Dale Lodge

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• 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 told us they felt safe living at the service. People were protected from the risk of abuse. Staff knew how to identify concerns if they arose and how to report concerns to the relevant authorities. There were systems in place to ensure any concerns were investigated. Where people were deprived of their liberty to help keep them safe, the appropriate authorisations were in place under the Mental Capacity Act 2005. There was enough staff to provided people with the support they needed. Staff were appropriately supervised and supported. Staff had the training they needed to undertake their role well. Staff knew about people’s health and wellbeing risks and how to support them effectively. Staff had the guidance they needed to support people safely.

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.

Staff were confident in their understanding of safeguarding. Staff knew the different types of abuse and how to identify them. When there were concerns staff had raised these with the registered manager. Staff told us they felt confident that if they reported concerns the registered manager would take action. The registered manager investigated concerns appropriately and had taken action as and when it was required. For example, changes were made to how people’s room keys were stored so people could safely lock their rooms if they chose to do so when going out.

Staff were attentive and mindful of people’s safety ensuring they were not at risk from neglect. For example, one person was moving items about the service. Staff identified this could lead to risk and supported the person to end this activity. They spoke to the person kindly and engaged the person in a consensual way to reduce the risk of the person becoming upset. Staff were aware of what might cause a person to become upset and knew how to support people to remain calm.

People told us they felt safe at the service. One person Said, “Oh yes. Staff, they are always there if you need them. They are never far away”. Another person told us, “I feel safe. There are codes on the door and I am the only one who has a key to my room". Relatives were also positive about the service’s safety. One relative said, “I think my [relative] is 100% safe in the service.”

There were systems in place to protect people from abuse. The registered manager assured staff undertook safeguarding training as required. There was a safeguarding policy in place which included information to remind staff about procedure and process. This also included information on who to report concerns to in the local authority. When concerns arose, the registered manager had reported these as required to both the local authority and CQC. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. People can only be deprived of their liberty when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found appropriate legal authorisations were in place to deprive a person of their liberty. Any conditions related to DoLS authorisations were being met.

Staff and the registered manager had a good understanding of people’s health needs. Staff knew what support people needed to maintain their health and wellbeing, including where people needed support with their emotional wellbeing. For example, staff knew what equipment and support people needed to eat safely and if they needed a soft diet to reduce risks. Staff understood what might lead to people being upset and how to support them to remain calm.

We observed people being safely supported throughout the day. For example, where people needed staff support to move about the service safely this was provided. Where people needed walking aids, they were supported to use these. Staff provided direct support with a supporting hand if this was also needed. The support people were provided was as set out in their care plans and risk assessments. People were also encouraged to join in activities such as keep fit to support people to maintain their health, mobility, as much as possible. These activities also promote positive mental health. Most people joined in in what way they were able to. Staff were providing support and people were singing and smiling.

People and their relatives were supported by staff who knew people well and knew how to support them safely. When we asked relatives if they thought staff were meeting people’s health needs, they told us they thought staff did. Comments included, “Yes, they do everything they can and more. They are very patient with all the residents”, “I have no worries about [them] when I leave here.”, and “The way [my relatives health need] has been managed has actually improved her quality of [their] life since she’s been there.”

Staff had the information they needed to support people safely. People had care plans in place which set out the risks to their health and what staff needed to do to reduce these risks. For example, where people were supported to move using a hoist there was information on what equipment was to be used and how staff were to use it. People’s needs were assessed using best practice tools, such as tools to assess if people were at risk from a high or low body weight. The information from these tools was used to inform people’s care planning. Care plans were reviewed regularly to ensure they provided staff with the most up to date information.

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

We saw there were enough staff to provided people with the support they needed. For example, there were enough staff to support people during lunch and provide assistance as required. Staff attended to people’s care needs but also spent time speaking to people one to one and encouraging people to join in activities.

The registered manager used a dependency tool to help them to calculate the number of staff needed to provide support to people. Care staff were supported by a cook, laundry, maintenance and housekeeping staff and a Leisure and Lifestyle coordinator who arranged activities with people. The service worked with regular agency staff to provide cover if staff were off sick or on annual leave. Staff undertook the training they needed to provide support to people. This included areas such as dementia training and the care certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme. Training was a mixture of face to face and online training. Staff competencies were checked to ensure they were undertaking tasks such as manual handling and medicine administration safely. Staff undertook a period of shadowing more experienced staff before they provided support to people alone.

Staff were positive about the service and the support they received. One staff said, “Everyone helps out everyone. People have been so welcoming”. Staff told us they had regular staff meetings and supervisions. Staff had the knowledge they needed to support people. For example, one member of staff told us how they supported a person to move using a hoist. They knew how to support the person safely and told us they felt confident supporting the person in this way. One staff said, “We do regular training. If we wanted extra, we can ask and [they] will sort this”. The registered manager told us they were supported by staff from the provider if they needed this. There were two services run by the same provider on the same site. The registered manager oversaw both services. They told us the service next door was able to provide staff support in the event of an emergency such as a need to evacuate people.

People and their relatives told us there was enough staff to support them. One person said, “They are always there if you need them. They are never far away”. Feedback about staff’s abilities was also positive. Comments included, “The staff are smashing. It is very homely here” and, “All the staff have been very good with {my relatives] care.”

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.