Archived: Sovereign Lodge Care Centre

At the time of this inspection 25 people were living on the ground floor and 25 people were on the first floor with six people living on the second floor. This inspection took place on 30 March and 1 April 2016 and was unannounced.

The service had a registered manager in place. 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 quality monitoring systems needed further development to ensure they were used to ensure best practice and to identify shortfalls and demonstrate effective responses. This included the provision of suitable guidelines for medicine administration and accurate records for the application of topical creams in order to demonstrate staff delivered these in a consistent way. In addition some care documentation was not completed contemporaneously or consistently. This could lead to staff not having up to date information on people’s needs and care provided.

People were looked after by staff who knew and understood their individual needs well. Staff were attentive, treated people with kindness and compassion and supported them to maintain their independence. They showed respect and maintained people’s dignity. All feedback received from people and their representatives were very positive about the care, the atmosphere in the service and the approach and openness of the staff and registered manager. Comments included, “Everything is brilliant now. I have seen this home become an excellent place with caring staff and a manager who listens and changes things when they need to be changed.”

All feedback from visiting professionals was positive. They told us staff work with them to improve outcomes for people and were keen to learn new approaches when working with people living with a dementia.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and followed correct procedures to protect people’s rights.

Staff were provided with a full induction and training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people’s needs could be met in a timely and safe fashion. The registered nurses attended additional training to update and ensure their nursing competency.

People were given information on how to make a complaint and said they were comfortable to raise a concern or give feedback. A complaints procedure and comment cards were readily available for people to use.

Staff monitored people’s nutritional needs and responded to them. Preferences and specific diets were provided. People were supported to take part in a range of activities maintain their own friendships and relationships. Staff related to people as individuals and took an interest in what was important to them.

Feedback was regularly sought from people, relatives and staff. People were encouraged to share their views on a daily basis and satisfaction surveys had been completed. The management style fostered in the home was transparent listened and responded to people and staff’s views.

At the time of our inspection the service provided care and support to 58 people.

We spoke with a number of people who used the service. Many were not able to tell us about their experiences of living at the home because of their complex needs. However, 11 people were able to provide feedback to us on the care and treatment they received.

We also spoke with seven visiting relatives and twelve staff members. Staff spoken with included the cleaning and activities staff, care staff, registered nurses, the deputy manager and the registered manager.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. To see the evidence that supports our summary please read the full report.

Is the service safe?

People had been cared for in an environment that was clean and hygienic. Risk assessments were in place to provide information to staff to help minimise the risk of any harm to people.

All feedback indicated that there was enough staff and they were competent in the work they undertook.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The manager was able to describe when a DoLS would be applied for and gave an example when one had been used in the past. Staff had received training on the mental capacity act and DoLS.

Is the service effective?

We saw individual plans of care were in place. There was evidence to confirm that these were reviewed and updated to reflect any changing need.

It was evident from our observations and from speaking to staff that they had a clear understanding of people’s needs. The people who used the service that we spoke with told us the staff looked after them well. One person said, “We are looked after very well the staff are lovely." Another said, “I am well looked after. I have no concerns. "

Training records seen confirmed staff had received appropriate training to meet the needs of people living at the home.

Is the service caring?

People were supported by kind and caring staff. We saw that staff were patient and pleasant at all times to both people living in the home and visitors to the home.

Our observations confirmed that people were encouraged to be independent but were helped when they needed any support.

Is the service responsive?

We saw that people’s needs had been assessed before they moved into the home. Individual care plans were developed for each person following admission. People were encouraged and enabled to make choices about their daily activity. Staff in the home provided activities and visitors were warmly received, supporting people to maintain relationships with their friends and relatives.

Is the service well-led?

We saw that a number of quality assurance processes were in place. These included feedback from people who used the service and their representatives.

People, visitors and staff told us that if they had any concerns they would speak with the manager who always listened and responded appropriately.

Staff told us they were clear about their roles and responsibilities. The manager was supported by a deputy manager and a team of registered nurses. .

We looked at the environment and reviewed the systems that the home had in place to maintain a clean and hygienic environment. We reviewed staff practice and training and the procedures the home followed in relation to infection control. We found that risks associated with cross infection had not been fully addressed and the home was not clean in all areas.

We used a number of different methods to help us understand the experiences of people using the service, as they had complex needs which meant they were not always able to tell us their experiences. We spent time with people using the service and observed interaction with each other and the staff.

We saw that the staffing numbers allocated by the home were in place. Staff were available to monitor and supervise people living in the home. Staff told us that they felt well supported and trained to do their work.

We looked at a number of records and found that these had been completed in a consistent manner.

We spoke with five people who used the service, seven relatives, one visiting health care professional and ten staff members. We met with the regional manager who was visiting the home on the day of our inspection.

We used a number of different methods to help us understand the experiences of people using the service, as they had complex needs which meant they were not always able to tell us their experiences. We spent time with people using the service and observed interaction with each other and the staff.

We looked at the systems and processes that the home had in place to ensure the people who used the service were protected from abuse. These processes ensured that staff knew what constituted abuse and what to do if it was suspected.

We saw that the staffing numbers allocated by the home were in place. However, there was evidence that the number of staff available did not always ensure safe care was being provided.

We looked at the systems and processes the home had in place to respond to complaints. These processes ensured complaints raised were resolved to people's satisfaction with information used to change practice. We looked at a number of records and found that these were not completed in a consistent manner.

We spoke with eight staff members, five visiting relatives and five people who used the service. Some people had complex needs and were not always able to verbalise their experiences, so we observed the interaction between staff and people closely.

We looked at systems the home had in place that ensured appropriate care, treatment and support for people using the service. We saw that people were assessed and plans of care were used to inform the care provided. Care provided was reviewed and professional advice was used to ensure care was appropriate.

We reviewed the staffing arrangements and systems in place that ensured suitable staffing was maintained. The management had taken steps to recruit and retain suitable staff to resource the home effectively in relation to its current occupancy.

In this report the names of a two registered managers appear Mrs Yvonne Christina Harris was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.