Castle Lodge Independent Hospital

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

The service worked with people to understand and manage risks so that the care provided met all of their needs in a way that was safe and supportive and enabled people to do the things that mattered to them. The service detected and controlled potential risks in the ward environment and made sure that the equipment, facilities and technology supported the delivery of safe care.

This service scored 78 (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.

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

We spoke with 3 patients and 3 carers who told us they felt safe on the wards. Patients were involved in monthly community meetings where they were asked individually about whether they felt safe. Patients had access to an independent advocacy service and were automatically referred if they lacked capacity. The service had a positive risk-taking culture and a focus on the least restrictive approach. Patients were supported to engage in activities that mattered to them, and the risks managed. The service worked with partner organisations to support patient's access to the community or to maintain relationships by using effective risk management.

Staff told us they completed an accredited course on restraint training. All staff completed tissue viability training and the nursing staff carried out regular skin integrity checks, where needed. The service considered these specific risks when restraining older people. Patients were assessed and reviewed by specialist teams such as occupational therapists and speech and language therapists, when appropriate. Allergy information was contained within patient’s risk assessments and all staff we spoke with were aware of this.

All patients had up to date risk assessments, wellbeing plans and profiles in place, including falls care plans were appropriate to manage risk. Evidence based risk assessments were reviewed every 3 months and involved the patients or their carers or advocate if they lacked capacity. Restraint was only ever used as a last resort. Records showed the service had no incidents of prone or supine restraint and all restrictive interventions were analysed monthly.

The hospital fully involved patients to control potential risks within the ward environment. Patients were encouraged to comment on the environments in community meetings and specifically asked if they felt safe on the ward. Patients and carers we spoke with told us they felt safe and that any patient interactions were managed well. Families and carers told us they were involved in patient care. The hospital offered unrestricted visiting times, families and carers were asked to join multi-disciplinary meetings and invited to attend a monthly carers forum.

Hospital managers completed a daily walk around the environment and fed back concerns into a daily managers meeting. Senior management also carried out monthly hospital checks and reviews. Safety issues were identified and addressed as part of these processes. Staff were involved in patient risk assessments so that these were kept current and up to date. Staff carried out checks of equipment within the environment such as a weekly emergency equipment check. The hospital had a full-time trainer on-site. Part of their role was to show staff how to operate any equipment, for example slide sheets to eliminate the need for lifting a patient. The trainer went onto the wards unannounced to check that staff were using equipment correctly, provided feedback and supported them with further learning where required.

A ward tour and check of the environment and equipment was undertaken during our onsite activity. This included a check of the clinic room environment and emergency bag, and we found no concerns within the environment or issues with equipment. Staff had access to a range of equipment to support patients such as pressure reliving equipment, hoists and wheelchairs.

Staff training met the needs of staff and patients to support the delivery of safe care. At the time of our assessment the overall training compliance was 96%. The occupational therapy team completed risk assessments of patients and considered how to keep people safe from psychological harm, in relation to any sensory needs. The hospital had an audit schedule in place which included completion of a health and safety environmental audit. We reviewed data and other evidence that actions were identified as part of these audits and completed. The hospital had good governance in place regarding patients who required restrictive or safety interventions, such as the use of bed sensors, assistance with personal care, wheelchair or bath belts and covert medication. A multi-disciplinary team carried out regular reviews of the use of these interventions which involved carers, families and advocates, where appropriate. We saw evidence of good use of and record keeping in relation to the Mental Capacity Act and best interest decision making.

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

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.