Aurora Hyde 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

Improvements had been identified to partnership working to ensure people’s outcomes were achieved. Health care professionals were liaising with the service including the management and support staff so that people had clear objectives and staff knew how best to support people with their individual needs. This supported a culture that was open to partnership working. There was a system for reporting incidents, accidents and safeguarding concerns. Although not all safeguarding concerns had been raised with the local authority and with The Care Quality Commission (CQC). This included where physical incidents had occurred and concerns around medication errors. Improvements were also needed to how the service recorded actions taken as it was not always clear who had been informed. People did not always have a Mental Capacity assessment and Best Interest Decision in place relating to their individual care needs. For example, where staff were using monitoring equipment to keep the person safe. The provider had Deprivation of Liberty (DoLs) authorisations in place. Although staff were not always familiar with what authorisations were in place although they knew where to check this. Staff knew how to raise concerns and how to access whistleblowing procedures. We observed people’s interactions with staff. People appeared relaxed and comfortable with staff. People were supported with health and social care professionals this included social workers, visiting professionals and spending time with their families. People were supported by staff who had a comprehensive recruitment and induction process. Most staff had received relevant training to support people although one member of staff needed epilepsy training the registered manager actioned this following our inspection and staff could benefit from receiving training which covered the risk of choking as some staff were supporting people with dysphagia.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

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.

Families felt people received good care. They told us, “Really really pleased with the service” and “No concerns”. Family members felt able to raise any concerns they had with the service or the registered manager. One professional shared their concerns around how the service was supporting people with their activities. The service was having meetings with professionals so they could make improvements to partnership working to ensure people’s outcomes including activities were better achieved.

Staff knew people well and they knew how to report abuse. The management of the service had not always raised all incidents with the local authority safeguarding team. Where we identified these concerns we shared the information with the local authority safeguarding team.

Staff were seen supporting people in a calm and relaxed manner. There was enough staff available to support people during our inspection.

Not all incidents were being raised with the local authority safeguarding team or The Care Quality Commission following incidents of a certain nature. Improvements were also required where people lacked mental capacity as not all assessments and best interest decisions had been undertaken for people. Where people were being deprived of their liberty paperwork was in place to support these arrangements.

People were supported by staff with their individual needs. Families that we spoke with confirmed when they had been made aware of incidents and actions taken following these incidents. One parent confirmed two incidents which they had been made aware of. Following these incidents they had purchased a TV and the person ate their breakfast in a different part of the home. Families told us about people’s complex needs and that they were made aware sometimes daily about how the person’s day had been.

Staff knew people well and how to support people with their individual needs and any associated risks.

Staff we spoke with where not always familiar with people’s individual needs. For example, during our inspection one person who's care plan confirmed to drink from a specialised cup was observed to drink from a can. Their care plan was not always current and up to date to highlight the risk of choking and there was no clear guidance for staff to follow. Staff we spoke with were not all aware this person had a speech and language therapy plan in place.

People’s care plans did not always contain important information relating to people's individual risks and this had not been identified as needing improvement. Such as two care plans needed speech and language guidance putting in place. Another care plan needed confirmation of what medication the person was to be administered and if this was daily, every other day or every 3 days. Their care plan also confirmed differing information relating to how often staff were to support with a specific procedure relating to their nutrition and if this was weekly or monthly. People had health care plans in place which gave important information about people’s conditions such as Epilepsy. People had hospital passports in place. These contained important information about people’s conditions although there was no reviewed by date and one person had no information recorded following a Speech and Language Therapy assessment. People had detailed Personal Emergency Evacuation Plans (PEEPs) in their care plan.

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

People were supported by enough staff although some staff were new to the service which meant they were new to building a rapport with people. Families confirmed there had been changes to the staff team with some staff leaving after they had worked in the service for a long time. Where the provider was using agency staff the same staff were being requested so they were familiar with people and the service. Comments were, “There is always someone who knows him”, “Quite a few carers have gone, They try and put the same agency staff with him”. “There has been an increase in agency staff with different staff in the house, I have asked for the same staff to support”.

Staff confirmed they had an induction when they started. A staff member said, “The induction included an introduction to residents, staff, systems and mandatory training. It was a good starting point, it included shadowing.” Staff told us there were enough staff and there had been a high use of agency staff although they felt staffing was improving. They said, “Always fully staffed with the correct numbers", Another member of staff told us,“100% staffing has got better, a few new staff are due to start.” Staff told us there was currently only 3 drivers and whilst other means of public transport were available this impacted on people’s activities. One staff member said, “Drivers is an issue, we only have 3 drivers.” Staff felt supported with supervisions. One staff member said, “Yes, I have monthly supervision. It is really helpful.”

We observed people being supported by staff safely. This included whilst having lunch and the person being support with an activity and following having a bath.

The provider had a robust recruitment procedure in place for new staff, which included the shadowing of staff. Staff received training such as first aid, manual handling and safeguarding. However, we identified staff could benefit from some training specific to people’s needs. For example, dysphagia training. This was so staff had received necessary training to enable them to support people with their individual needs. Improvements had been identified by the provider around undertaking competency assessments for staff. This was so they could review staff were competent following their training. The provider acknowledged recruitment of staff had been challenging. They were committed to working towards a stable, consistent staff team and the use of agency staff was reducing. Where agency staff were being booked the service was using the same agency staff so people were supported by staff they knew.

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.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.