14 September 2021
During a routine inspection
Kings Lodge Nursing Home is a residential care home providing personal and nursing care to 67 older people with a variety of health needs at the time of inspection. One part of the home provides specialised care for people who were living with dementia. The service can support up to 77 people.
People’s experience of using this service and what we found
Medicines were not always administered or stored in a safe way. New admissions to the home were not managed in line with government guidance. Some infection prevention and control systems were not sufficiently robust to protect people from unsafe care or treatment.
Care plans for some people with a learning disability did not provide detailed information or guidance for staff to ensure they received person-centred care.
People told us they felt safe living at the home. The home was open to visitors. A friend of one person was visiting the home and told us, “We were able to visit in the pod. It wasn’t ideal, but at least I was able to see her again. It was so important that we could visit”. Staffing levels were sufficient to meet people’s needs and new staff were recruited safely.
People’s needs were assessed before they came to live at the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support:
• Model of care and setting maximises people’s choice, control and independence
Care records lacked information for staff as to how people’s independence could be promoted, or how to support people to have choice and control of their lives.
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Staff knew people well and provided personalised care. However, records did not show how staff should promote people’s dignity and privacy or protect their human rights.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
There was no evidence to show how the home promoted inclusion in order for people to feel empowered.
The registered manager was not aware of the principles of Right support, right care, right culture. On the second day of inspection, they told us they had accessed this strategy and would be reviewing the care, including records, that people living with a learning disability or autism received.
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 rating for this service was Good (published 3 November 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.
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.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. The provider has taken some action to mitigate the concerns
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Kings Lodge Nursing 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.
We have identified breaches in relation to the safe administration and management of medicines, infection prevention and control, 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.