Lakeside View Nursing 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

We assessed 4 quality statements in the safe key question and found both areas of good practice and areas where improvement was required. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. Appropriate systems were in place to identify, record and report safeguarding concerns. Staff described the action they would take to protect people from abuse and provided reassurance that they would not hesitate to speak up if they observed poor practice or people being mistreated in any way. The registered manager understood their safeguarding responsibilities and told us they regularly revisit good safeguarding practice with staff in team meetings and supervisions. Risk was effectively identified, monitored and mitigated. An appropriate system was in place to record and analyse safety related incidents. We were assured the analysis of incidents led to staff taking action to reduce the risk of harm. There were enough staff deployed to safely meet people's needs. Staff were recruited safely and undertook a wide range of training courses to equip them with the knowledge needed to carry out their roles. Staff told us they received an induction and training when they started their employment and described how this prepared them to carry out their roles. People received their medicines as prescribed. People's medicines administration records were generally well completed. However, we found some improvement was required as not all medicines dosage information was recorded correctly and a medicine required to manage the symptoms of a person who was receiving end of life care was out of stock. We were assured the principles of the Mental Capacity Act 2005 were applied in practice. However, we identified shortfalls with the completion of mental capacity assessments as they did not always relate to a specific decision.

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.

People told us they felt safe living at Lakeside View Nursing Home. They confirmed staff treated them well and understood how to support them to maintain their health, safety and wellbeing. Overall, relatives told us they had no concerns about how their loved ones were treated. Comments included, "They treat him very well, he is safe" and "I think she is treated very well and they do their best to keep her safe."

Staff described the action they would take to protect people from abuse and provided reassurance they would not hesitate to speak up if they observed poor practice or people being mistreated in any way. Staff knew where to access safeguarding policies and they were able to relay what they learned from the safeguarding training they completed. The registered manager understood their safeguarding responsibilities and told us they regularly revisit good safeguarding practice with staff in team meeting and supervisions. The registered manager understood their role in assessing people's capacity in line with the principles of the Mental Capacity Act 2005 and understood the correct processes to follow to legally deprive a person of their liberty. They were open and honest about shortfalls they recently identified with mental capacity assessments and discussed the action plan they had already put in place to improve this area.

Our observations found people were supported to stay safe from harm and neglect. Staff were observant of risk in the environment and took the necessary action to reduce the risk of harm. During the assessment, a person raised concerns regarding their care and treatment. The registered manager and provider acted appropriately to the concerns and ,through our observations, we were assured by their overall response to protect the person while a full investigation was carried out. We were assured the provider worked alongside the local authority safeguarding team in relation to the persons concerns.

Appropriate systems were in place to identify, record and report safeguarding concerns. The registered manager reviewed safeguarding referrals made and focused on learning lessons from incidents to improve the safety of the service. For example, the registered manager had recently improved their preadmission checklist following concerns raised about a person's skin integrity. Staff received training in the principles of the Mental Capacity Act 2005 and we were assured these principles were applied in practice. However, we identified shortfalls with the completion of mental capacity assessments as they did not always relate to a specific decision. We were assured sufficient action was being undertaken to address the shortfalls and found records recently completed were of a good quality.

People were supported to understand and manage risk and told us they felt safe in the care of staff. Relatives also provided positive feedback about their loved ones safety during moving and handling interventions. Comments included, "Staff are trained, they know how to lift her properly using the hoists" and "I have witnessed staff using the hoist and he seems very safe." Relatives told us staff identified when people's needs changed and were proactive in responding to new risks. Comments included, "They have tried to put more things in place and have increased her support so she gets one to one support" and "They respond quickly if I have concerns, they call me if she has a fall even if there is a near miss they will call."

The registered manager described in detail the processes they followed to ensure risk was effectively managed and people's risk assessments remained up to date. They described the "resident of the day" process which ensured all care plans were reviewed and were reflective of people's current needs and risks. Staff told us they were informed about people's individual risks and knew what action to take to keep people safe. A staff member told us, "I make sure I'm informed of their health care needs, and support them by talking to them and providing appropriate care for level they require."

