Clapham Lodge Care 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

At our last assessment we found some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. Systems were either not in place or robust enough to demonstrate safety was effectively managed. The provider had not protected people from the risk of falls and lessons were not learned from incidents. The provider had failed to ensure there were sufficient numbers of staff deployed. This placed people at risk of harm. Following the assessment, we received assurances from the provider and a new manager was recruited. At this assessment we found improvements had been made. People were safe at Clapham Lodge and this was reflected in their comments and feedback. Staff had a knowledge of safeguarding, how to recognise the signs of potential abuse and reported this appropriately. A relative told us, “A couple of the staff who were quite intimidating have gone and been replaced with genuinely caring staff, adding to a great team.” There was guidance available to staff to promote people’s safety without restricting them unnecessarily. The environment was clean and tidy, with safety check having taken place. There were enough staff of the right skill set to keep people safe and meet their needs. People and their relatives spoke positively about staff and how they were responsive to each need. Medicines were managed safely and delivered in a way which met people’s preferences. The registered manager had oversight of this so any issues could be identified.

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.

People and their relatives told us they could tell staff about things that concerned them. They were confident that changes would happen if they did. People said they, “can suggest things,” and, “they [Staff] listen to us.” A relative told us, “I have found that the staff at Clapham lodge have been open to suggestions with the care that they give.”

Staff recognised incidents and reported them appropriately. The registered manager reviewed the accidents and incidents monthly to ensure actions were taken to reduce the risk of recurrence. Staff we spoke to were aware of actions to take when people became distressed. However, this was not routinely translated into people’s care plans, there were no documented guidelines for staff.

There were processes in place to monitor accidents and incidents affecting people’s safety. Some of the planned measures to quality assure the service had not been completed and there was little evidence of lessons learnt. The registered manager was aware of these shortfalls and told us they were committed to making improvement.

People were supported with health appointments. People told us and relatives confirmed that people had access to services including GP’s and chiropodist.

Staff had made appropriate referrals to other health and social care services as needed to enable people safe continuity of their care. Staff worked closely with external professionals to ensure people’s needs were suitably met.

Feedback from visiting professionals was positive. Comments included, “[Registered Manager] seemed extremely competent and experienced as a manager. [Their] knowledge of each and every resident and their medical issues and medications was extremely good.”

Systems were in place to ensure smooth transitions between services when required. The service worked well with external professionals and commissioners to ensure people received appropriate care.

People told us they were happy with the service. People told us they felt safe, and the staff were, “kind,” and “caring.” Relatives told us they were happy with the care. They said, “[Name] was very dependent on assistance for [their] personal care and [they] always appeared clean and appropriately dressed.”

Staff told us they were confident their concerns would be listened to. One staff member said they, “Can raise concerns. [Registered Manager] is brilliant. We can go to [Name] will any problems.” Another staff member said, “You can go to [Name] with anything. [Name] is very good at taking action.” A third member of staff said, “A year ago I had many safeguarding concerns. Now it’s so much better. People weren’t safe, they are now. It’s all down to [Registered manager].”

We saw people and staff had positive relationships. There was an open culture of communication and we saw no evidence that people were at risk or fearful of the staff team.

Staff had received training in how to safeguard people. Information regarding safeguarding was available to all staff as guidance for dealing with any concerns. There were clear reporting guidelines for staff to follow. The registered manager understood how to respond to allegations of abuse. They displayed a positive attitude to ensuring people were protected from the risk of abuse. Safeguarding concerns were reported in a timely manner to the relevant authority. The registered manager also kept track of those who were under Deprivation of Liberty Safeguards (DoLS) and, when these needed to be renewed, had made appropriate referrals.

People told us they felt safe at Clapham Lodge. Staff knew people’s needs well and how to support any associated risks safely. A relative told us, “Clapham Lodge is the perfect home for my [relative] with staff who show [them] love and also care for [them] to the highest of standards. [Name] is thriving like never before and constantly comments on how happy and well looked after [they are].” Another relative said, “After only a short time we could see [Name] was healthier and happier than [they] had been at home in a long time and even [they] had to admit the staff made [them] feel cared for and safe.”

Staff knew people’s individual risks and how to support them safely. Staff supported people to remain safe and well and were aware of potential risks.

