Background to this inspection
Updated
9 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 27 and 28 June and was unannounced.
The inspection team consisted of two inspectors.
Before our inspection we reviewed previous inspection reports and notifications we had received. A notification is information about important events which the provider is required to tell us about by law.
During our visit we spoke with the registered manager, the assistant manager, nine members of staff, five relatives and three people. After the inspection we obtained feedback from two healthcare professionals.
We pathway tracked four people using the service. This is when we follow a person’s experience through the service and get their views on the care they received. This allows us to capture information about a sample of people receiving care or treatment. We looked at staff duty rosters, four staff recruitment files, feedback questionnaires from relatives, care plans, risk assessments, fire safety reports, quality audits, training records and support and supervision documents.
We last inspected the home on 2 November 2016 and found two breaches of the Health and Social Care Act 2008. The service was rated requires improvement.
Updated
9 August 2018
We carried out this unannounced inspection on 27 and 28 June 2018.
Farehaven Lodge is a service that is registered to provide accommodation for up to 40 older people, some of whom are living with dementia. Accommodation is provided over two floors and there are stair lifts to provide access to people who have mobility problems. At the time of our visit 28 people lived at the home.
Farehaven Lodge had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.
We previously inspected Farehaven Lodge on 2 November 2016 and found the provider failed to identify medicine errors and take appropriate action. This was a breach of Regulation 12 of the Health and Social Care Act 2008 Regulated Activities Regulations (HSCA RA) 2014 Safe care and treatment. We also found governance systems were not always effective. This was a breach of Regulation 17 of the HSCA RA Regulations 2014 Good governance.
At this inspection we found the provider had made progress and was no longer in breach of Regulation 12. Whilst governance systems did prompt improvement we found other areas of care delivery that were not consistently to the standard expected detailed in the regulations. We issued a repeated breach of Regulation 17. We also issued a breach of Regulation 18 HSCA RA Regulations 2014 Staffing, a breach of Regulation 15 HSCA RA Regulations 2014 Premises and equipment and a breach of Regulation 9 HSCA RA Regulations 2014 Person centred care.
The provider did not ensure sufficient numbers of staff were appropriately deployed to meet peoples’ needs at all times.
The provider did not ensure CQC were notified about incidents of possible abuse.
The provider did not ensure Farehaven Lodge was consistently meeting fire safety requirements.
People were not always supported to engage in meaningful activities and were often left without stimulation.
Further improvement was required to enable people living with dementia to navigate throughout the home safely and effectively.
Staff were aware of people’s individual risks and were able to describe the strategies in place to keep people safe.
Staff knew each person well and had a good knowledge of the needs of people.
Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.
Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests. Appropriate arrangements were in place for people who were subject to DoLS.
Food menus offered variety and choice. The chef prepared meals to meet people’s specialist dietary needs.
Where possible, people and relatives were involved in care planning.
Staff supported people with health care appointments and visits from health care professionals.
Care plans were amended to show any changes and they were routinely reviewed every month to check they were up to date.
People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.
People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person, their relatives, and where appropriate other health and social care professionals.
The provider had appropriate arrangements in place should people require end of life care.
We issued four breaches of the Health and Social Care Act 2008. You can see what action we took at the back of this report.