Louth Manor Care 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

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 62 (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 positive culture of safety, based on openness and honesty. Staff listened to concerns about safety, upheld people’s rights and investigated and reported safety events. Staff were asked to reflect on their practice following incidents. However, further learning about more proactive responses to reduce the likelihood of safety incidents between people had not been recorded. Lessons learnt from these incidents were not always clearly identified or shared to embed best practice.

There was mixed feedback from people and relatives. Some people did not feel they were always listened to or that improvements from complaints were sustained. A relative said, “I have made observations in the past. I think they listen and have a word with the staff, but often the issue you have raised has not been resolved.” Other relatives told us the staff and registered manager were helpful and responsive. A relative told us, “The incident with my [family member]. I sat in the office with [registered manager] and they came up with ideas. It was constructive, very good. They didn’t fob me off, it was thought through.”

The provider 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.

The views of people were taken into account for any changes to services they needed. People were supported to have regular health reviews with their GP or access more specialist medical advice. We received positive feedback from people about the process of moving between services and the level of support offered. One relative wrote, ‘All together you made the move possible. You were all Amazing. Without us working as a team, I’m sure we’d have never got my [family member] moved. You all went above and beyond and prioritised them so we didn’t miss the window of opportunity to succeed. And you supported me, which meant so much.’

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe and we saw from records and processes that risks of avoidable harm were minimised. A relative told us, “My [family member] is very safe. Staff are very careful, they are very good, we are very impressed with them.” Staff received training on safeguarding and were knowledgeable about what abuse looked like and how to report this. Professionals were also positive about how safeguarding events were being managed.

Where restrictions to people's lives were in place to ensure their safety, there were clear processes followed for mental capacity assessments, best interest processes and a DoLS applied for. Anyone with a DoLS was monitored for conditions and expiry dates. The mental capacity assessments were well written to evidence how people were supported to try and understand the decision being discussed and their responses.

The provider worked with people to understand risks. Staff provided care to meet people’s needs. However, people’s care records did not always detail what the risk was or how to reduce the likelihood of avoidable harm. For example, care plans did not always identify risks related to health conditions such as strokes or diabetes. Not everyone requiring the use of a hoist had clear guidance for how to manage risks related to moving and handling. Risk assessments were in place but were often scoring sheets with no context. This meant they lacked sufficient guidance for staff to understand how to safely support a person.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. All equipment was serviced in line with best practice and legal requirements. The service employed full time maintenance staff member who was able to respond to all repairs including out of hours emergencies.

We found there was a strong odour or urine on one floor on both the day 1 and day 2 visits. However, the provider found the cause and this was resolved. People told us they did not typically smell any unpleasant odours. There was some consideration for a balance between a dementia friendly environment, such as contrasting coloured grab rails by the toilets or clear signage and maintaining a dignified décor.

There was a problem with the technology for call bells. This compounded concerns about staffing levels as it made it difficult to be sure of the impact on people and the risk of avoidable harm if emergency bells were not heard. The provider was already aware of this and working with the technical engineers to find a solution to this problem. They had also implemented a manual checking system to try analysing the impact on people.

The provider did not always make sure there were enough qualified, skilled and experienced staff to fully meet the physical and emotional needs of people.

Staff did not have time to sit and chat to people, resulting in care being task-led and not person-centred with people having to wait for support to use the toilet or move to other parts of the home. The provider acted quickly to this feedback and staffing levels in the daytime had improved when we visited on the second site visit. This was still under review for evening and nighttime staffing levels where people gave mixed feedback about wait times. Some people told us they had to wait a long time for support with personal care or pain relief medicines. Other people told us staff came quite quickly. A relative said, “I would personally say not enough staff, because if they had the personnel there, there wouldn’t be a wait. They are always on the go; I think they are overstretched on staff.”

Staff were receiving regular supervision and appraisals and told us they felt supported by managers and the provider. However, records showed the supervision was not effective and there was limited encouragement for developing skills. This meant there were missed opportunities for encourage learning, development and self-reflection. Clear objectives were not set and outcomes and learning not always recorded.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The registered manager ensured regular audits were conducted to identify any areas of concern, which were acted upon. Cleaning schedules were in place for daily and deep cleaning. Staff had training in IPC and access to the required personal protective equipment such as disposable gloves and aprons. Good food and personal hygiene was followed.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened and people had regular reviews of their medicines with a health professional. The registered manager regularly audited medicines management to identify any concerns.

Most people were happy their medicines were being administered correctly. Some people were supported to self-administer their medicines and the risks for this had been assessed and protocols were in place. Relatives told us where there had been concerns with medicines these had been resolved quickly.