Through our observations, it was clear people were supported by staff who understood their individual risks and took the necessary action to keep them safe. For example, we observed staff helping people to mobilise around the home and observed staff assisting with moving a person using a hoist. We found this was carried out safely. Overall, our observations found people lived in a safe environment. Where people required monitoring equipment to reduce the risk of falls, we observed this was in place. Where people required specialised equipment to reduce risks associated with skin integrity, we saw this was in place. We did identify some minor environmental hazards such as lights not working and unlocked storage rooms on the first day of the assessment. However, by the second day, any minor issues that had been identified and shared with the registered manager had been addressed.

Risk was effectively identified, monitored and mitigated. People's individual risks were comprehensively assessed and validated tools were used to inform clinical judgement. Risk assessments were very detailed and helped to guide staff on how to keep people safe. We found regular reviews took place involving the relevant professionals where required to ensure people's care plans contained accurate and up to date information about areas of risk. An appropriate system was in place to record and analyse safety related incidents. We were assured the analysis of incidents led to staff taking action to reduce the risk of harm.

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 told us they were supported by knowledgeable and experienced staff. Relatives also felt staff demonstrated the necessary skills to effectively support their loved ones. Comments included, "Staff are trained, in fact very well trained", "They [Staff] are brilliant" and "Staff are trained they know how to lift [Person] properly using the hoist." Overall, people and their relatives told us there were enough staff to meet their needs. However, some relatives explained their loved ones could experience delays with receiving support during busy periods. Comments included, "[Person] has a buzzer, sometimes when he presses it he has to wait for a bit, but staff always apologise if there has been a wait."

Staff told us they received an induction and training when they started their employment and described how this prepared them to carry out their roles. Staff were confident additional training would be made available if they requested this. Staff raised no concerns about the staffing levels in the home. A staff member told us, "Best staffing levels I’ve seen around."

Our observations found enough staff were deployed to safely meet people's needs. We found staff responded promptly when people pressed their call bells for assistance. We were assured staff displayed the necessary skills and competence to support people effectively. For example, we observed two staff performing a moving and handling technique and found this was carried out safely with staff regularly reassuring the person they were assisting.

Staff were safely recruited and undertook a wide range of training courses to equip them with the knowledge needed to carry out their roles. The training courses exceeded those recommended under health and social care best practice guidance. We found areas of good practice as a range of training courses were provided to meet people's specific needs. Systems ensured clinical staff maintained their professional registration and regular clinical competency assessments were undertaken to ensure they retained the skills to help people achieve good health outcomes. The system for calculating safe staffing levels was appropriate and records showed more than the minimum number of staff were regularly deployed.

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.

People and their relatives told us they received their medicines when they needed them. Comments included, "I get what I need every day", " Yes she gets it when she needs it and if it needed to change they would discuss it with me" and "She always gets her medication and I often see her being given it."

The registered manager explained they had recently implemented a new electronic medication management system. They described how they increased auditing processes to ensure people received their medicines as prescribed and put measures in place to ensure staff were trained and competent in the use of the new system. The provider outlined how lessons had been learnt from their other locations when embedding the new electronic medicines systems. They described how this provider wide learning helped to reduce the risk of medicines related errors.

People received their medicines as prescribed. People's medicines administration records were generally well completed. However, we found some improvement was required as not all medicines dosage information was recorded correctly and a medicine required to manage the symptoms of a person who was receiving end of life care was out of stock. While these shortfalls had not been identified by the providers monitoring systems, we found no evidence of harm and were assured by the registered managers immediate response to obtain the missing medicine and update the relevant records. The registered manager undertook a review of all medicines prescribed to people who were at the end of their lives and worked alongside the GP to ensure dosage information was accurate following the assessment. We found areas of good practice in relation to medicines care planning, for example, records guided staff on the flammability risks associated with certain topical medicines. We also found evidence that thorough competency assessments were undertaken with staff in line with best practice guidance to ensure they administered medicines safely.