The Ark Care Lodge Limited

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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider had processes to record accidents and incidents, which were reviewed by managers, including incidents where people experienced distress. Managers had acted on changes to people’s known responses or behaviours and worked with people, relatives and external agencies to prevent further occurrences. Relatives spoke of how the service had improved over the last 12 months, which were attributed to the new management structure put in place.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.  Managers told us about the work they had undertaken to improve relationships with partner agencies and healthcare professionals. Records showed staff contacted healthcare professionals such as GP’s and dietitians in response to changes in people's needs. People had communication and distress passports which supported safe care in the event people transitioned from the service or were admitted to hospital.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. We observed people were happy, comfortable and confident with the staff team who were supporting them. Managers worked alongside staff and had day to day contact with people. This enabled the management team to have oversight at any time and promoted an open culture. People and their representatives were involved in all aspects of their care. People’s emotional and sexual health needs were considered and supported.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. People were supported and empowered to take risks in areas they wanted to and to enhance their lives. For example, lifestyle choices and hobbies and interests. When people’s needs changed or staff noticed changes in people’s mood or communication style, care plans and risk assessments were reviewed. People’s care plans included clear guidance for staff to follow in relation to de-escalation and distraction techniques in place of restrictive interventions when people experienced distress. We observed staff followed these during our site visit. Guidance was available to enable staff to support people with specific health conditions.

The service did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. We identified areas of the premises that presented potential risks for people, including wardrobes that were unstable and not secured to walls, a lack of assessment and mitigation of risks where ground floor windows did not have restrictors to ensure access was restricted and improve security and 2 radiators that did not have covers to protect people from the risk of surface burns. Work was in progress to upgrade areas of the premises; however, audits and checks had not identified all areas or resulted in timely action being taken. The registered manager acted immediately on our concerns and remedial work was completed 24 hours following our site visit.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us they had good relationships with staff; their comments included, “I like all the staff here, they help me,” and “The staff are nice and friendly.” We observed positive interactions between people and staff, with people initiating contact and communication with staff to enable them to be in control of their day and how they spent their time.

The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. For example, we found toilets without hand towel dispensers, a ripped sofa and stained seating, poor quality bedding and cleaning equipment stored outside. Although there was no evidence people had been harmed, there was a risk cleaning was not effective and therefore the risk of infections was not effectively mitigated. Audits and checks had not identified all these areas of concern. The registered manager immediately acted and addressed our concerns following our site visit.

The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The service had safe systems for appropriate and safe handling of medicines. However, systems used were not always in line with the provider’s medicines policy. For example, we found there was no designated lockable fridge to maintain the safety of medicines room temperatures were not routinely monitored to ensure safe storage, topical medicines were not always recorded as administered on medicine administration charts and risk assessments were not always completed for paraffin-based emollient creams. The registered manager addressed all our concerns immediately after our site visit, however, their audits had not identified these areas of concern. Staff had received training in administering medicines and their competencies were regularly assessed.