Lennox 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

During our inspection we found Lennox House was providing a safe service. We assessed a number of evidence categories in this key question and found staff and leaders to be alert to safe guarding concerns. They demonstrated a good understanding of risk and safety related policy. Staff numbers were sufficient to provide safe care and staff received appropriate and regular training to perform their roles. There were some improvements to be made to safe management of medicines. Changes were made promptly and practice updated to ensure safety. We were satisfied by the end of our assessment that medicines were being managed safely. There was evidence that learning took place when things went wrong to ensure future safety.

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.

Staff told us they felt able to raise concerns openly and that they were listened to when they did. People's care plans were regularly reviewed with input from care staff sought to ensure care was reflective of need.

Incident reporting processes were clear and effective. Leaders shared openly when concerns arose and sought to use such occurrences as opportunities for improvement. Processes for regular reviews of people's care were in place and working well and included collaboration with all people, their representative and healthcare teams.

We spoke with the GP for Lennox House during our inspection who told us they were proactive in their engagement relating to people's healthcare. MDT meetings were well attended by a range of relevant partners and the cross sector working was well managed to ensure continuity of care.

People had appropriate risk assessments conducted prior to and during their placement at Lennox House - these were reviewed and updated regularly as well at at times when moving between services. Assessments and care plans were modified according to need and all changes well documented and explained.

People we spoke to told us they felt safe and able to raise any safety issues. They felt they were listened to and action was taken when needed. People and their representatives knew how to raise concerns regarding safety.

Staff were knowledgeable about safeguarding and how to report any concerns. Staff were able to explain what steps to take to prevent abuse and received up-to-date training in this area. We found managers encouraged staff to discuss and raise any concerns through daily meetings and individual supervision.

Safeguarding protocol was clear and well communicated. Any issues presenting a safety concern were recorded with actions, outcomes and learning documented and communicated as necessary. Concerns were appropriately reported to CQC and local authority where relevant with open and transparent communication evident.

People felt their preferences were respected and they were supported to continue to engage with things that are important to them. Activities were designed to reflect people's interests where possible.

Staff told us the service was following a holistic approach in supporting people engaging the GP, the clinical leads and the nursing and care support teams. During our visit, the GP conducted their scheduled round in the service. A member of the management team told us: “We are working closely with the GP to ensure safety nets are in place”. For people who transition from their own home to the service, staff told us a holistic pre-assessment that includes family input takes place.

People's care plans were specific to the individual with their wants and preferences recorded and met where possible. People were given choice and supported to live how they chose. People were made aware of any relevant risks but informed enough to make their own decisions and supervised where necessary.

People we spoke to were happy with the environment. One person advised they had reported a defect in their bathroom which was quickly attended to and repaired.

Maintenance staff were present during our visit. Staff told us the maintenance team were available every day to ensure any maintenance tasks are dealt with promptly. We observed some warm and caring interactions between them and people.

We observed the service had made spatial adaptations for disabled people and fully equipped accessible bathrooms were available. The moving and handling equipment was checked regularly by staff. This ensured people lived in a safe environment. During our visit a member of staff with housekeeping duties was checking and cleaning all rooms. The premises were of good cleaning standard. A staff member checked and recorded the room temperatures ensuring people felt comfortable in their rooms.

All regular maintenance checks of equipment and property were up to date and records well maintained. Action points were followed up in a timely manner. Fire safety checks were regularly conducted and evacuation plans clear. Audits of emergency call bells showed responses were prompt.

People we spoke to said they felt staffing levels were good. One relative we spoke to who said they visit every day told us there were always enough staff.

Staff told us the staffing numbers had recently started to increase as Lennox House prepares to increase admissions. One staff member told us the team could use some additional team members. We discussed this with members of the senior team. They told us there were plans followed to recruit new staff and to retain the existing team. The service was working on developing the current care staff skills with nursing knowledge. Staff told us they felt part of a team at Lennox House with joint objectives and a desire to provide a high level of care to people. One staff member told us, "2 years ago i would have said no, but now I feel well supported by colleagues and managers."

Even though staff were present during our visit and people’s immediate needs were observed to be met promptly, our conversations with some staff members felt rushed as they needed to return to their duties. More than one staff member from the care and nursing team on duty seemed to be available to respond to alarms and call bells used by people during our visit.

Staff employment records showed that staff had relevant experience and qualifications to conduct their roles safely. Staff were given opportunities to develop further if desired. the staff induction process was thorough and consistent. Opportunities to ensure all staff were able to attend training regardless of their working hours. All staff were given training on dementia care even if providing care was not their role (such as kitchen/maintenance staff), to ensure an understanding of people who live there and ensure all interactions are dementia friendly.

Staff told us they had access to adequate PPE equipment to perform their duties. They also showed an understanding of how it should be used and disposed of. This ensured infections could be controlled from spreading at the service.

We observed different staff with varied roles using PPE equipment correctly during our visit. This showed staff were knowledgeable about managing the risk of infection amongst vulnerable people.

Housekeeping records showed that all areas were well cleaned and this was audited by management, both by checking records but also by conducting observation. There were clear plans in place for caring for people who may have a transferable infection in order to prevent further spread. Relevant agencies were informed in the event of any such break out of infection including visitors to the home.

Some people were prescribed medicines for pain relief and constipation to be taken on a when required (PRN) basis. Guidance in the form of PRN protocols were in place to help staff give these medicines consistently. We saw people with swallowing difficulties were supported to safely take their medicines. We saw regular reviews from the local speech and language therapist(SALT) team in these residents. When people were prescribed medicines to be given at specific times staff gave them at the right time. The service had good records with details of medicines that need to be monitored regularly which helped doctors have greater oversight of the people in their care. People had up to date care plans which contained information about how they were supported when taking medicines.

The staff informed us they received training and were competency assessed to handle medicines safely. We saw evidence of these being completed. Most staff who administered medicines told us they were supported by leaders and were given enough time to safely administer them. Staff told us they worked closely with the local GPs and local hospital healthcare professionals. Staff were able to contact them when they had any queries about residents’ medications or conditions. The service was also supported by community teams including community nurses, care home support teams and speech and language therapists.

The service had a new clinical lead in post who supported staff with improving medicines management. For example, we saw a new fluid recording system that allowed staff and visiting doctors to easily track the input and output of fluids for people . The staff carried out regular medicine audits. The service had a log of issues found in the audits and referred back to them to ensure they had been actioned. The service had a process for administering medicines covertly. We saw evidence of advice from relevant healthcare professionals including pharmacists to ensure that medicines were safe to be administered covertly. People’s medicines were stored safely and securely including medicines that needed additional storage such as controlled drugs . Staff did not always record medicines accurately. Staff did not have enough suitable equipment to carry out their role. We saw that there were not enough laptops for staff make accurate records of administration. Because of this, we saw staff record administration at different times to when it was made. Following our inspection service leaders were able to evidence changes to this practice with the purchase of additional equipment for staff. New medicines were not always recorded accurately on the resident’s electronic administration record. We saw an example where a medicine strength had been incorrectly entered onto the electronic medications administration record (eMAR). This was raised with the service to investigate. The persons had received their medicine as prescribed, but staff had not noticed the discrepancy. After the inspection, service leaders showed us an action plan to prevent recurrence.