Elpha Lodge Residential 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

People felt safe and were enabled to take positive risks. Risk was assessed and monitored. Staff understood how to keep people safe and had received suitable training. There were enough staff on duty and systems were in place to ensure they were recruited safely. Staff learnt lessons from mistakes. Care plans were in place, and where people were at risk of harm, assessments were carried out. We identified some improvements to records was required and the registered manager addressed this immediately. People received their prescribed medicines, and some updates were made to record keeping during our inspection to further enhance procedures. Staff followed infection control procedures although we found some areas which needed attention. The registered manager addressed these and continued to work with the local infection control team.

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.

There was a good learning culture. People said they felt empowered and encouraged to give their views openly and this leads to changes. For example, one person told us, “I feel very able to speak up and say honestly what I think to the manager, deputy and the owner. “ Residents hold their own meetings where they discuss any issues or suggestions.

Staff said there was an open culture where they were encouraged to speak up. Staff described the management team and director as approachable and supportive. One staff member commented, “The manager is a good listener and gets things done.”

Processes were in place to learn from accidents and incidents and improve the quality of the service.

Safe systems were in place. People described positive experiences of safe transitions from other care services to Elpha Lodge. People had felt highly involved in this process and had visits and trial periods so they could make an informed choice about it. People made very favourable comparisons about their move to this care service.

The deputy manager described the pre-admission process which included individual arrangements such a range of visits at different times to the service to meet other people as well as trial stopover period to ensure people could make an informed choice about whether it was a good placement for them.

Other healthcare professionals said staff worked well with them to better support people living at the home. One said, "The deputy manager is currently undertaking the Northumberland County Council Managers Excellence course."

Systems were in place to ensure information was shared between the multi-disciplinary team of professionals who involved with people's care. These meetings were felt to be productive where valuable information was shared.

People said they felt “safe” and “well cared for” and had no concerns about the service. One family member said, "Yes, very much so (when asked if their relative was safe)" People said they had no concerns and felt able to speak to members of the management team at any time if they wanted.

Leaders and staff understood their responsibilities to improve people’s lives while also ensuring their safety and protection from abuse. Staff said they had training in safeguarding people and understood their responsibilities to speak up if they were concerned. Staff were complimentary about the approachability of the management team to discuss any concerns and felt these were acted upon. For example, one staff commented, “It’s definitely a safe place [to live and work]. The manager is a good listener and acts on things.”

We observed positive interactions between people and staff throughout the inspection.

Safeguarding procedures were in place and followed by staff.

People were involved in risks around their health and wellbeing. People said they led their own lifestyle and made their own lifestyle choices. They did not feel restricted by the service, other than by its location in a rural area which meant they required transport to go out. Where people were physically able to manage aspects of their own care, such as showering independently, this was promoted.

Staff collaborated with people to understand and manage risks together so that positive risk-taking was supported whilst the care met their needs in a way that was safe. Staff were trained and understood how to manage risk. Staff said their role was to support people to lead their own lifestyle, including tasks that may involve responsible risk-taking. The manager’s said people were encouraged to be involved in their own care planning. One staff member said, “Our primary aim is to improve people’s daily lifestyle.”

Observations confirmed difficult situations were handled well.

We found a small number of updates on risk assessments was needed and the manager sent us updates to confirm they had been completed.

Overall, people felt their accommodation was safe and clean. However, they commented on the inequity in facilities across the two units. In the main building there was only one shower room for the 12 bedrooms which led to restrictions in people’s choice of when they were able to shower. In the newer building, each bedroom contained its own en-suite shower room which meant those people could shower whenever they wanted.

The registered manager told us ongoing refurbishment continued and a new refurbishment plan was in place. Staff told us fire drills took place. The provider and staff team were aware of the inequity of individual accommodation and facilities. The provider had plans to create new premises which would improve people’s access to facilities.

During the first visit to the service there were several doors openable that should have been locked, including a sluice room and cleaning cupboard. This was immediately addressed by the registered manager and keypad locks were fitted.

Audits and checks were in place to ensure the environment remained safe. This included checks on fire safety and ensuring every person had a personal emergency evacuation plan in place. Checks on utilites, including electrical equipment took place regularly.

People and relatives said there was enough staff. People were complimentary about the availability and attentiveness of staff when they needed assistance. People felt staff were competent in their roles.

Staff said they were appreciative of the staffing levels and designation of staff which was beneficial in supporting each person with their individual needs. Staff commented, “We have enough staff to allow us to support people in a personalised way.” Staff said they had essential training during their induction and felt that specialist training was beginning to improve. Some staff said it would be beneficial to have training to understand the specific neurological conditions of the people who lived there. The registered manager said this was being arranged.

There were sufficient staffing arranged for each unit and to meet the mobility needs of people. Care staff were visible and active in both areas. They supported people straightaway and did not rush or hurry people. Staff had time to have meaningful interactions with people.

The provider operated safe recruitment processes to make sure potential staff were suitable to work with people.

People said the home was kept clean and praised the housekeeping staff for their efforts. Relatives were complimentary. When asked about cleanliness, one relative said, “Oh yes, it’s one of the nicest homes around."

Staff told us they had received infection control training and had fully use of personal protective equipment (PPE) as they required. One staff member told us the management team carry out spot checks to ensure they are carrying out their roles in line with best practice regarding infection control.

The provider’s infection, prevention and control processes needed improved. Home-made padding around the back of a toilet cistern and around a hoist had exposed foam which was not impervious so presented an infection control risk. Soap dispensers in some bathrooms and toilets were empty, preventing good hand-hygiene. The communal shower room contained a rusting, aged radiator despite this being previously raised by a visiting IPC professional. Some light pull cords and grab rails in toilets were grubby. The registered manager had the padding and radiator removed and replaced soap dispensers. At the time of the assessment the home held a food hygiene rating of 5 which meant hygiene standards are very good and fully complied with the law.

There were processes in place to monitor infection control in the service. The registered manager was going to review these in light of our feedback.

People and their relatives reported no concerns with their medicine regimes. One relative said, "Yes, (no problems) on the medication, even down to new batteries for their hearing aids. Also, eye tests and the like. Staff are very good in communicating with us."

Senior staff confirmed they had training in medicines management, and this was regularly updated. Compentency checks were also carried out. Senior staff also received specific training in the administration of medicines via PEG (tube into the stomach) and had training in managing PEG care.

Processes were in place for the safe management of medicines, including regular audits. ‘As required’ medicines records needed updated, and the manager addressed this before the end of the inspection. A small number of topical (creams and ointments) records needed to be updated and this was done immediately. During breakfast we observed a small number of people who did not receive medicines which should be given before food. There was no harm to people, and the registered manager updated procedures to ensure this did not happen again. The registered manager told us they were going to fully review their medicines audits in light of our feedback to ensure systems were as robust as they could be.