1 July 2014
During a routine inspection
People who lived at Tollington Lodge told us they were treated with dignity and respect by the staff that supported them. They told us that the staff were competent at their role and they felt safe within the home
Where people had identified risks, for example with mobility, we saw that an assessment had been completed and a plan to guide staff on how to support the person safely was in place.
Staffing levels were not always sufficient to ensure that people were cared for safely. The current staff numbers were not calculated on people's assessed dependency. There were times during the day when some people's individual needs meant staff were not be available to assist any other people in the home.
People were not always protected from the risks of unsafe or inappropriate care and treatment as their records did not contain accurate and appropriate information.
Is the service effective?
People told us they were involved in care planning and decisions about their daily living. The care people received reflected the needs of each individual. We saw the home had a system to review people's care needs on a monthly basis to ensure changes in people's needs were identified.
We received positive comments about the staff employed at the home and the level of care that people received. One person said, 'The staff here are good, I get everything I need.' Another person said, 'They (the staff) look after me very well here.' One person's relative said to us, 'The staff here are very good, I'm happy with the care.'
Staff said that information was shared about people to ensure any changes in a person's care needs were highlighted. We also saw that people's needs were discussed at staff meetings.
Is the service caring?
People gave positive feedback about the staff at the home and the level of care they received. One person who had recently moved into the home said the staff had been very caring and had helped them adapt to the significant change they were going through.
We saw that people received the support they needed and people told us their needs were well met by staff.
Is the service responsive?
We saw that the service involved other healthcare professionals as required. For example, district nurses were involved in relation to a person's leg ulcer and catheter. We saw from people's care records that a person's GP was called when the home was concerned about somebody, and appropriate professionals had been consulted when an increase in falls had been identified.
Is the service well led?
Some aspects of the service were not well led as action had not been taken to rectify shortfalls.
The provider had not responded when staff had identified the requirement for additional staffing at busy times to ensure people's needs could be met.
There was not a dependency assessment of people's needs that ensured sufficient staff were on duty to meet people's needs.
The provider did not have a system in operation to monitor staff record keeping that would have identified the poor record keeping we found during the inspection
We saw that there were systems in place to monitor the quality and safety of the service provided. This included resident surveys to gather the views of the people who lived at the home and their relatives.
Accidents and incidents that occurred in the home were recorded and analysed to establish any trends.