Archived: Liberham 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

People received safe care and treatment from staff who understood their healthcare needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks. Staff knew people’s needs and ensured people were involved in managing their individual risk and could access safe support when needed. When people’s needs changed or lessons learnt were identified from incidents and accidents, staff took action to protect them from avoidable harm. Staff received ongoing training and support. Staff knew how to raise concerns when needed. Medicines were managed safely. The home was safe and clean.

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 registered manager told us, “We want to learn from every incident.” Staff we spoke with confirmed they knew when risks to people changed and lessons learnt were shared with them. One staff member told us how because of a review of how a person had acquired a bruise, the support they provided around mobility had changed, so the person was no longer at risk of injuring themselves.

People and their relatives told us their care was safe and staff knew what to do if their needs had changed. For example, a relative told us how their loved one was now supported with a particular daily task to keep them safe due to a change in their abilities.

The provider had a clear system in place to report, analyse and action any incidents and accidents. All staff had access to an electronic reporting system where they completed relevant records including details of incident, immediate action taken, and steps taken to prevent future incidents. Then reports were reviewed by managers. Lessons learnt were discussed regularly during staff meetings.

Staff and managers told us how they worked with other healthcare and social care services to ensure people had ongoing access, and information was shared when needed, so people received seamless and timely care. For example, when they needed ongoing treatment around specific health conditions or in emergencies, medical advice was sought in a timely way.

Partners working with the home complimented its responsiveness and the way people were supported when they needed multiple services to support them. One visiting professional said, “[Specific health issues] are promptly communicated via email. Staff follow up with me after treatment, discussing the treatment and acknowledging if any future assistance is required. I am notified promptly if any issue arises, demonstrating a proactive approach to resident well-being. Staff at Liberham Lodge consistently follow up on agreed care plans.”

People and their loved ones told us their care was well-coordinated and tailored to their individual needs which brought good outcomes for them. For example, when people required follow up care in the home after hospital admission, this was provided in a way which effectively addressed their holistic health needs and as a result people’s condition had improved.

The provider had systems and processes in place to enable staff to refer people to other healthcare and social care services and this was done where required efficiently. People’s care was coordinated to ensure good exchange of information when needed. For example, the service used the Herbert Protocol. The Herbert Protocol is a simple risk reduction tool which can be given to police to help them in their search for vulnerable people if they go missing.

The provider had clear and robust safeguarding and whistleblowing policies in place which were available for staff. Safeguarding concerns were recorded, reported, and investigated. The registered manager ensured action was taken to protect people from any ongoing risks. Staff received safeguarding training. The local authority partners provided positive feedback around how the service worked with them when required to safeguard people. A social care professional told us, “[The registered manager] has done a fantastic job there and is very transparent. I would say we have a very good working relationship with the home, and I know they would not hesitate to pick up the phone to discuss any potential safeguarding concerns. [The registered manager] reports safeguarding concerns to MASH (Multiagency Safeguarding Hub) appropriately and always answers any questions we have regarding safeguarding enquiries.”

Staff supported people in a safe way and engaged with people to check how they were.

People and their relatives told us the home was safe and they felt safe with staff. One person said, “Yes (I feel safe), I would talk to staff if I didn’t.” Relatives told us, “I have never felt [person] was unsafe. The staff are vigilant and caring.”; “She is safe in the home, very much so, and what is important to me that [person themselves] feels safe in the home.”

Staff felt confident who to report to any concerns and that these concerns would be swiftly actioned by the managers to ensure people’s safety. One staff said, “Report to line manager or care home manger where it will then be referred to (local authority) safeguarding team.”

People’s care and clinical records included relevant information around their individual risks and what staff had to do to support people to remain safe and well. For example, risks around mobility, skin, nutrition, continence needs, or diabetes were assessed, monitored and reviewed regularly.

Staff knew people’s needs and individual risks and provided safe care. One staff member explained, “We keep people safe by having pendants, call bells, staff situated all over the home. We also have regular health and safety checks to ensure residents are safe at all times, we also use things such as sensor mats, floor mats, sensor lights.”

People received safe care meeting their needs. One person said, “I definitely get good care here.” People’s relatives we spoke with talked about examples of how staff supported people safely around their individual needs. For example, around eating and drinking, health conditions or mobility.

Staff supported people to be safe. For example, staff ensured people used their walking frames when mobilising. Some people required support to eat on a one-to-one basis. Staff supported people at a pace which was safe and comfortable for the person.

People’s relatives told us the home environment was safe. A relative told us, “The home is very safe from the environment to how the staff carry themselves and do their job.”

