety, legionella, water temperature testing, hoists, and fire equipment testing.

Staff had received appropriate health and safety training including moving and handling and fire safety.

People had individual personal evacuation plans (PEEPS) in place to guide staff on how to safely evacuate people from the building in an emergency. Staff had received training in evacuation procedures, and the registered manager had a system in place for staff to practice fire drills. Fire safety equipment was well maintained and had been serviced.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. There were appropriate staffing levels and skill mix to make sure people receive consistently safe care that met their needs. Where people receive one-to-one support, staff skills and experience were matched to the needs of the person.

Staff files were held electronically at the head office and were not easily available on the day of our visit. The registered manager had to request individual staff files from the provider’s HR department to be viewed by a virtual meeting. Appropriate checks were in place before staff started work, including providing references and a Disclosure and Barring Service (DBS) check. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. On the first day of our visit, staff files viewed did not include a full employment history or explanations for gaps in employment. The service promptly addressed gaps in employment history identified during our initial visit.

The service had processes in place to ensure all staff received an extensive induction. New staff members were given opportunity to shadow more experienced members of staff. Staff received training appropriate and relevant to their role and their competency was assessed annually by the registered manager in areas such as medication, manual handling and supporting people to eat and drink. Training was refreshed at regular intervals to maintain knowledge and skills in line with best practice.

A senior manager told us they were recruiting new staff due to some staffing changes recently. Agency staff were used and where possible, the provider had used the same agency staff to ensure continuity for people. The registered manager confirmed agency staff training was up to date and they had completed an induction to the service. Relatives told us that while staff were not always consistent, they felt their loved ones were cared for and safe. One relative said, "there's always some familiar faces but a lot of them come and go", and another commented, "Everything seems to be okay but there's been quite a few different faces every time I go in".

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. Staff had received training in infection prevention and control (IPC). During the assessment, we observed good hygiene practices among staff. Staff had also received training in food safety and understood the importance of food hygiene, when preparing or handling food.

The registered manager regularly carried regular IPC audits to ensure that infection control measures were implemented correctly and consistently, reducing the risk of an infection spreading. The audit identified areas for improvement, listed outstanding actions and if they had been completed. Overall, the home appeared clean and well-maintained. Personal protective equipment (PPE) was readily available to staff.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. A spreadsheet was used to track the completion of training and competency assessments. Staff responsible for administering medicines had their competency checked to ensure they had the skills to do this safely. People were supported to have their medicines by staff who were suitably trained and skilled to administer medicines.

Medicines policies were in place to support the safe administration of medicines, and the medication records we reviewed were in good order. The registered manager carried out audits to ensure oversight of medicines. Where medication errors had occurred, these had been fully investigated and action taken to learn from events to prevent these from happening again.

There was clear person-centred guidance in place to support the safe administration of when required (PRN) medicines. The provider had a policy requiring staff to contact a senior team memberbefore giving when required (PRN) medication, to ensure it was administered appropriately and only when needed.