Archived: Derwent Lodge Care Centre

We undertook a focused inspection on the 9 May 2017 to check how medicines were looked after. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Derwent Lodge Care Centre’ on our website at www.cqc.org.uk

Derwent Lodge Care Centre provides nursing care for up to 62 people. There are three floors and the units offer nursing care for older people including those with dementia care needs and people with physical disability needs. At the time of inspection there were 40 people using the service.

The service is required to have 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 2008 and associated Regulations about how the service is run. The previous registered manager had left the service in January 2017 and an interim manager was in post at the time of this inspection.

The provider had appropriate processes in place for the ordering of medicines.

Systems were in place for the safe administration of medicines.

Medicines were stored safely and securely.

We have made a recommendation about reviewing and learning from medicines incidents.

Derwent Lodge Care Centre provides nursing care for up to 62 people. There are three floors and the units offer nursing care for older people including those with dementia care needs and people with physical disability needs. At the time of inspection there were 44 people using the service.

The service is required to have 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 2008 and associated Regulations about how the service is run. The registered manager was due to leave the service the week after the inspection and an interim manager had been appointed and was already working at the service.

People were not always protected against the risks associated with the inappropriate management of medicines.

Staff recruitment procedures were in place but were not always being followed to ensure only suitable staff were employed by the service.

Although the majority of staff responded well to people’s needs, activities were limited and care and treatment was not always provided in a way that met people’s individual preferences.

Processes for auditing and monitoring had not been effective in identifying all shortfalls within the service.

Processes for auditing accidents and incidents were not being followed so any themes and trends were not being identified.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted. Improvements had been made with related care records, however further improvements were required to ensure information relating to people’s mental capacity and DoLS authorisation conditions was identified in the care plans.

Improvements had been made with the care records and the majority were comprehensive and information was clear. Further work was needed to ensure care records were kept up to date.

The environment had not been reviewed to encompass the sensory needs of people with dementia. We have made a recommendation in respect of this.

Staff demonstrated a caring attitude towards people and took the time to make people feel valued and communicate effectively to meet their individual needs. Some care seen on the first floor was task driven and did not meet people’s emotional care needs.

Procedures were in place to safeguard people against the risk of abuse and staff understood the importance of keeping people safe and reporting concerns. Accidents and incidents were being recorded and reported and related documentation completed accurately.

Equipment was being used safely and correct procedures were being followed when moving and handling people.

Systems and equipment were being serviced and maintained. Policies for infection control were in place and were being followed to maintain a clean environment and protect people from the risk of infection.

Staff received training to provide them with the skills and knowledge to care for people effectively.

People’s dietary needs and preferences were being identified and met.

People’s healthcare needs were identified and they received the input they needed from health and social care professionals.

A complaints procedure was in place and people and relatives said they would express any concerns so they could be addressed.

The interim manager was proactive and approachable and was aware of the areas of improvement required within the service.

We found four 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 the report.

Derwent Lodge Care Centre provides nursing care for up to 62 people. There are three floors and the units offer nursing care for older people including those with dementia care needs and people with physical disability needs. At the time of inspection there were 48 people using the service.

The service is required to have a registered manager and there was a registered manager in post. 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 2008 and associated Regulations about how the service is run.

The provider had arrangements in place to safeguard people against the risk of abuse however these were not always being followed and some incidents had not been managed appropriately.

Staff did not always follow correct procedures for moving and handling which placed people at risk.

The staffing levels were not based on dependency levels and there were not always enough staff on duty to meet people’s needs. We have made a recommendation about monitoring staffing levels.

Staff received training around how to care for people’s needs, however they did not always put the training into practice, which placed people at risk.

Staff did not always find the registered manager was approachable and supportive.

Risk assessments were in place for identified areas of risk with action plans to minimise them.

People’s nutritional needs were assessed and monitored.

Systems were in place to monitor the quality of the service, however these had not always been effective in identifying issues.

We found two 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 the report.

Derwent Lodge Care Centre provides nursing care for up to 62 people. There are three floors and the units offer nursing care for older people including those with dementia care needs and people with physical disability needs. At the time of inspection there were 55 people using the service.

The service is required to have 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 2008 and associated Regulations about how the service is run. The manager has been in post since October 2015 and is applying for registration with CQC.

Care records reflected people’s individual needs, interests and wishes, however the information was not always current and records were disorganised and sometimes difficult to read.

People were happy with the service and confirmed they felt safe living there.

Staff treated people with dignity and respect, listened to them and provided care and support in a caring and gentle way.

Risk assessments were in place to reflect the risk to individuals and the care and support they required to minimise these. Premises and equipment were being serviced and maintained to keep them in good working order.

There were suitable arrangements in place to ensure people were protected against the risks associated with the inappropriate treatment of medicines.

Staff understood safeguarding and whistleblowing procedures and were clear about the process to follow to report any suspicions of abuse. A complaints procedure was in place and people and relatives said they would express any concerns so they could be addressed.

Staff recruitment procedures were in place and being followed to ensure only suitable staff were employed at the service. Staff received regular training and updates understood people’s individual choices and needs and how to meet them.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted. However, information regarding DoLS authorisations was not identified in people’s care records, which could place people at risk of not having their best interests decisions met.

People’s nutritional needs were identified and were being met. Input from the GP and other healthcare professionals was available to address any health concerns.

Staff understood people’s needs and provided people with person-centred care. People’s religious and social needs were being identified and met.

The manager was working to improve the service and provided meetings for people and relatives to express their views, with action being taken to address issues raised. Staff had mixed views regarding the management style and the manager was receptive to feedback we provided on this.

Systems were in place for monitoring the service and action was taken to address any issues identified.

We found one breach 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 the report.