Horsell 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

People were cared for by staff who were knowledgeable in their responsibility to safeguard people from harm. Risks to people were managed appropriately due to sufficient numbers of staff being on each shift. Infection prevention and control procedures were in place and the management of medicines was safe.

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.

People and relatives said action was taken to put things right if they raised concerns. For example, a relative told us, "There are sometimes little niggles, like the laundry service can be a bit hit and miss. Sometimes socks do not come back, or [family member] gets the wrong clothes back. We have mentioned that, and they have taken steps to improve things."

The registered manager told us they aimed to establish a culture in which staff felt able to be open and honest if things went wrong as these would be viewed as opportunities for learning and improvement rather than apportioning blame.

If an accident or incident occurred, this was recorded by staff and reviewed by managers to identify any actions that could be taken to reduce the risk of a similar incident happening again.

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 at the home and when staff provided their care. Relatives were also confident their family members were safe. One person said they felt, "Happy and safe" at the home. A relative told us, “[Family member] enjoys it here; she feels safe and secure."

Staff confirmed they attended safeguarding training and that they knew how to report any concerns they had. One member of staff told us, "We are told about whistleblowing. If I see something, I need to report it, I need to whistleblow. I learned that the law can protect me after whistleblowing." Another member of staff said, “I would report to my senior or the manager. I know I could go to the social services or CQC." People’s rights were protected as staff understood the principles of the Mental Capacity Act 2005. One member of staff told us, “You don’t assume people lack capacity; this can fluctuate depending on their health. We must always gain their consent in relation to personal care.” Another member of staff said, “You have to understand if a person is able to process and respond to information. We have to explain things to people so they understand what they are consenting to.”

We observed during our site visit that staff supported people safely and in a way that promoted their privacy and dignity. Personal care was provided discreetly and respectfully, and staff respected people’s right to privacy when they wanted it.

Staff attended safeguarding training in their induction and had access to online refresher training. The provider had responded to requests for information from the local authority when safeguarding enquiries took place.

People and their loved ones felt risks to them were managed safely. In relation to the management of a person’s health need, their relative told us, “The staff are very good at picking anything up. They monitor it. They knew when it was a red flag.”

Staff said any changes in people’s needs were discussed at team meetings, which helped them manage the risks. A member of staff told us, “We have regular meetings where we discuss people’s needs and any changes, so I am aware of their individual needs and risks and how to manage them.”

We observed during our site visit that staff supported people safely and in line with the guidance in their care plans.

When accidents or incidents occurred, these were recorded by staff and reviewed by the registered manager to identify whether any changes were needed to people’s care plans to reduce the risk of a similar incident happening again. Where causes which could be resolved had been identified, such as purchasing suitable footwear, this had been done and resulted in a decrease of falls for this person.

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 their needs were met by a consistent staffing team. They told us there were enough staff available when they needed support. One person told us, “They are always available. They are good.” Another said, “They are always around. No problem with any of them. They are always the same staff. I know them well.”

The staff we spoke with indicated there were enough staff to meet people's needs effectively. They said this had improved since new staff had been employed. A staff member told us, “I do think there are enough staff now. There's been lots of new [staff] in the past three months.” Staff also told us they received an induction and supervision although this was not always regular.

We observed there were enough staff which meant people were receiving quality time with the staff. The staff and people were engaged in a variety of activities. People were happy and engaged in conversations with staff throughout the day. The staff appeared caring and friendly and carried out their duties efficiently and calmly.

We observed there were enough staff which meant people were receiving quality time with the staff. The staff and people were engaged in a variety of activities. People were happy and engaged in conversations with staff throughout the day. The staff appeared caring and friendly and carried out their duties efficiently and calmly.

We asked people their views of the cleanliness of the service. One person told us, “They are always cleaning here.” Another person said, “You can see yourself. It’s always clean and nice.” People confirmed the staff wore personal protective equipment (PPE) appropriately when supporting them with personal care.

Staff fed back that they managed a sewage flood incident in the basement well and the incident did not impact on the cleanliness of the home and the provision of safe care to residents. They confirmed correct infection prevention and control procedures were followed, such as wearing the correct personal protective equipment (PPE) when providing personal care to people.

The kitchen operations where back to normal following a relocation to temporary mobile kitchen. This was due to an incident in which nearby building works caused a sewage leak in the kitchen area of the service. However, the provider had taken appropriate action and had managed well to re-organise the service as best as they could during a difficult time. The kitchen was well organised and clean. The freezers and refrigerated cold store were clean and tidy and food was stored appropriately. The whole home was clean and hygienic and free from odours. We observed cleaning staff on each floor throughout the day.

Temperature checks of refrigerators and freezers were taken daily. There was a housekeeping team who were available in the home seven days a week to ensure cleanliness. The laundry was well organised and different colour bags were used to identify the content.

People received their medicines safely and as prescribed. People told us they were as involved as they wished to be in the management and reviews of their medicines. People said they had access to pain relief medicines when they needed them.

Staff confirmed they had received relevant training and their competency had been assessed before they carried out this aspect of people’s care.

Medicines were managed safely. There were appropriate arrangements for the ordering, storage, and disposal of medicines. Medicines administration records were maintained accurately and audited regularly. There were protocols in place for medicines prescribed ‘as required’.