Lampton House

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

People told us they felt safe living at Lampton House and were able to approach staff with any needs. People and their relatives felt involved in the service at all points. Policies and staff practice ensured there was joint working with other agencies and continuity of care to keep people safe. Staff had training on how to recognise and report harm and abuse and they knew how to apply it. Incidents and accidents were reported openly, and learning was shared to improve where necessary. Staff worked with people, relatives and other professionals to assess and manage the risks people might face in a balanced way. Staff knew when people’s risks changed and took appropriate actions to keep them safe. They used equipment safely to assist people. People were supported to make choices, and decisions were made in their best interests where necessary. Relatives were involved in reviewing care plans and risk assessments as appropriate. When we highlighted some risks which required further assessment, the provider took action to update records promptly. The building and equipment were regularly checked to reduce and manage risks and improvements made where required to keep people safe. The service had effective infection prevention and control measures. Staff supported people safely with their medicines in the way people preferred. Staff who gave medicines had regular training and checks to ensure their practice was safe. People and their relatives spoke positively about the staff team. The numbers and skills of staff matched the needs of people using the service. Staff were safely recruited and received supervision and training to ensure they were skilled, and people were kept safe.

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.

People told us they felt able to raise any concerns and the service had responded to feedback they had provided. A person said, “I feel happy to go to [registered manager] to raise issues.” Relatives told us they were involved in discussions about people’s care plans and risk assessments and had been offered opportunities to provide feedback via questionnaires and relative’s meetings. A relative said, “I have done a questionnaire, and they did have a [relative’s] meeting, but I couldn’t get to it.” Following a survey completed by people who lived at the service, a meeting was held to inform people what actions had been taken in response to feedback.

Staff told us the management team were open and shared learning with them. They felt able to raise concerns and said incidents were reported with openness and honesty. Staff were confident that actions would be taken where necessary to manage risks and make improvements. The management team responded openly and proactively to our feedback about areas for improvement identified during the assessment.

The provider had processes to monitor standards and identify, record and learn from incidents that happened within the home. This included regular audits, supervision, meetings and external checks. This helped to ensure staff could make changes where necessary to improve care for people.

Assessments started as soon as people were referred to the service and included reviews of needs, development of care plans and personalised risk assessments. Relatives told us they were involved in discussions about their family member’s care plans and risk assessments.

The registered manager told us about the processes used to ensure people were safely admitted to the service. These included initial enquiries, pre-admission assessments, contact with relatives and visits to the person. People and their relatives were encouraged to visit the service before their admission and maintain ongoing contact.

Feedback from health and social care professionals did not raise any concerns. Professionals were complimentary about how the service worked with them to ensure people were safe and received the care they needed.

The service had suitable systems and procedures to support staff in working with other professionals. Policies and processes about safety reflected joint working with other key partners to promote shared learning and drive improvement. For example, there were links with the local authority safeguarding team and public health colleagues. Hospital passports provided records of people’s health needs and were shared with other professionals as required. This helped to keep people safe when receiving treatment and promoted continuity of care.

People told us they felt safe living at the service. One person said, “I feel safe – they help by supporting me walking, I feel as safe as houses”. A relative said, “I think my relative is safe because they are much loved by the staff.” People appeared relaxed and comfortable with the staff who supported them. People and their relatives told us they would speak with staff if they were unhappy or had concerns.

Staff received training about how to recognise and respond to safeguarding concerns. The registered manager carried out regular competency assessments to ensure staff had the skills to keep people safe from harm and risk. The staff we asked demonstrated an understanding of safeguarding, but some were unsure when a safeguarding concern might need to be raised. We highlighted this to the management team. The registered manager told us they repeated new information and learning in staff handover meetings over several days to ensure all staff were informed and had the opportunity to discuss any issues. The management team told us they also raised awareness of safeguarding and whistleblowing in resident’s, relative’s and staff team meetings. The registered manager explained how they would investigate safeguarding concerns and involve relevant agencies including the local authority, the Care Quality Commission (CQC) and police as necessary. When concerns had been raised previously, the local authority had been satisfied with the service’s investigation process and records.

Staff were attentive and mindful of people’s safety, ensuring they did not face unnecessary risks. People were able to move freely around the building, but they were kept safe because staff were present, and equipment was appropriately used.

The provider had effective systems, processes and practices to make sure people were protected from abuse and neglect. Safeguarding materials were displayed for people, visitors and staff to see. The Mental Capacity Act 2005 provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff assessed people’s capacity to make decisions and ensured decisions were in the individual’s best interests. Assessments were discussed with other parties and outcomes recorded. If needed, there were appropriate legal authorizations to restrict people for their own safety. In care homes these are called Deprivation of Liberty Safeguards (DoLS). We told the management team that not all staff we spoke to were able to demonstrate a good understanding of DoLS principles.

Where possible, people were informed about risks and supported to keep themselves safe. Staff were proportionate in their approach to risk and respected people’s choices. Relatives said staff knew their family members well and understood the risks they faced. Relatives shared examples of the measures the service had in place to manage their family member’s risks. One person had expressed their wish to manage their own medication and staff were supportive of this. Some people’s relatives were involved in making risk decisions in their family member’s best interests. Relatives told us they were updated and involved in discussions about people’s care plans and risk assessments.