Staff were visible throughout our visit and provided support in a way which minimised risk for people. Where people were at high risk of pressure damage, staff had access to appropriate nursing equipment to reduce the risk. For example, pressure relieving mattresses were in place.

Risks to people were assessed on admission to the service and regularly updated. Risk assessments were completed. Where risks had been identified these had been assessed and actions were in place to mitigate them. Staff were aware of actions to take when people became distressed. However, this was not routinely translated into people’s care plans.

People and their relatives told us the environment was safe. People appeared at ease in the service. Feedback from people and their relatives was positive. Comments included, “In the last several months there has been a noticeable improvement at Clapham Lodge in terms of the overall ambience together with improved maintenance generally.” Another relative told us, “[Person] room has been improved and [they] now has a fabulous mural on [their] wall, which reflects [their] interests. The room was redecorated and a wipe board has been installed and is used.

Staff had received fire awareness training. They told us the training was online and they, “would like physical training,” to improve their understanding of the actions they should take in the event of a fire.

The environment was safe. Care equipment was in good order. There was no clutter and the home was accessible for people with mobility needs. Staff used equipment appropriately to promote people's safety. For example, we saw that when people rang their call bells, staff were very quick to respond and assist them.

The registered manager ensured health and safety and maintenance checks were regularly completed, for example legionella water risk assessments. There was a schedule of regular environmental checks to monitor the safety and upkeep of the premises including checking fire call bells.

People and their relatives told us they were happy with the staffing numbers; they said their care needs were being met. Comments from people included, “If you ring your bell they always come.” A relative told us, “I am happy with the care and kindness my [relative] is given.” Another said, “They [staff] really put the care in care home.”

Conversation with staff evidenced that they were knowledgeable and competent. Staff were generally positive about the training available. They said they felt that it gave them most of the skills and knowledge needed to provided good care. However, they said, “Everything is online.” Staff told us they would like some of their training to be in person, specifically training in manual handling and the use of manual handling equipment and fire training and fire evacuation processes.

Staffing levels were appropriate to meet people's needs and there were sufficient numbers of skilled and experienced staff deployed to keep people safe. We saw staff supported people in a relaxed manner and spent time with them. During our visit we saw staff were available and responded quickly to people. People did not wait for long periods of time when they required assistance.

There were clear processes to ensure there were enough staff. The registered manager had a dependency tool which they used to assess how many staff were required to meet people’s needs. Record’s we reviewed detailed staff had been allocated to work in line with the dependency tool. Staff recruitment processes promoted safety. The registered manager followed safe recruitment practices which included requesting references from previous employers and checks with the Disclosure and Barring Service (DBS). DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

People and their relatives told us the home was clean and tidy. Comments included, “[Their] room was clean, comfortable and airy” and, “The home could do with a bit of decorating in places but I was more concerned about [their] safety and happiness.”

Staff understood the need to wear protective clothing (PPE) such as aprons and gloves, where this was necessary.

We saw staff were able to access aprons and gloves and these were used appropriately throughout the inspection visit.

Suitable procedures were in place to ensure food preparation and storage meets national guidance. The provider had achieved a level five rating at their last Food Standards Agency check. 

People told us they received their medicines as they were prescribed. People’s medicines were administered safely. A visitor told us how their relative was receiving end of life medication and, “I would be hard pressed to find fault as I have been in awe of the staff throughout all this time.”

Staff told us of the training they had received in medicines handling which included observation of practice to ensure their competence. All the staff we spoke to regarding the administration of medicines told us that they felt confident and competent.

There was a dedicated room for storing people’s medicines. We saw that a lockable fridge was available to store medicines that required lower storage temperatures. Daily temperatures of the fridge were taken and recorded to ensure the fridge remained at a safe temperature. The medicines storeroom was locked when not in use and during the medicines administration round the trolley was locked when unattended. Each person had a medication administration record (MAR) detailing each item of prescribed medication and the time they should be given. Staff completed the MARs appropriately for any tablets given. Staff waited to check people had taken their medicines before signing the administration records. However, records were not maintained for the administration of prescribed creams. There were no guidelines for the administration of medicines required as needed (PRN) for some people. However, we saw that people were given explanation regarding their medicines and offered pain relief. There were safe systems in place for the receipt and disposal of medicines. A record was kept of all medicines received and removed from the service.