Background to this inspection
Updated
19 July 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
2 inspectors undertook the inspection.
Service and service type
Saxby Lodge is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Saxby Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people who used the service and 2 relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, care workers, chefs, a company director, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 8 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
19 July 2023
About the service
Saxby Lodge is a residential care home providing the regulated activity of accommodation with personal care for up to 19 people. People had a range of care needs including frailty of age and people living with dementia. At the time of our inspection there were 13 people using the service. Accommodation was over two floors in one adapted building.
People’s experience of using this service and what we found
There were misunderstandings between the provider, registered manager, and staff about the way the service was managed. This had a negative impact on the culture of the service and how it operated. Governance processes were not effective in identifying some service shortfalls. There was a failure to take appropriate action to keep people safe.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People did not always experience person centred care. There was a lack of activities and opportunities for meaningful engagement and stimulation. People had a limited choice of food or snacks to meet their needs or preferences. People told us they had enough to eat and drink.
People had access to healthcare services and staff engaged with health and social care professionals. People received visitors and relatives told us they were kept up to date with their loved one’s well-being.
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 requires improvement (published 17 February 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.
Why we inspected
We received concerns that the service was regularly running out of food. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the effective section of this full report. People had enough to eat. There was enough food to last until the next food delivery.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Saxby Lodge on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to person centred care, protecting people from harm and how the service was managed at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.