Elstow 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

At our last inspection we identified breaches in relation to people’s safe care and treatment and staffing levels. At this assessment improvements had been made and the service is no longer in breach of regulations. People were supported safely at the service and risk assessments were in place to support people to minimise any risk they faced and still be supported to take positive risks in line with their choices. There were enough staff to support people safely and spend quality time with people. Staff kept the environment safe and followed good infection prevention and control measures whilst supporting people.

This service scored 50 (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 relatives told us how staff learned lessons when things went wrong. One relative said, ‘‘I know that if me or [family member] want anything changed, this happens immediately, and staff respect our wishes.’’ Staff were supported to learn lessons as incidents and accidents were discussed in team meetings and supervisions. Staff told us how they changed their practice based on people’s previous experiences, for example, changing the way they supported a person when they became upset to better keep the person and others safe. The manager and deputy manager had implemented a system to monitor and review incidents and findings from audits. If areas for improvement were found these were added to action plans and improvements were made in a timely manner. The manager told us this system was still new, however showed us evidence which assured us it worked well. The hard work and dedication of the management and staff team meant there had been a lot of learning and improvements at the service since our last inspection as discussed in the rest of this report.

People and relatives told us they were supported to safely visit other services such as hospitals if they needed this support. One relative said, ‘‘[Family member] has needed to go to hospital once or twice but staff are on top of everything and they are perfectly safe.’’ Staff were confident in communicating people’s needs to other services and professionals. People were supported by staff to attend appointments. One person said, ‘‘[Staff] take me to the doctor if I need it.’’ Staff told us how they supported a person who needed more support from health professionals as their needs changed and knew this person well. The manager and deputy manager had effective processes in place to help ensure people’s support needs were assessed on a regular basis. They communicated and worked well with health professionals and partners in the community to help ensure people were well supported in other services.

People and their relatives told us they/ their family member were safe living at the service. One person said, ‘‘Yes, very safe’’ when we asked them if they felt safe. Another person signed to us to say they felt safe. People were relaxed being supported by the staff team. A relative said, ‘‘[Family member] is as safe as they can be and I have complete faith in the staff team.’’ Staff were trained in safeguarding and knew how to recognise and act on any signs of abuse. Staff knew how to raise any concerns they had with outside organisations such as the local authority safeguarding team or CQC. The manager and deputy manager reported safeguarding concerns as appropriate and had measures in place to learn from these if required.

People had risk assessments in place based on their support needs and these detailed how to minimise risks people faced as far as possible. People and relatives were invited to discuss these risk assessments regularly to see if any changes were needed. One relative said, ‘‘[Staff] always invite me to talk about [family member] but they know them the best so I never have much to say. The paperwork is very detailed.’’ Staff knew the risks people faced and were able to tell us how they supported people to minimise these risks. We observed staff supporting people in line with these risk assessments, For example, one person was feeling upset and staff supported them to feel better in line with their risk assessments and care plans whilst keeping them safe. The management team and staff team had processes in place to monitor people’s support and the risks they faced and update care plans in relation to this. People were supported to speak about their risk assessments in ways that made sense to them. Risk assessments were detailed and gave good guidance to staff.

People and relatives felt the environment at the service was safe. One relative said, ‘‘I know the staff always do checks of the building and recently a lot of work has happened to make the building look nicer too.’’ Staff completed health and safety, including fire safety checks of the building regularly and took actions if these were needed. The management team completed audits to monitor the safety of the environment.

People and relatives told us there were enough staff to support them/ their family member safely and the staff team was consistent. One person said, ‘‘I know all the staff. Get on with them all.’’ Another person happily said, ‘‘Nice’’ when we asked them about staffing levels. A relative said, ‘‘[Family member] does not get on well with lots of different faces all the time and consistency is important for them. It is great that all the staff know them well and this means a lot to us.’’ Staff told us there were enough staff not only to support people with their personal care and essential tasks, but also to sit and spend time with people. We observed staff taking the time to sit and speak with people and people reacted positively to this. One relative said, ‘‘It is not just care, they treat [family member] like one of their own relatives too.’’ Staff had training in all areas relevant to their job role and were knowledgeable about the training courses they had attended. In particular, staff had embraced training about best practice when supporting people living with a learning disability and autistic people and this had been very positive for people. The management team ensured there were the right amount of staff to support people at any given time. They monitored and supported staff to attend training and upskill in their job roles. A relative said, ‘‘[Staff] 100% know what they are doing and are well trained.’’ The provider ensured new staff were recruited safely in line with legislation.

The service looked clean and fresh, and we observed staff members following good IPC practices. One person said, ‘‘Staff help me clean my room and help us tidy up.’’ Another person was visibly happy when staff supported them to tidy away after lunch. The management team completed IPC audits to ensure the service was cleaned regularly.

People were supported safely with heir medicines. One person was supported to be involved in administering their own medicines and this clearly meant a lot to the person. One relative said, ‘‘It is very reassuring the staff know how to handle all [family members] medicines for them.’’ We observed staff administering medicines to people in line with their preferences and with kindness. As a result, people were happy to take their medicines. Staff were trained how to administer medicines safely and had their competency to do so assessed regularly. The management team had policies in place to make sure medicines were managed safely. We found some small areas for improvement in relation to some care plans not being specific to people’s support needs in relation to medicines. These did not impact people’s safety and the management team assured us they would act on these areas for improvement immediately.