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Archived: Totham Lodge Residential Home for the Elderly

Overall: Requires improvement read more about inspection ratings

Broad Street, Green Road, Great Totham, Maldon, Essex, CM9 8NU (01621) 891209

Provided and run by:
Mrs M Page

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Background to this inspection

Updated 6 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 August 2016 and was unannounced. The inspection team was made up of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed information we held about the service, including the notifications they had sent us. A notification is information about important events which the provider is required to send to us.

During the inspection we spoke with 18 people who used the service, five relatives, four staff, a care manager and the registered manager. We carried out observations of the interactions between staff and the people who lived at the home. We also carried out observations using the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We reviewed the care records and risk assessments for seven people, checked medicines administration records and reviewed how complaints were managed. We also looked at six staff records and reviewed information on how the quality of the service was monitored and managed.

Overall inspection

Requires improvement

Updated 6 December 2016

This inspection took place on 23 August 2016 and was unannounced. The home provides accommodation and personal care for up to 28 older people, some of whom may be living with dementia. On the day of the inspection, there were 26 people living in the home. Four of the bedrooms were for shared accommodation for two people.

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.

People felt safe and there were systems in place to safeguard them from the possible risk of harm. Risks to each person had been assessed and managed appropriately, and there were risk assessments that gave guidance to staff on how risks to people could be minimised.

The service followed safe recruitment procedures. However, people were at risk of harm because there was not always staff to supervise them in the lounge and dining room. There were safe systems for the management of people’s medicines and they received their medicines regularly and on time.

People were supported by staff who had received the relevant training but did not demonstrate that they had the skills required to support people who were living with dementia. Individual needs were not met by the design and decoration of the building. The service was not dementia friendly. Staff received supervision and support from the management.

Staff were aware of how to support people who lacked mental capacity to make decisions for themselves and had received training in Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards.

People’s nutritional needs were met and they were supported to have enough to eat and drink. However, choice in the menu had not been provided.

They were also supported to access other health and social care services when required.

People were treated with respect but their privacy and dignity was not always promoted. People and their relatives were involved in decisions about their care and support they received.

People had their care needs assessed, reviewed but not always delivered in a way that mattered to them. They were not supported to pursue their social interests and hobbies and to participate in activities provided at the home. There was an effective complaints procedure in place.

There were systems in place to seek the views of people, their relatives and other stakeholders. Regular checks and audits relating to the quality of service delivery were carried out. However, the systems in place were ineffective.

The provider was not meeting some of the regulations. We also recommended that the provider needed to review and act on current guidance on creating dementia friendly environment. You can see what actions we have told the provider to take at the back of the full version of the report.