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Stoneacre Lodge Residential Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 September 2018

This comprehensive inspection took place on 20 August 2018 and was unannounced, which meant that nobody at the service knew we would be visiting. The last comprehensive inspection took place in July 2017 when we identified three breaches of regulation. This was because there was a system in place to receive record and respond to complaints made by people who used the service or others, however this was not being used. Also, systems or processes did not operate effectively to assess, monitor and improve the quality and safety of the service and staff were not provided with appropriate supervision and appraisal as is necessary to enable them to carry out their duties. The service was rated as ‘requires improvement’.

Following the last inspection, we asked the registered provider to complete an action plan to show what they would do to improve the key questions safe, effective, responsive and well led, to at least ‘good’.

At this inspection we checked if improvements had been made. We found the registered provider had made improvements but not addressed all the concerns raised at our last inspection and the service continues to be rated ‘requires improvement.’ This is the fourth time the service has been rated ‘requires improvement.’

You can read the report from our last inspections, by selecting the 'all reports' link for 'Stoneacre Lodge' on our website at www.cqc.org.uk.

Stoneacre Lodge is a 'care home' that provides care for up to 31 people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection the service had a registered manager. 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.

The management team were unsure about their responsibilities in notifying relevant people in relation to accidents, incidents and safeguarding. We found some potential safeguarding concerns, which had been recorded as accidents but not notified to us or reported to the safeguarding authority. We did not have concerns that these accidents had caused a detrimental effect on people’s health and wellbeing. However, this meant concerns may not be investigated in line with current safeguarding protocols, which could place people at risk.

People received their medicines at the right time and in the right way to meet their needs. However, we found a discrepancy in the stock amount of one medicine and found two staff had not always signed when controlled drugs were administered. These concerns had not been identified on the managers weekly audit of medicines.

Staff employed at the home had been recruited in a way that helped to keep people safe because thorough checks were completed prior to them being offered a post.

Staff were not provided with appropriate supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. Also, there was no clear system in place to record staff training. Which meant the registered provider and registered manager could not be assured all staff had completed the required training.

Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people's care when necessary.

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

Staff knew the people they were supporting and provided a personalised service. Support plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. This included being helped to maintain good health, through a well-balanced diet.

We observed staff displayed caring and meaningful interactions with people and treated people with respect. We observed people's dignity and privacy was actively promoted by the staff, supporting them in a situation where some people could not speak up for themselves.

A varied range of activities were made available and we saw staff were proactive in engaging people with individual activities which most people enjoyed.

The registered provider and registered manager had addressed some of the areas for improvement in the previous inspection report. However, issues of concern regarding staffing and good governance of the service were still found. This showed that more in-depth monitoring of the quality of the service was needed.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 15 September 2018

The service was not always safe.

Medicines were not always administered safely and in line with safe medicines management procedures.

Staff were unclear about the process for reporting accidents to the safeguarding authority to protect people from the risk of harm.

People who used the service were protected by the registered provider's recruitment practices.

Effective

Requires improvement

Updated 15 September 2018

The service was not always effective.

Staff were not given appropriate support through a programme of regular and on-going supervision and appraisal. Also, appropriate systems were not in place to support staff with their training and development needs.

Staff understood the requirements of the Mental Capacity Act (MCA) and considered people's best interests.

Staff liaised with other healthcare professionals as required if they had concerns about a person's health.

People were supported by staff to eat a balanced diet and meet their health care needs.

Caring

Good

Updated 15 September 2018

The service was caring.

People who used the service and their relatives made positive comments about the staff and told us they were treated with dignity and respect.

The relationships between people who used the service and staff were warm and friendly. The atmosphere in the home was calm and relaxed.

Responsive

Good

Updated 15 September 2018

The service was responsive.

People were involved in the planning of their care and support, which included details of people's needs and preferences.

Staff supported people to take part in meaningful activities at home and in the community.

There was a complaints procedure made available to people should they wish to raise any concerns about the service.

Well-led

Requires improvement

Updated 15 September 2018

The service was not always well led.

The registered provider and registered manager had not addressed all the areas for improvement in the previous inspection report. Continuing issues of concern regarding the governance of the service showed that more in-depth monitoring of the quality of the service was needed.

People who used the service and their relatives were asked their opinions of the home and felt listened to. However, staff did not always feel supported and listened to.