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Faringdon Lodge Requires improvement

Reports


Inspection carried out on 24 July 2019

During a routine inspection

About the service:

Faringdon Lodge is a residential care home registered to provide personal care, support and accommodation for up to 28 people in one adapted building across two separate wings, each of which have separate adapted facilities. At the time of our inspection the care home accommodated 23 people, many of whom had dementia.

People’s experience of using this service:

We have found several concerns about the service. Staff understood how to identify abuse but they did not always follow procedures to report them. Medicines were administered safely but not always stored correctly. There were times that the service was short staffed. People’s care plans were not followed with regards to their bathing preferences. Staff inductions were not always recorded. The provider’s quality assurance systems were not always effective.

We have made one recommendation in the report about record keeping with regards to people’s capacity.

Risks to people were recorded. There were infection control measures in place.

People told us staff were experienced and knew how to do their jobs. Staff received training and supervision. People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were supported with their healthcare needs and the service worked with other agencies to the benefit of people. People’s needs were assessed. People enjoyed the food they were provided and were supported to eat and drink healthily.

People and their relatives told us they were treated well. Staff understood equality and diversity. People could express their views and be involved with choices around their care and treatment. People told us their privacy and dignity were respected and their independence promoted.

There were mixed views on the activities the service provided. People’s needs were recorded in their care plans and staff understood these needs. The service made information accessible to people with communication needs. People were able to make complaints and when doing so these were responded to appropriately by the service. The service was working with the local authority to make improvements to how they provided end of life care.

People told us they thought highly of the management team. The registered manager was responsive and wanted to improve the service to the benefit of people who lived there. People held meetings and were engaged with the service. People and relatives were able to complete surveys to assist with improving the service. The service completed audits to monitor the safety and care of people using the service.

Rating at last inspection: At the last inspection the service was rated Good (report published on 7 March 2018)

Why we inspected: The inspection was prompted in part due to concerns received about short staffing and record keeping. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-Led sections of this full report.

Enforcement:

We have identified breaches in relation to incidents not being reported, short staffing, people not being bathed as per their care planned wishes and the service’s quality assurance systems at this inspection.

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 for 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.

Inspection carried out on 18 December 2017

During a routine inspection

Faringdon Lodge is registered to provide personal care, support and accommodation for up to 28 older people. Some of the people who use the service are living with dementia. At the time of inspection 21 people were using the service.

Faringdon Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection

The home is a large converted property split into two units, Sandringham and Balmoral. In the Sandringham unit accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. The home is registered for 28 people. This includes five double bedrooms. However, all rooms currently in use are used as single rooms which means the numbers of spaces is limited to 23.

This unannounced inspection took place on 18 December 2017. At the last inspection on 28 September 2015 the provider met all of the legal requirements we looked at and was rated good.

Faringdon Lodge is a traditional care home for older people, providing a reliable care service to older people. The care provided is valued by people using the service and relatives. Investment is needed to improve the décor and more thought and consideration about activity provision and dementia care. Otherwise this is a good service which has retained its good rating.

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 and associated Regulations about how the service is run.

Staff understood their duty to protect the people in their care. Staff knew what to do in order to protect people from abuse and minimise potential risks to people’s health and welfare. Medicines were safely managed.

There was a suitable number of staff to meet people’s needs. People, and relatives, told us that they were happy and that staff provided safe and good care, showing respect and consideration to people.

People were supported to consent to care and the service operated in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff undertook training which helped them to carry out their role. The supervision and appraisal system also supported them to carry out their work.

The service carried out assessments of people’s needs before they moved in. Care plans described each person as an individual, the degree of support they required [including support for people suffering with dementia] and were tailored to respond to people’s unique needs. Care plans were regularly reviewed. People were supported to maintain good health. People had access to health care services whenever this was needed. People received a nutritionally balanced diet to maintain their health and wellbeing.

The service had a clear management structure in place. The service had various quality assurance and monitoring systems in place to oversee the day to day operation of the home and to plan for changes and improvements. The provider listened and responded to the views of people who used the service, relatives and other health and social care professionals.

Inspection carried out on 28 September 2015

During a routine inspection

This unannounced inspection took place on 28 September 2015. At the last inspection in November 2014 we found breaches of legal requirements. This was because people were not protected against risks associated with medicines. The registered person did not have effective systems in place to monitor the quality of service delivery. They also failed to maintain accurate records in respect of each person who used the service so that care plans and risk assessments were not regularly updated and reviewed when people’s needs changed. At this inspection we found improvements had been made and the service now met the required standards.

Faringdon Lodge is registered to provide personal care, support and accommodation for up to 28 older people. Some of the people who use the service are living with dementia. At the time of inspection 23 people were using the service.

The home is a large converted property split into two units, Sandringham and Balmoral. In the Sandringham unit accommodation is arranged over two floors and there is a lift to assist people to access the upper floor. The home has 23 rooms in total, two of which are double rooms. We were informed that the double rooms are now used as single rooms.

At the time of the inspection there wasn’t a registered manager at the service. An interim manager has been in charge of the home since June 2015. They have made an application to the Care Quality Commission to become the 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.

