Archived: Beatrice Court and Citygate Lodge Home

Updated 13 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out this inspection on 6 and 7 October 2014 and the visit was unannounced.

The inspection team was made up of four inspectors, a specialist advisor who was a registered nurse specialising in tissue viability and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience of supporting older people including people living with dementia.

Prior to the visit we looked at information we held about the home. This included notifications that the provider had sent us. Notifications inform us about incidents that have occurred within the home. We also had information from a staff member from the local authority that commissions services from the home.

During the visit we spent time talking with 19 people who used the service, three relatives and other visitors. We also spoke with 10 staff and the manager and provider. We reviewed 10 care records and looked at a range of documents relating to the running of the home and to monitoring and reviewing the quality of care.

We undertook some observations of staff supporting people and a short observational framework inspection (SOFI) over lunch in one of the units. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Following the inspection we spoke with four relatives, four health care and social care professionals and a representative the local authority that commissions care from the service to obtain their views about care people received.

Updated 13 April 2015

This inspection took place on the 6 and 7 October. It was an unannounced inspection.

Beatrice Court and Citygate Lodge are registered to provide personal and nursing care to 128 people. At the time of this inspection there were 81 people living at the home. Two units were closed and were being refurbished. Citygate Lodge accommodated people with residential care needs; Magnolia units provided care for people with both nursing and personal care needs. Ivy units were specifically for people with needs relating to mental ill-health and people living with dementia. The provider told us that when the home was fully open it would provide accommodation for 101 people.

The service has not had a registered manager since 2012. The current manager had recently applied to be registered with the commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

When we completed an inspection in December 2013 we asked the provider to make improvements in safeguarding people from abuse. The provider had made the necessary improvements.

People we spoke with and their relatives were positive about the care provided at the home. Although we saw some very positive aspects of care we also saw some areas that needed improvement.

Systems were in place to keep people safe but we saw some improvement was needed to be taken to ensure people’s ongoing safety. Some bedroom doors were wedged open and the provider did not have some equipment they had identified as necessary to support people to evacuate the home in the event of an emergency.

Some records of care were not completed or were not up to date. This meant that that there was a risk that people may receive inappropriate care and their preferences would not be taken account of.

Staff were not always following the principles of the Mental Capacity Act 2005. For example, people’s capacity to make decisions was not assessed and there was inadequate information to show the actions that were needed to support people to make decisions. This meant that people’s rights may not be upheld.

People living with dementia did not have enough to do. People spent periods with little stimulation and engagement with people and objects. When people were engaged and stimulated we saw positive benefits in their well-being.

Although people had noticed an improvement in the leadership and management of the home there remained areas that needed to be addressed to improve people’s care.

Staff had the knowledge and understanding to identify and act when potential abuse of people was suspected. This helped to make sure people were kept safe.

People’s health care needs were assessed and their individual needs were acted upon. People were supported to receive appropriate specialist health care support.

People were supported to have sufficient to eat and drink. There was a good choice of meals throughout the day. People could choose where to have their meals.

People told us and we observed that staff spoke with people in a caring and respectful manner. People felt that staff cared about them. Most people told us that the care staff took account of their individual needs and their wishes and choices were respected.

The home had an effective complaints procedure in place. People and relatives told us that the staff were responsive to their concerns. They said that when issues were raised these were acted upon promptly.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.