Portelet Lodge Care Home

Portelet Lodge Care Home is an adapted property in a residential area of Bournemouth. Registered for up to 23 people, there were 20 people living at the home, some of whom were living with dementia. The home was accessed over three floors via stairs or a lift.

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

People were safe and told us they were happy living at Portelet Lodge. Risks people faced in their day to day lives had been identified and assessed, measures were in place to keep people safe.

The home was undergoing improvements to fire safety and the work was ongoing. Staff were trained in fire safety and regular testing, drills and practice evacuations took place. Utility checks and general risks within the home were in place and assessed. Equipment was maintained regularly and staff were trained in it's use.

Staff and people interacted with each other in a kind and affectionate way. The home felt relaxed, with a vibrant, fun feel.

Infection control measures were robust to contribute to a safe environment and prevent avoidable infections.

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 25 November 2017).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about risk management within the home. Following this inspection, we were satisfied by the management of risk for people. The overall rating for the service has not changed following this targeted inspection and remains good.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Safe practices were in place for welcoming visitors to the home. These included rapid COVID-19 testing, personal protective equipment (PPE), temperature, health checks and hand hygiene. Vaccination status was checked for all visiting professionals and records of staff vaccinations were maintained. Staff testing for COVID-19 was at the frequency in line with government guidance and a process was in place for monitoring.

People told us they happy and felt safe living at Portelet Lodge Care Home. We spoke with people informally as we walked through the home. Kind and caring interactions between staff and people were noted. The manager, deputy manager and staff at the home had worked hard to keep people safe. Policies and procedures within the home were robust and ongoing monitoring meant that the home worked safely and within good practice and government guidelines.

Supplies of PPE were in good supply, stock checks maintained, and we observed staff wearing this correctly. Staff had training in infection prevention and control and were shown how to put on and take off PPE correctly. The home was a good standard of cleanliness. Emergency planning procedures in place meant that the home could operate under pressures such as an outbreak or staff shortages. Domestic staff worked hard to keep all areas of the home clean and tidy including high touch points and deep cleaning, weekly.

People were supported to maintain contact with their loved ones during the COVID-19 pandemic. Visiting restrictions changed and the home adapted its policies, practices and communicated to people and their relatives. Risk assessments were completed for all aspects of care and support including additional risks related to COVID-19. The manager told us they had a good working relationship with external health and medical practitioners, this included regular checks of the medical needs.

Portelet Lodge was registered for 22 people. There were 22 older people living in the home at the time of our inspection. People had a variety of care and support needs related to their physical and mental health.

This unannounced inspection took place on 25 November 2017. At our last inspection in July 2015 we identified a breach of regulation. This breach was in respect of the application of the Mental Capacity Act 2005 (MCA) where people were not able to consent to their own care. At this inspection we checked to see if the provider had made the improvements necessary to meet the requirements of the regulation. We found that staff understood how the MCA supported their work and that best interest decisions had been made when people could not consent to their care.

Care documentation was being transferred to a computerised system and staff were positive about the benefits of this for accessing and monitoring information. We have made a recommendation about ensuring these records develop to reflect people’s wishes and preferences.

There was a registered manager for the service. 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.

People, staff and relatives described that the home had been through a challenging period. They were all confident that the registered manager had secured change and stability. People were happy with their care and they shared appreciation and confidence in the registered manager and staff team.

Staff were consistent in their knowledge of people’s care needs and spoke with confidence about the individualised support people needed to meet these needs. They told us they felt supported in their roles and had taken training that provided them with the necessary knowledge and skills. There was a plan in place to ensure staff received refresher training as deemed necessary by the provider.

People felt safe. They were protected from harm because staff understood the risks people faced and how to reduce these risks. Measures to reduce risk reflected the person’s preferences. Staff knew how to identify and respond to abuse.

People told us they received the care and support they needed. They also told us they saw health care professionals when necessary and were supported to maintain their health by staff. People’s needs related to on going healthcare and health emergencies were met and recorded. People received their medicines as they were prescribed.

Where people had received end of life care at Portelet Lodge feedback from relatives was consistent in its acknowledgement of the kindness and compassion of the staff team in ensuring people’s wishes and needs were met.

People described the food as good and there were systems in place to ensure people had enough to eat and drink. Where people changed their mind about what they wanted to eat they were offered alternatives.

People had support, care and time, when they needed it, from staff who had been safely recruited.

People were engaged with activities that reflected their preferences, including individual and group activities both in the home and the local area.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their lives. Care plans reflected that care was being delivered within the framework of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards had been applied for when necessary.

People were positive about the care they received from the home and told us the staff were kind. Staff were cheerful and treated people and visitors with respect and kindness throughout our inspection.

We used a number of different methods to help us understand the experiences of people using the service. This was because people were physically and mentally frail and unable to tell us about their experiences of the care they received. We therefore examined records and documents, spoke with a visiting healthcare professional, observed the home's routines and also where appropriate observed some of the care and support people received.

We also checked whether requirements we made at our last inspection of the home on 22 November had been met.

We saw that people received safe, appropriate care and support that met their complex needs and protected their rights.

People were provided with nutritious meals and supported to have adequate hydration.

Arrangements were in place that ensured medicines prescribed for people were managed safely and they had their medicines at the times they needed them.

The premises were maintained to ensure they were safe and secure for people who lived and worked there.

A system of checks or audits were carried out of the homes procedures and working practices to identify where and how the quality of service could be maintained and improved.

Records kept by the provider about people who lived at the home were up to date and accurate. This ensured people received safe and appropriate care.

Care staff were attentive, understanding, empathetic and patient and provided people with the support they needed in accordance with their care plans. They also engaged people in social activities in order to provide stimulation and interest.

We were able to speak with five people and they all told us they received the care and support they needed. They said their accommodation was comfortable.

A visiting healthcare professional told us they thought the care provided for people was good.

We found that the provider had arrangements in place that ensured the care and support provided for people was in accordance with either their consent or that of appropriate representatives.

The provider's had some measures in place that ensured the property was maintained and safe. Also that equipment needed to promote people's safe care and treatment worked effectively.

At the time of our inspection there were enough staff deployed on duty to provide the supervison, support and care people needed.

The provider's arrangements that should have ensured risks to the health, safety and welfare of people using the service and others were not sufficiently comprehensive and robust.

Records the home kept about the care people needed were not always accurate or up to date and have compromised people's safety.