Staff knew people well and demonstrated a positive approach to managing risks and respecting people’s dignity. The registered manager told us people’s care plans and risk assessments were reviewed with them and their relatives. The team worked alongside the local GP surgery as well as speech and language therapists, physiotherapists, district nursing and mental health teams to manage risks safely. Staff had access to up to date information about people’s risks and responded to changes. For example, a person reported feeling unwell to the registered manager in the morning of the site visit. Staff contacted the GP, and they visited the person in the afternoon.

Our observations raised no concerns about staff practice, or the management of people’s risks, and staff had a good understanding of people’s needs. We saw staff supporting people in line with safe practice and their individual risk assessments. When people needed help to move, staff used equipment safely and applied appropriate techniques.

Care records were regularly reviewed with the involvement of people, relatives, and staff to ensure they contained the most up to date information. Care plans overall described risks which might be faced by people, and what staff should do to reduce these risks. However, during the site visit we identified 2 areas of risk which were not fully assessed. These related to a person managing their own medication and another person who was at risk if they left the service alone. We highlighted these to the management team, who responded promptly to update the risk assessments

We spoke with people and their relatives who all spoke positively about the environment, it’s condition and cleanliness. Several people praised the garden areas in particular. One person said, “The gardener does a lovely job; the garden is beautiful.”

Staff received training to keep people safe, such as fire safety and the use of different types of equipment. They told us about safety measures for individual people, such as the safe use of straps and brakes on a person’s wheelchair. Staff felt able to deliver safe and effective care because facilities and equipment were well-maintained and helped them meet people’s needs. During a recent fire inspection, some areas for improvement had been identified. The nominated individual shared the report and action plan and told us all the improvements had been made.

The environment was safe and met people’s needs. The service had an ongoing programme of maintenance and improvement to ensure the building, fixtures and equipment continued to be kept in good working order. During our visit, we identified that the front and rear doors to the building could be more secure to help control potential risks. We discussed this with the management team, and they sent us evidence of changes to the doors which had been made immediately.

The provider had systems to detect and control potential risks in the care environment. This included building safety and equipment checks, management audits and a process for identifying and rectifying issues. We received evidence the service had necessary checks and certificates.

People and their relatives spoke positively of the support they received from staff. One person said, “Staff are nice, approachable. They will do their best to sort out your problem.” We were told there had been several recent changes to the staff team, but people and their relatives told us staff were competent and there were usually sufficient staff available to meet people’s needs. A relative said, “There are enough staff, and they are lovely. I think the staff are busy and stretched. They are very pleasant and courteous with my relative. There have been lots of staff changes recently.”

Staff we spoke with told us there were enough staff to meet people’s needs. Staff were positive about working at the service. Staff said they received regular supervision, appraisal and training. Training records showed staff were up to date with essential training in subjects such as fire, manual handling and safeguarding. They attended regular refresher courses to ensure their knowledge and skills remained up to date. New staff followed an induction process which included essential training, shadowing more experienced staff and meeting with the registered manager. During their induction, new staff also completed the Care Certificate. This is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.

On the day of our visit, we saw there were enough staff to provide people with the support they needed and there was a calm atmosphere in the home. The staffing levels we saw were in line with those deemed safe by the provider.

The nominated individual told us they used a dependency tool to ensure safe staffing levels were maintained and the service did not use agency staff. Staffing levels were altered as and when people’s needs changed to make sure they received consistently safe, good quality care that met their needs. Staff were recruited safely by the provider, and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for people. The service had suitable systems and processes to monitor and ensure training and supervision were up to date and supported best practice.

People and their relatives told us the home was clean and tidy and no concerns were raised. One person said, “It’s clean, they are always cleaning, and all the staff are helpful.”

Staff received training and had a good awareness of infection prevention and control principles. The registered manager told us the service had measures to keep people safe. This included the effective use and disposal of personal protective equipment (PPE), cleaning, laundry management, staff training and competency assessments such as hand washing.

The premises was an older, adapted building. During our visit, we found the service to be clean and free from clutter and odours. Staff used appropriate PPE to keep people safe during mealtimes. We were assured that the provider was protecting people, relatives, staff and visitors from the risk of infection.

Staff conducted regular audits to ensure the home remained clean and met hygiene standards. Staff maintained records of daily and deep cleaning which were regularly checked by the management team. The service had an infection prevention and control policy which reflected relevant national guidance.

People received their medicines safely and as prescribed. People and their relatives told us they were satisfied with the support they received with medicines. A relative said, “The staff bring my relative’s medication in a dosette box and watch to make sure the tablets are taken.” A person said, “I’m not on much medication, but staff do that for you. I am not in pain. I’ve not seen the GP as I am very fit.” Although we did not have concerns about the management of medicines, some people told us medicines were not always given on time. One person said, “Staff bring medication round, it’s usually on time, but sometimes a bit late. The lift has been a problem recently.”

Staff who gave medicines had received training and their competency was checked by the registered manager to ensure their practice was safe. The staff we spoke with had a good awareness of safe medicines processes and practice.

The service had quality assurance measures to ensure medicines were managed safely. This included staff training and competency assessments, weekly audits and stock checks. In addition, the manager from another service completed regular medicines audits. During the site visit, we identified 2 cases where medicines in stock did not match the medicines record and a risk assessment which required more detail. The registered manager responded promptly to update the risk assessment and investigate the discrepancies in stock. These were recent recording errors which had not resulted in any dispensing errors. The medicines policy was up to date and reflected current and relevant best practice and professional guidance.