The registered manager ensured maintenance and health and safety checks were incorporated in day-to-day running of the home. People had individual personal emergency evacuation plans and fire safety checks were completed by staff. The care equipment was appropriately maintained. Technology was used safely in the home.

Staff and managers knew their responsibilities around maintaining a safe home environment for people. One staff member said, “We have all attended face to face training (for fire safety), along with e-learning plus weekly on the spot drills, so in the event of a fire we would go to the panel in the entrance and take our guide from our fire marshal.”

The home environment was safely maintained and suitable for people’s needs. The home was decorated in a way which made it accessible for people who were visually impaired or lived with dementia.

The management team regularly reviewed people’s needs to ensure there were always adequate numbers of staff in the home. Staff training was well-organised and monitored, so staff maintained their skills and new staff were competent before supporting people on their own. New staff were recruited safely, and appropriate checks were completed. Most of the staff team worked both nights and days to ensure good teamwork and consistent care for people. Additional staff were deployed in the mornings as it was recognised many people wanted support at the same time. This ensured people did not need to wait for support and all staff knew their needs well.

There were enough staff available to support people during the day and at night. People did not have to wait for support when they wanted it. We observed staff were competent to provide care and support to people, for example, for those living with dementia.

Staff told us the team was large enough and deployed well, so they were able to meet people’s needs. Staff told us managers would review staffing regularly and make any changes when needed. One staff said, “Management would contact team members and bank staff who are not working to offer shifts, they would also use agency if required.” Staff received ongoing training and support and found it useful to be able to fulfil their roles. Staff told us, “Training is always ongoing so any training I see as a positive.”; “I feel confident in my job role, supported by the management and provided with very good training, tools/equipment.” The nursing staff told us they received support from managers to maintain their professional qualifications and keep their clinical training up to date.

People and their relatives told us there were always enough skilled staff on duty to provide with timely support. One person said, “Staff have never rushed me.” Comments from relatives included, “They are a relatively stable staff with not too much turnover. They all get rotated around the floors, so all know who my [relative] is.”; “Well-staffed and monitored friendly reception. Call buttons regularly checked. Staff very aware and responsive.”; and “They all seem to know exactly what they need to be doing all the time.”

People and their relatives told us the home was always clean and comfortable and staff followed good infection prevention and control practice. One person said, “Yes (staff wear personal protective equipment), and during the pandemic not just with personal care.” Multiple relatives told us the home was ‘spotlessly clean’ in all areas. One relative commented, “The cleanliness is unbelievable, second to none. I have never ever, ever smelt anything bad in there, it’s better than [hotels] we have stayed at.”

Staff were aware of good infection prevention and control principles, both when caring for people, but also around maintenance of the home environment and food hygiene. Staff told us they had regular training and access to personal protective equipment. One staff member said, “We organise the kitchen to ensure there is no chance of cross contamination.”

The provider had clear policies, procedures and resources for staff around infection prevention and control and management of any infectious diseases outbreaks. The registered manager ensured staff were trained in infection prevention and every outbreak was well-managed to protect people. There were clear risk assessments and audits in place around infection prevention.

The home was clean and hygienic on the day of the site visit. People’s bedrooms, communal areas and bathrooms were free of malodours, pleasant and hygienic.

People and their relatives told us they received their medicines safely and could remain as independent as possible. One person told us, “I manage some of mine and then some of the trickier ones [staff] help me with.” A relative told us, “[Staff] are great and they push for reviews (of medicines with the prescriber), so [person] is not taking too much for too long.”

There were safe systems in place for management of medicines. Staff used appropriate and safe storage and we saw they administered medicines to people in a person-centred, safe way. Staff completed appropriate medicines records and managers audited medicines regularly. Audit findings were actioned. Staff knew how to manage ‘when required’ and high-risk medicines. We raised some feedback around recording of specific medicines with the managers on the day of site visit and improvements were made on the same day. People were encouraged and enabled to manage their medicines on their own where possible. Staff completed and regularly updated suitable risk assessments, so appropriate support was provided to enable them to do that safely.

Staff were knowledgeable and competent to support people with their medicines. One staff member said they liked the new electronic medicines records as it enabled them to be more ‘on top of it’. They also told us they received training and their competency was assessed. They knew medicines people were taking and the systems used in the service. The registered manager commented, “We have the clinical lead who is great, they are unbelievably knowledgeable, and I find them a great asset to the home. I can trust them to keep the medicine management side of things up to a high standard.”