Archived: Coniston Lodge Nursing Home

Coniston Lodge Nursing Home is a nursing home and is part of Lifestyle Care Management Ltd. It provides accommodation for up to 92 older people in single rooms. The service has four units but at the time of our inspection only three were in use. The home is situated within a residential area of the London Borough of Hounslow. At the time of our visit there were 42 people using the service.

At the time of the inspection there was no registered manager in post. An interim manager had been in post for two weeks before the inspection. 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.

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.

Coniston Lodge Nursing Home is a nursing home and is part of Lifestyle Care Management Ltd. It provides accommodation for up to 92 older people in single rooms. The service has four units but at the time of our inspection only three were in use. The home is situated within a residential area of the London Borough of Hounslow. At the time of our visit there were 55 people using the service.

At the time of the inspection the manager had been in post since October 2016. The new manager was about to start the registration process with the Care Quality Commission. A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.

At our last comprehensive inspection on the 23, 24 and 26 February 2016 we found breaches in relation to good governance in respect of information provided on 'do not attempt resuscitation' (DNAR) forms, maintenance records and equipment levels. During the inspection on 10, 11 and 12 January 2017 we found improvements had made in relation to these areas.

Risk assessments did not provide up to date information in relation to individual’s risks when receiving care.

Some people using the service did not receive appropriate support when eating and food was often cold due to delays in serving and providing support.

Care was often task led which meant staff did not always provide appropriate support for people’s emotional and social needs as they were focused on tasks.

Activities were organised at the home but some of these were not meaningful for people and when the activities coordinator was unavailable there were limited activities organised.

Care plans were not written in a way that identified each person’s wishes as to how they wanted their care provided. Daily records were focused on the tasks completed and not the person receiving the support.

The records relating to care of people using the service did not provide an accurate and complete picture of their support needs.

A range of audits were in place but some of these had not provided appropriate levels of information to identify aspects of the service requiring improvement and action had not always been taken to address issues.

People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.

The provider had processes in place for the recording and investigation of incidents and accidents. Each person using the service had an evacuation plan in place in case of an emergency.

The provider had an effective recruitment process in place. There was a policy and procedure in place for the administration of medicines and these were administered in a safe way.

The provider had policies, procedures and training in relation to the Mental Capacity Act 2005.

Care workers and nurses had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers and nurses had regular supervision with their manager and received an annual appraisal.

The care plans identified the cultural and religious needs of people using the service. The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.

We found five 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.

Coniston Lodge Nursing Home provides care for a maximum of 92 people. The service has four units, three of which are for general nursing care and dementia care needs and one for people with advanced dementia care needs. At the time of the inspection there were 57 people using the service. The service is a purpose built nursing home and has been used for this purpose since it was first registered.

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 service has had two managers since it registered on 30 October 2015 and at the time of inspection the position was vacant and the provider was in the process of recruiting for a manager. The service was being overseen by the quality support manager until a new manager was recruited.

Information regarding people’s capacity to make decisions for themselves was not always recorded. Records for people’s resuscitation status needed reviewing to reflect changes in people’s capacity and identify those who had been consulted regarding these decisions.

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.

Systems were in place for monitoring the service, however these were not always effective in ensuring shortfalls identified were actioned in a timely way.

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

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

Risk assessments were in place to reflect the risk to individuals and the care and support they required to minimise these. Systems and equipment were being serviced 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 management 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 expressed 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 training and updates and understood people’s individual needs and choices and how to meet them.

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

Care records reflected people’s individual needs, interests and wishes and were up to date. Staff understood people’s needs and provided people with person-centred care. People’s religious and social needs were being identified and met.

There had been two changes of manager since the provider registered the service and the post was vacant at the time of inspection. The frequent changes of management meant people, relatives and staff were unclear as to who was managing the service and felt unsettled by this. The quality support manager was overseeing the service and with the deputy manager was providing support for staff, people and relatives.

We found breaches of one Regulation 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.