Grangewood Lodge Residential 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 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.

Staff understood their responsibilities to record and report any accidents or incidents. The management team implemented systems to ensure accidents and incidents were monitored to identify any emerging themes or patterns to mitigate further risks and improve the care provided. Learning from events had been cascaded through the staff team and staff were informed on how risks were managed. For example, referrals were made for assessment for specialist support. Relatives told us they were kept up to date and informed of any accidents or incidents where appropriate. One relative told us, “The [management team] were responsive following an accident and worked with us to answer our questions and we decided together for [relative] to move into a different room which was better for them”.

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.

The provider implemented an effective system for ensuring people’s needs and expectations could be met prior to them starting to use the service. People were involved in their assessments and in making the decision the care home was the right one for them. People and their representatives were encouraged to visit the care home wherever possible before choosing to move in. People had care plans and risk assessments which were based on the assessments completed and these were reviewed and updated when needed. One relative told us, “It took [relative] a little while to settle. The staff were very good and got to know how they like things to be done.”

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.

People were protected from abuse and avoidable harm. People told us they felt happy and safe using the service, we observed people to be familiar and comfortable with the staff supporting them. People understood who to raise any concerns they had to and were confident these would be addressed. Staff had received training in safeguarding and knew how to recognise signs of abuse and how to safeguard people if they had any concerns.

We found that the service implemented the principles of the Mental Capacity Act 2005 to ensure people’s safety and had made appropriate Deprivation of Liberty Safeguard (DoLS) applications. DoLS is a legal framework in the UK toensure any deprivation of liberty for individuals is lawful, necessary, and in their best interests.

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 safely supported to live their day to day lives in line with their choices and preferences. Staff demonstrated a good understanding of people’s needs and how to mitigate their known risks. One relative told us, “The staff know what they are doing, my [relative] is safe.”

Staff were kept informed about any risks and changes to people’s care and support needs through handover meetings. Where appropriate, relatives were informed of any changes. One relative told us, “They [staff] are on the ball with contacting us, they let us know if there are any issues.”

People were observed to be supported in line with their care plans. For example, where people needed support with eating and drinking.

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

The provider implemented effective systems to monitor the safety of the premises, for example, regular maintenance and safety checks were completed. Hazards, including fire safety, were assessed, identified and addressed as required. The provider had developed a rolling refurbishment plan for the property to capture the planned and responsive work to maintain the standards of decoration and furnishings and equipment in the home.

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.

The provider implemented effective systems to ensure staff were safely recruited, trained and deployed to meet people’s needs. The registered manager completed a tool to identify the number of staff required to meet people’s needs safely. During our assessment, staffing levels met the assessed needs of the people living at the service. People, their relatives, staff and visiting professionals told us staffing levels were safe.

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.

The provider had effective systems and procedures in place to manage infection, prevention and control safely in the home. The provider understood, and was responsive to, the needs of people living at the home to maintain cleanliness. Specialist equipment was used daily in the home and staff followed cleaning schedules using appropriate products to help manage infection risks. From our observations during the assessment, and from what people, their relatives, staff and visiting professionals told us, the standard of cleanliness in the home was good. One relative told us. “The home is always clean; I have no concerns.”

Personal protective equipment (PPE) was in good supply and available in the home. During a mealtime it was observed appropriate PPE was not consistently used by staff. The registered manager was informed not all staff were wearing gloves to serve food. This was immediately responded to, and good practice was observed following this.

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.

The provider implemented systems to ensure the safe management of medicines in the home. Staff received training and competence checks to ensure they could safely support people to manage their medicines. People were supported by staff who knew and respected their preferences and were offered their medicines in the way they preferred. Staff worked with people to ensure appropriate prescribed pain relief was offered when needed.

Differences between staff practice and the provider’s medicines policy were seen during the inspection. For example, staff medicines recording errors, had been identified by the registered manager during regular checks and action taken to address them. The provider was in the process of transferring to an electronic system for the management of medicines which could make consistent recording easier for staff to complete and reduce the risk of recording errors happening.

People were assessed to see if they could administer their own medicines, to help maintain their independence. Where this was not possible, staff supported people with their prescribed medicines in the way each person preferred.