Elm 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

Medicines were not always managed in a safe way. We identified some areas where improvements were needed. The provider acted on this, investigated what had gone wrong and made the improvements. The staff assessed risks related to people's health and wellbeing. People were cared for by staff who were appropriately recruited, trained and supported. The environment was clean and well maintained. There were processes for learning when things went wrong and responding to accidents, incidents, complaints and safeguarding alerts.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were able to speak up when something was wrong. There were opportunities for them to speak with the management team. They told us concerns had been heard and responded to.

Staff had been involved in learning when things went wrong. There was evidence of supervision and team meetings to discuss concerns, and the staff confirmed they were asked for their views and involved in planning ways to improve the quality of care and safety.

There were processes for dealing with complaints, accidents, incidents, and other adverse events. These were effectively implemented. There were systems to learn from things that went wrong. The management team reviewed all adverse events and worked with staff to help mitigate risks. There were clear and detailed records of all accidents and incidents. There was evidence of improvements made to the service because of these. The management team had worked closely with other organisations to make improvements to care. The provider understood their responsibilities under duty of candour and had apologised when things went wrong.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff explained they had undertaken training to understand about safeguarding people. They were able to explain what they would do and who to report concerns to.

There was information on display about who to report abuse.

People told us they felt safe at the service and with the staff.

There were systems for safeguarding people from the risk of abuse and these were effectively operated. The staff and registered manager had worked with the local safeguarding teams to investigate and respond to allegations of abuse.

We saw people were cared for and supported in a safe way. Staff explained what they were doing, allowed people to make choices and did not rush them. Staff followed good practice guidance.

The staff were able to describe how they supported people safely to reduce the risk of harm. They had undertaken relevant training. They knew how to support people to move safely, how to use equipment and and how to safely support them when they were eating and drinking.

The risks to people's safety and wellbeing had been assessed and planned for. These assessments and plans were reviewed and updated each month and when people's needs changed. The provider had reviewed and updated risk management plans following incidents and accidents. There were procedures to help ensure people were safe and to minimise risks. This included procedures for preventing falls. Staff were aware of these.

Risks to people's safety and wellbeing were well managed. They were provided with personalised support and equipment to support them to be independent and minimise risks to their safety and wellbeing.

People lived in a safe and well-maintained environment. They liked their rooms, and the way communal areas were decorated and furnished. The lighting, ventilation and temperature were appropriate and met people's needs.

There were processes to ensure risks within the environment were assessed and monitored. There were regular audits and checks. Staff worked with other professionals to assess people's equipment needs and to make sure they had the right equipment.

We identified a small number of potential hazards within the environment, including some unlocked storage areas We alerted staff to these, and they took immediate action to mitigate the risks. However, not enough action had been taken before we alerted the staff. There was enough suitable furniture and equipment to meet people's needs and to ensure they were comfortable. There were features to help make the environment attractive, homely, and helpful for people to orientate themselves.

Staff were attentive and responsive when people needed care and support. The staff knew people well and demonstrated this through personalised care and support.

The staff felt well supported. They explained they undertook a range of training, and this was useful. They had enjoyed some recent training and were able to tell us about how this impacted on their work. The staff felt there were enough of them, and they worked well as a team. Staff told us they had regular meetings with their line manager. They felt well informed and told us communication was good.

People using the service and their families told us there were enough staff. They explained they did not have to wait for care. Some of their comments included, ''The best thing here is the staff'', ''The staff are marvellous'' and ''We have enough staff to help us, we are looked after.'' People felt the staff were well trained and had the right skills to care for them.

There were enough staff to meet people's needs and keep them safe. There were suitable procedures for recruiting and selecting staff. These helped to ensure the staff had the skills, knowledge, and competencies to care for people. Staff completed a range of training and observations by managers. They regularly met as a team and individually to discuss their work and learn about good practice.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

There had been 1 instance where a person had not received the prescribed thickener in their drinks as requested by the Speech and Language Therapists (SALT). This meant there was an increased risk of the person choking. There was a system for recording the administration of medicated creams and topical medicines. The staff had not always completed records accurately. We discussed the concerns we had identified with the management team. They provided us with evidence of their investigations into these following our feedback. They took action to mitigate the risks of these issues reoccurring. The provider had a system to obtain and record best interest decisions for people who did not have the mental capacity to consent to their medicines being administered. These were followed and recorded. However, we saw these decisions included all the person's medicines. The provider should ensure decisions relate to individual prescribed medicines. Allergies were documented in people’s individual care plans and on medication administration records. There were effective systems to order people's medicines from the GP and pharmacy. The service had a good relationship with the local healthcare providers. The service had a process to check performance of the service through a series of audits. The service had a system to record, investigate and learn from medication incidents. We reviewed policies and saw they were up to date, relevant and referenced national guidance.

Staff told us they knew how to report medicines incidents when these occurred. They told us there had been no medicine related incidents in the 6 months prior to the assessment. Staff completed regular training about medicines management. Managers completed annual competency checks to ensure staff remained competent.

People told us they received the support they needed with their medicines. They were happy with this support. We observed staff administering medicines to people in a safe and appropriate way. People’s behaviour was not controlled by excessive and inappropriate use of medicines. Care plans for people contained details on the medicines they were taking, and the level of support required to take these medicines.