Hankham Lodge Residential Care Home

Updated 28 June 2022

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

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hankham Lodge Residential Care Home 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. Hankham Lodge Residential Care Home 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. The registered manager was also the provider.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 23 May 2022 and ended on 26 May 2022. We visited the location’s service on 23 May 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with eight people who used the service. We spoke with six members of staff including the provider. We observed interactions between staff and people. We spoke with nine people’s relatives by telephone. We reviewed a range of records. This included four people's care records and multiple medicine records. We looked at two staff files in relation to recruitment and further records relating to the quality assurance of the service, including feedback surveys and accident and incident records.

Updated 28 June 2022

About the service

Hankham Lodge Residential Care Home is a residential care home providing accommodation and personal care to up to 20 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 20 people using the service.

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

Risks to people's safety were not always assessed and managed. People's care plans and risk assessments were not up to date and did not always contain enough guidance for staff to keep people safe. The provider had begun working with an external consultant to make improvements to care plans and risk assessments.

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 that may lack capacity did not have capacity assessments in place to see if the person was able to make their own decisions, and no best interest decisions had been recorded. DoLS (Deprivation of Liberty Safeguards) applications had not been made when required.

People did not always receive person-centred care. People's care plans did not contain information about people's individual wishes and interests. People did not always have enough meaningful activity to keep them occupied.

Governance and oversight of the service needed improvement. Audits to identify shortfalls at the service were not always in place, for example for medicines and care plans.

People were supported by staff that knew people well. Staff spoke about people warmly and enjoyed supporting people. People told us they were happy at the home. Staff were recruited safely and there were enough staff to support people. The home was clean and hygienic.

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

Rating at last inspection and update

The last overall rating for this service was requires improvement (published 1 August 2020). This was a focused inspection to review Safe and Well Led.

At the last comprehensive inspection (Published 25 January 2020) we identified breaches of regulations around the need for consent, staffing and person-centred care. The provider completed an action plan after this inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

At our last inspection we recommended that the provider check the environment was maintained and decorated to a good standard. At this inspection we found that improvements had been made.

At our last inspection we recommended that people should have access to drinks throughout the day. At this inspection we found people were provided with drinks throughout the day.

At our last inspection we recommended that the provider ensure staff have sufficient time to spend with people and that people have choices around their delivery of care. At this inspection we found that improvements had been made.

At our last inspection we recommended that the provider make a record of complaints and evidence how complaints had been investigated and resolved. At this inspection we found that the provider kept a record of complaints and actions taken.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 7 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve person centred care and need for consent.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. During the inspection, we found evidence to suggest we needed to look at the safe key question. This meant we opened up the inspection to a five key question inspection.

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 Hankham Lodge Residential Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk management, person-centred care, need for consent and governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.