Background to this inspection
Updated
13 April 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Stoneacre Lodge is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Stoneacre Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We looked at information we held about the service. This included details about incidents the provider must notify us about, such as allegations of abuse and serious accidents and incidents. We also reviewed all other information sent to us from other stakeholders, for example the local authority and members of the public.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with two people who used the service and two relatives about their experience of the care provided. We spoke with eight staff, including the registered manager, care staff and ancillary staff.
After the inspection
We continued to seek clarification from the provider to validate evidence found including training data and quality assurance records.
Updated
13 April 2022
About the service
Stoneacre Lodge is a residential care home providing accommodation for people who require personal care. The home can accommodate 31 people. Some people were living with dementia. At the time of our inspection there were 22 people using the service.
People’s experience of using this service and what we found
We were not assured that the provider was promoting safety through the layout and hygiene practices of the premises. For example, the outside store for clinical waste was overfull, the carpet on the upstairs corridor was extremely worn, items of clean and dirty laundry were seen on the same trolley, the windowsill in the sluice was damaged and not able to be kept clean. Staff were seen not wearing PPE correctly, touching their masks and on occasions, wearing the same gloves for different tasks.
Risks associated with people’s care had been identified. However, risks to people were not always minimised. For example, the file containing personal emergency evacuation plans was not up to date, people's weights were not reviewed to ensure risks in relation to weight loss were monitored and one person was a high risk of pressure areas, but this had not been reviewed since December 2021.
People's medicines were not always managed in a safe way. Medication systems in place had not been followed by staff to ensure people received their medicines as prescribed.
On the day of our inspection we observed staff interacting with people and found there were enough staff to meet people’s needs. Staff had been recruited appropriately.
The provider had a process in place to record and analyse accidents, this was last completed in October 2021. Analysis of trends and patterns to minimise future incidents, could be improved on.
There was a policy in place to safeguard people from the risk of abuse. A record of incidents was in place which showed actions taken and the outcome. However, this had not been updated since 2020, and we identified one concern that had been reported to the local authority but not to CQC.
The provider’s system for auditing the quality of the service was not always effective. Concerns identified during the auditing process were not always resolved. For example, a pressure cushion audit stated that some cushions were stained but no record of any actions taken. We also found care plan audits had not been completed since December 2021, and the IPC audit not completed since August 2020.
There had been some changes in the management team which had led to the lack of auditing and senior staff having to lead the home with minimal experience of the manager role. The deputy manager post had been vacant approximately six months prior to our inspection, other members of the management team had needed to take time away from their roles. This had impacted on the day to day running of the home.
People did not always receive person centred care and support. For example, dining tables were bare, no placemats or tablecloths, one bedroom had a hole in the door where a lock mechanism had been removed and people could see in to the room from the corridor, the communal area was locked at both exits and limited access to the toilet, bathroom, and bedrooms, personal information was stored in an unlocked cupboard in the bathroom, the food menu was only available in a written format, there were no picture menus and people were not offered choices at lunchtime. Care plans were not person centred and reflective of people’s current needs.
Staff training was out of date with some staff not receiving infection control training throughout the COVID-19 pandemic. Staff informed us they had been given handouts by members of the management team in regard to appropriate use of PPE and infection control.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 27 October 2020).
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
Concerns were identified. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stoneacre Lodge on our website at www.cqc.org.uk.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.