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Chandos Lodge Nursing Home Requires improvement

We are carrying out a review of quality at Chandos Lodge Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 April 2019

About the service:

Chandos Lodge Nursing Home is a service registered to provide accommodation and personal or nursing care to older people. The service can provide accommodation and care to up to 31 people and there were 27 people living there at the time of the inspection.

People’s experience of using this service:

People told us they were safe at the service. There were a sufficient number of staff to keep people safe. However, people were not always protected from risks around unsafe recruitment as there was not always evidence available the provider sought evidence of staff conduct prior to the staff working with adults at risk. People received their medicines in a timely manner and the medicines were stored safely. However, we found where people received their medicines covertly (in food or drink) the provider did not adhere to the good practice guidance therefore we could not be reassured medicines remained effective. Risks to people’s well-being and individual conditions were assessed and recorded. Risks surrounding infection control were managed appropriately and the service was clean. Individual people’s accidents and incidents were recorded but there was no overview to monitor the accidents for any trends and lessons learnt. Arrangements around planning for emergencies, such as in an event of evacuation needed improving.

People were supported to make their own choices and staff were aware of principles of the Mental Capacity Act. However, we found there was not always written evidence available that people’s capacity to make specific decisions had been assessed. People were supported to access health professionals and any advice received was incorporated into the care planning process. People were encouraged to maintain a good diet and nutrition. Staff received ongoing training and told us they felt supported.

People continued to receive caring and kind support. We observed kind and caring interactions. Staff respected people’s privacy, dignity and their individual needs including people’s individual communication needs. People told us they built positive working relationships with the staff.

People received support that met their assessed needs. The feedback received from people, relatives as well as the records demonstrated people did not always receive meaningful activities in line with their choices, preferences and assessed needs. People knew how to raise any concerns, we saw complaints were managed in line with the policy. No people were receiving end of life support at the time of our inspection, people’s end of life wishes where appropriate, had been recorded.

There was a registered manager in post who was supported by a team of staff. The provider’s quality assurance processes were not always effective as they did not identify concerns we found during our inspection. This included the requirement to display the rating and to inform the Care Quality Commission about reportable occurrences. People and staff were involved and their views were sought. The team at Chandos Lodge worked well in partnership with other agencies and the local social and health professionals.

At this inspection we found improvements were required as the evidence gathered for Safe, Effective, Responsive and Well-Led domains demonstrated the service met the Requires Improvement characteristics. We found three breaches of Regulations 17 and 19 of the Health and Social Care Act 2008 (Regulations) 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. We also made one recommendation to improve the quality and safety of the service.

Rating at last inspection:

Good (report published 15 April 2016).

Why we inspected:

This was our scheduled, planned inspection based on previous rating.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

More in

Inspection areas

Safe

Requires improvement

Updated 9 April 2019

The service was not always safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 9 April 2019

The service was not always effective.

Details are in our Effective findings below.

Caring

Good

Updated 9 April 2019

The service was caring.

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 9 April 2019

The service was not always responsive.

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 9 April 2019

The service was not always well-led.

Details are in our Well-led findings below.