Staff understood their responsibilities to protect the people in their care. They were knowledgeable about how to protect people from abuse and from other risks to their health and welfare. Medicines were managed and handled safely for people. Arrangements were in place to keep people safe in the event of an emergency.

There were sufficient staff to meet people’s needs. Staff were attentive, respectful, patient and interacted well with people. People told us that they were happy and felt well cared for. Risk assessments were in place about how to support people in a safe manner.

Staff undertook training and received supervision to support them to carry out their roles effectively. The interim manager and the staff team followed the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff training records showed they had attended training in MCA and DoLS.

People were supported to maintain good health. They had access to health care services when it was needed. People received a nutritionally balanced diet to maintain their health and wellbeing.

People’s needs were assessed before they moved in to the home. Care plans were person centred and were regularly reviewed. Care plans were updated when people’s needs changed.

The service had a clear management structure in place. People and staff told us they found the interim manager approachable and that they listened to them.

The provider sought feedback about the care provided and monitored the service to ensure that care and treatment was provided in a safe and effective way to meet people’s needs.

Any complaints were documented along with the actions taken. There was an effective system in place to monitor the quality of service provided.

Inspection carried out on 26 & 27 November 2014

During a routine inspection

This was an unannounced inspection carried out over two days on 26 November and one inspector on 27 November 2014.

Faringdon Lodge provides accommodation for up to 28 older people who need support with personal care. Some of the people who use the service are living with dementia.

The home is a large converted property split into two units, Sandringham and Balmoral. In the Sandringham unit accommodation is arranged over two floors and there is a lift to assist people to get to the upper floor. The home has 23 single rooms and three double rooms. We were informed that the double rooms are now used as single rooms.

At the time of the inspection there was no registered manager at the service. An interim manager has been in charge of the home since June 2014. They have made an application to the Care Quality Commission to become a registered person to manage a care home. 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.

We found improvements were needed to ensure records were reviewed and up dated to make sure staff had adequate information about people’s care needs. For example, we found risk assessments, including manual handling assessments, were not up to date and could potentially place people at risk of receiving inappropriate care.

We also found improvements were needed to make sure the quality monitoring systems in place were fully effective in identifying and addressing shortfalls in practice which could affect the well-being of people.

We found that people were not fully protected against the risks associated with medicines because proper procedures for the administration of medicines were not in place.

The risks of abuse to people were minimised because all staff were thoroughly checked before they began work. Staff were aware of what may constitute abuse and how to report it.

People said they continued to make decisions about their day to day lives. A range of different social activities, which were age appropriate to meet the needs of people that lived at the home were available. All the visitors we spoke with told us they were made welcome by the staff in the home.

Staff had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training. Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety. The manager and staff were aware that on occasions this was necessary and the process they should follow.

People received meals in line with their needs and preferences. They were happy with the food provided, which maintained health and well being.

People told us they thought the staff group were trained and knowledgeable about their needs. Staff told us they had received the training and support needed to do their job.

You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 5 November 2013

During an inspection to make sure that the improvements required had been made

At this inspection we checked compliance in areas identified for improvement during our inspection in May 2013. This was in regard to requirements relating to workers. We found that improvements had been made in this area to achieve compliance.

People and their relatives were very positive about the service. One relative said "they keep us informed and involved with everything that goes on here.The new manager is very good.You can tell the staff are calmer, things are improving and settling down."

People's needs were met by staff who were appropriately recruited, qualified and experienced to carry out their role. A member of staff told us " they carried out checks and interviewed me before I got the job." Another said "there is a good team here and that is what makes me want to come to work here."

The service had procedures in place for dealing with complaints which were listened to and acted upon by the acting manager. A relative told us "I would not hesitate to talk to the manager or the provider if I was concerned about anything."

Inspection carried out on 20 May 2013

During a routine inspection

At this inspection we checked compliance in areas identified for improvement during our inspection in October 2012. This was in regard to staffing levels. We found that improvements had been made in this area to achieve compliance.

People told us that they liked living at Faringdon Lodge. They received the help and support they needed from staff who were aware of their needs. We found that people's views were sought in relation to their care. We saw that people received assistance with their personal care and were being supported in accordance with their individual care plan. A relative said "the carers know her needs and meet them.They are very caring, like an extended family." Another told us "I have been involved in her care plan."

We found there were sufficient staff available to assist people when needed. However, we found that appropriate checks were not undertaken before staff began work, this put people at risk of receiving care from potentially inappropriate staff. A compliance action has been set for the provider to meet this regulation.

Inspection carried out on 13 September 2012

During a routine inspection

Faringdon Lodge is registered to provide care for 28 older people. However, the home has 23 single bedrooms hence they accomodate this number of people. During the course of the inspection we met and spoke with four people who lived at Faringdon Lodge. We observed the care provided and how people interacted with staff. We also spoke with two relatives of people who used the service and with one care co-ordinator. All those we spoke with were happy with the care and support provided by the service. We saw that people were treated with respect by the staff team.

One person said, “thumbs up, I like it here.” Another person said, “staff are charming, very caring. Staff take safety and care very seriously, they know what they are doing.” Relatives said, “they saved my mum’s life when she came here. We were involved every step of the way.” Another said, “they keep me in the loop and I am involved.”

Reports under our old system of regulation (including those from before CQC was created)