Chesterton 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

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good: This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. People told us staff managed incidents and accidents well. One person said, "Staff come quickly when falls happen." Another person said, "I fell over. Staff came to help me.” Staff told us they spoke to team leaders or management to review incidents and discuss the actions taken. Lessons learnt from incidents and accidents were analysed and shared with the staff team during handovers and team meetings.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. People told us they felt safe living in the home. One person said, "I feel very safe here. If I didn’t, I would speak to any member of the staff." Relatives told us initial assessments were carried out on people new to the service. One relative said, "An assessment was carried out when my family member moved into the home". However, another relative expressed concerns over the safety of their family member due to another person living in the home. We spoke to the registered manager and social worker about this person. It was clear action was being taken to address these concerns. Staff told us they had access to people's care plans and risk assessments as and when required. One staff member said, "The care plans are better now they are electronic. It is easy to check and access the information, the information is available at our fingertips." Initial assessments were completed with people new to the service. People’s health goals were clearly recorded with actions detailing how people were supported to maintain or improve their abilities, such as mobility.

The provider shared safeguarding concerns quickly and appropriately. People and relatives told us they knew how to raise concerns or complaints regarding the care and support provided. One person told us, "If I was not happy, I would tell a staff member." One relative said, “I haven’t made any complaints, but I would definitely tell staff if there was anything wrong.” Staff told us they received safeguarding training, and they knew how to report concerns. One staff member told us about the types of abuse and how they would recognise the signs and symptoms. Another staff member said, "I would report any concern to the manager straight away." Safeguarding referrals were made in accordance with statutory responsibilities. Safeguarding concerns were analysed and reviewed.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, the systems in place to ensure risk assessments were sufficiently detailed were not always effective. Risk assessments were in place to meet people’s health and care needs. These included moving and handling, nutritional and falls risk assessments. Mitigation actions were clearly documented to reduce the risk. However, whilst some risk assessments were clear and easy to follow, others were not as in-depth and required more clarity to detail the actions needed to take to keep people safe. The manager responded to our feedback by updating the risk assessments to include more detailed information. People told us they could take risks and make their own choices, such as continuing to smoke cigarettes or choosing not to follow health professionals’ advice. One person said, "I can do what I want. I wake up at 5am, I’ve always gotten up early. Staff make me a cup of tea when I get up." Staff told us they encouraged people to make their own choices, and they respected their decisions. One staff member said, "We help people to make their own choices, such as choosing outfits. Sometimes we disagree with their choice of clothes, especially because of the weather, but ultimately, it's up to them. We encourage people and give advice."

The provider detected and controlled potential risks in the care environment. People told us the environment was well maintained and people had access to equipment when needed. One relative said, "The home is generally clean, presentable and well maintained. My [family member] uses a walking frame, this is always close by." Staff told us repairs were corrected quickly. One staff member said, "The home is well maintained, when something needs repairing, we report it, and it gets repaired or replaced quickly." Health and safety checks and environmental audits were regularly completed and action taken when required.

There was enough staff on duty to meet people’s health needs and provide prompt support when people requested assistance. However, our observations from the first site visit found staff appeared task orientated and did not have time to sit and interact with people or engage in activities. On the second site visit, there were more activities taking place and people were actively engaged. We received mixed feedback from people regarding staffing. Some people felt there was enough staff on duty. One person said, “I have used the call bell a couple of times and staff do come reasonably quickly.” However, another person raised concerns over the number of agency staff used on weekends and their communication styles, although they did say staff responded quickly when required. Staff told us there was enough staff to meet people’s health needs although they struggled to meet people’s social needs. One staff member said, “I find it frustrating that I do not have enough time to spend with people. We are more task orientated, there is just so much to do.” The manager told us they were aware improvements were needed to promote daily activities, and they shared their plans to promote more social engagement and recruit additional staff. Staff were recruited safely and received training, supervision and support. However, where people experienced specific health conditions such as epilepsy or diabetes, staff had not received specific training in these conditions. The provider shared information documents on these conditions which were available to staff and the district nursing team visited regularly to support people with these conditions. Although, without specific training, the provider could not be assured all staff had read the information documents and would be able to recognise signs and symptoms of these conditions.

The provider assessed and managed the risk of infection. People told us they lived in a clean environment. One person said, "It’s very clean, the staff hoover my room every day. "One relative said, "The home is spotless." Staff told us how they received infection prevention control training and followed safe practices, such as wearing personal protective equipment (PPE). We observed cleaning taking place and where there was the occasional malodour, this was quickly removed through cleaning practices. Infection prevention control audits took place regularly and actions were taken to address areas identified as needing improvement.

Medicines and treatments were managed safely and met people’s needs, capacities and preferences. People told us they received their medicines on time. One person said, “I get my medication regularly." Staff told us they received safe handling of medicines training, and their competencies were regularly assessed. One staff member told us about a medicines error they had made and how lessons were learnt from the error and improvements made to the administration process. Medicines were managed safely by suitably trained staff. People got their medicines at the right time and medicines were regularly reviewed.