Daffodil Lodge

Daffodil Lodge is a residential care home providing accommodation for persons who require personal care to up to 32 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 19 people using the service.

People’s experience of using this service and what we found

We were not assured people were living in an environment that was consistently clean and suitably maintained. We have made a recommendation about this. Staff did not consistently use language that upheld people’s dignity. We have made a recommendation about this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Medicines were stored, managed and administered as prescribed. People were safe and protected from abuse and avoidable harm. The management team identified risks, and this was documented to support staff and ensure people’s safety. Staff followed infection prevention and control procedures related to COVID-19 and other infections. Visitors were welcomed into the home and asked to follow infection prevention measures to keep people and staff safe. Staff were recruited safely, and staffing levels were enough to meet people’s needs. The management team had systems to learn from incidents to further improve the safety of the service.

Staff spoke positively about their colleagues, management support, teamwork and how much they enjoyed working at Daffodil Lodge. The management team had governance systems to maintain ongoing oversight of the service and make improvements where necessary. Staff worked effectively with health and social care professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good(published 05 September 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Staff had received training to help ensure their knowledge on infection prevention and control was up to date. Personal protective equipment (PPE) and infection control hand gel was available throughout the building for all staff and visitors. The registered manager and staff told us enough stocks of PPE were available and we confirmed this on the visit. One staff member said, “Training has been informative with COVID-19 guidance, we have never been short of PPE.”

The service supported people and their relatives to understand the policies and procedures surrounding protection against COVID-19, the isolation processes and how the service could help them to keep people safe.

Social media systems such as mobile phones and computer systems were used to facilitate contact between people and their relatives. One person said, “I have had visitors come to see me.”

People living in the home and staff were tested regularly for COVID-19. There were no staff employed who had not been vaccinated as now required.

The home was clean and hygienic. Cleaning schedules were in place and PPE stations placed around the home in individual rooms. Additional cleaning protocols were in place to ensure all areas of the building were regularly sanitised.

We found the following examples of good practice.

• The provider was in the process of installing floor to ceiling Perspex screens within one room to enable visits to take place indoors in the near future. This room was accessible by visitors from the outside and inside by people living at the home. All surfaces in the room were washable to reduce the risk of infection being spread.

• All visitors were asked to complete a health screening form, have their temperature checked and were provided with face masks to wear throughout their visit. Full PPE was available for all visitors along with access to handwashing facilities and hand sanitiser.

• Staff had all received training in infection prevention and control, COVID-19, handwashing and the wearing of PPE.

• The service had increased the cleaning schedules and routines to reduce the risks of cross infection. People who used the service commented positively on this and told us, "My room is cleaned regularly."

• We observed staff to be wearing the correct personal protective equipment (PPE) throughout the inspection.

• One relative said "The staff and management team are very good at keeping me updated about [Name]. I speak to [Name] on the telephone on occasions. I cannot praise them enough for the excellent care [Name] has at Daffodil Lodge."

• Staff stated they had felt really supported by the provider and management team throughout the pandemic. They told us they felt confident to support people with a COVID-19 positive diagnosis.

• Clear processes were in place for the management of people with a COVID-19 positive diagnosis. The provider was following national guidelines.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

Daffodil Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 30 people. Daffodil Lodge Care Home is a large detached building set within a corner plot located in Southport close to the town centre. Daffodil Lodge provide accommodation and care for persons aged from 50 years of age and above, whom require personal care and/or dementia care. Bedrooms were of a single occupancy. Corridors enabled the use of wheelchairs and there was disabled access to the garden. At the time of the inspection 24 people were in receipt of care at the home.

A registered manager was in post. 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.

We viewed four people’s care records and found in the main these provided evidence of the care and support people needed though there were some anomalies. Following the inspection, the registered manager undertook a care review to ensure people’s support plans recorded up to date and accurate information about people’s care and support. The registered manager has also implemented care document and person-centred document training for staff to improve the completion of the care records. The registered manager took prompt action in response to our findings.

People told us they felt safe. Systems were in place for safeguarding people from the risk of abuse and reporting any concerns that arose. Staff had received training and knew what action to take if they felt people were at risk

Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act (MCA) 2005 were followed in that assessment of the person's mental capacity was made to protect them. This included applications to the local authority for a Deprivation of Liberty Safeguard (DoLS) for people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Our observations showed when staff were supporting people they were attentive, caring and respectful in their approach. People and relatives, we spoke with, told us they liked the staff team and they were polite and helpful always.

People and relatives were involved in the planning of their care to support them and kept up to date with matters relating to their health and welfare.

There was enough staff to meet people's needs and keep them safe.

People were offered a good choice of meals and alternatives were offered if the menu choices were not to their liking.

People’s medication was safely managed and they received it on time and as prescribed. Staff were trained and deemed competent to administer medicines.

Staff had a good understanding of people's individual care needs and appropriate referrals to external healthcare professionals took place.

Risks to people’s safety and wellbeing were recorded to enable staff to support people safely whilst promoting their independence. Accidents and incidents were recorded and an analysis undertaken to look for trends or patterns to minimise the risk of re-occurrence.

People were supported with end of life care at the appropriate time.

Staff received training and support to undertake their job role.

Systems were in place and followed to recruit staff and check they were suitable to work with vulnerable people.

We found the environment to be clean and free from any odour. Staff had access to protective clothing such as, gloves and aprons to support the control of infection.

The premises and equipment were subject to safety checks to ensure they were safe and well maintained. The home was kept in good decorative order and there were some adaptations to ensure it met people's individual needs.

A system was also in place for raising and addressing concerns or complaints and people living at the home and their relatives told us they would feel confident to raise a concern.

Social activities were arranged for people and with the appointment of a new activities organiser the service was looking to improve the social programme which people told us they would like.

There were systems in place to consult with people who used the service, to assess and monitor the quality of their experiences. This included completion of satisfaction surveys. Feedback was limited and there had been no analysis of the findings to support the development of the service.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with our statutory notifications.

Governance arrangements included checks on key areas of the service. This helped to maintain standards and to support improvements.