• Care Home
  • Care home

Archived: Crosby Lodge Residential Care Homes

Overall: Inadequate read more about inspection ratings

2-2a Fitzharris Avenue, Charminster, Bournemouth, Dorset, BH9 1BZ (01202) 517186

Provided and run by:
P G Oliver

All Inspections

29 April 2016

During a routine inspection

We last inspected Crosby Lodge Care Home in September 2015 where we identified some shortfalls and made a number of recommendations. The home received an overall rating of requires improvement at that inspection.

This inspection took place on 29 April and 4 and 5 May 2016. The inspection was unannounced and carried out in response to information of concern received by the commission. During the inspection we identified serious shortfalls and breaches of the regulations.

Crosby Lodge Care Home is registered to provide personal care for up to 26 people living with dementia or severe and enduring mental health conditions. Nursing care is not provided. There were 16 people living at the home at the time of the inspection.

The home is made up of two separate buildings. These are called 2 and 2a. The two buildings are separated by a freestanding garage in its own driveway that does not belong to the service. This means that the movement of staff and certain activities such as meal distribution can only be achieved by leaving one building, walking a short way along a public road and entering the second building.

The home is currently being managed by the acting proprietor following the death of the proprietor in January 2016. The acting proprietor was supported by two interim consultants they had engaged as a result of serious safeguarding concerns identified by the local authority. The interim consultants had acted swiftly and responsibly to ensure people’s basic care needs and safety were met.

There was a registered manager at the home. However, they were not available at the time of the inspection. 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.

One relative told us that the home was, “Perfect”, and an agency staff member told us, “This place is the best, it’s like family, it’s very personal and they are very close to residents”. However we identified serious issues that impacted upon people’s health, safety and wellbeing.

People were not cared for safely. Prior to the appointment of the interim consultants, risks to people were not assessed and action was not taken to mitigate these risks. In addition, accidents and incidents were not robustly investigated to make sure patterns or trends were recognised to minimise the risks of further incidents. The interim consultants had taken action to ensure people’s basic safety needs were met and that people were not at imminent risk of serious harm. However, there remained a number of shortfalls because the interim consultants had not had sufficient time to fully safeguard people. In addition, the premises had significant infection control and environmental issues. Shortfalls in recruitment meant the acting proprietor could not be sure that the staff recruited were suitable to work with vulnerable people. Medicines were not managed safely so people had not received their medicines as prescribed.

Staff did not have the knowledge and skills to effectively care for or support people. Staff had not been supported through either training or supervision and appraisals to gain these skills.

Staff were not adhering to the principles of the Mental Capacity Act 2005 (MCA). Decisions made for people who lacked mental capacity had not been made in their best interests using the statutory framework, and one person was unlawfully deprived of their liberty at the time of the inspection.

People had not been supported to meet their nutritional needs although following their appointment, the interim consultants had taken action to ensure that there was enough food available for people to eat and that there was a chef in place to prepare meals.

Most of the staff had a caring approach and were genuinely interested in and concerned about the people they supported. However, they sometimes communicated with people, or supported them inappropriately because they had not been supported to develop the right skills.

People’s needs were not responded to appropriately. Some people’s needs had not been assessed or planned for. Other people had care plans in place which provided staff with inaccurate guidance. Some people had not received the care they required. Other people had not been supported to receive the healthcare they required, including in one circumstance healthcare that was urgently required in response to a fall.

The home was not well led. There was no effective governance and the management in place prior to the appointment of the interim consultants had not supported staff, assessed or monitored the quality or safety of care, or sought feedback from people or their relatives.

The overall rating for this service is inadequate. The death of the proprietor in January 2016 means that there is no registered person for CQC to take action against. The acting proprietor has made a decision to close the home and the last person moved out of the home on 27 May 2016. The home is now closed.

2 and 4 September 2015

During a routine inspection

This was an unannounced comprehensive inspection carried out by one Care Quality Commission Inspector on 2 and 4 September 2015. Our previous inspection of the home completed in July 2013 found the provider was compliant with the regulations.

Crosby Lodge provides accommodation, care and support for up to 20 people. At the time of the inspection 17 people were living at the home. The home comprises two adjacent properties and provides a service to people with dementia and also to people with enduring mental health conditions. People with higher needs were accommodated in one property and the other catering to people with lower care needs.

The home did not have a registered manager in post. 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.’ A new manager had taken up post a month before the inspection and a date was agreed for them to submit an application to become registered manager.

Generally, Crosby Lodge provided a safe service to people. Staff had been trained in adult safeguarding, although some staff required refresher training. The staff were knowledgeable about safeguarding and how to refer any concerns of abuse.

People’s care had been risk assessed to make care delivery as safe as possible, however, as these were not kept up to date there was a risk that people’s circumstances had changed and not therefore assessed. For people who had been accommodated for reasons of enduring mental health conditions, their care plans and assessments could be improved by focusing more on these needs rather than older person’s needs.

Accidents and incidents were monitored and audited to see if there were any trends that could make systems and care delivery safer.

The home employed sufficient staff to meet people’s needs.

There were robust recruitment procedures followed to make sure competent and suitable staff were employed to work at the home.

Medicines were managed safely in the home.

Some staff required update training in various topics and the new manager was putting a training plan in place. Staff supervision sessions had also fallen behind and the new manager was setting dates for staff to have supervision.

The home was meeting the requirements of the Mental Capacity Act 2005, although care planning could better reflect where ‘best interest’ decisions were made on behalf of people who lacked capacity. Appropriate referrals had been made to the local authority for people deprived of their liberty.

People’s consent was gained for how they were cared for and supported.

The new manager had plans in place to make provision of food more suited for people living with dementia. Overall, people’s dietary needs were being met with action being taken when there were concerns about people’s weight.

People felt the staff team were caring and supportive and this was corroborated from our observations. People also reported that their privacy and dignity were respected.

Care planning was out of date, however; the new manager was updating plans to make sure they reflected people’s current needs.

The new manager had plans to improve the level of activities on offer to people to keep people more meaningfully occupied.

The home had a well-publicised complaints policy and we saw that complaints were logged and responded to.

The home has been through changes of manager, which can be unsettling for staff and the home would benefit from sustained and stable management.

10 June 2013

During an inspection in response to concerns

We carried out this inspection because of concerns brought to our notice about the standard of care people received at Crosby Lodge. The concerns were not fully substantiated.

We were accompanied on our visit by two community nurses. We had co-ordinated our inspection visit with them because of the concerns about the care people received. They looked at and assessed the general health of their patients who lived at the home. They advised us that they believed that the standard of care at the home had improved.

We were also accompanied by an officer from the contracts department of Bournemouth Borough Council. They looked at the training the home's staff had completed in order to assess their competence and abilities. They told us they were satisfied the home's staff had received training that enabled them to meet the needs of people who lived at Crosby Lodge.

There were 11 people accommodated at the home at the time of our inspection and another person was in hospital. We were able to speak with six people to obtain their views about the service they received. They all told us they were content and received the help and support they needed.

The provider had taken steps that ensured people who lived at the home received appropriate and safe care and treatment.

There were measures in place to prevent and control the risk of infection to people who visited, worked and lived at the home.

1 May 2013

During a routine inspection

There were 13 people accommodated at the home on the day of our inspection. We were unable to speak with eight people because of their physical or mental frailty. We gathered evidence of some people's experiences of the service by observing the day to day routines, looking at records, speaking with staff and a visiting trainer/assessor.

We spoke with five people and they all told us they were happy living at Crosby Lodge. They told us staff were polite and provided the help and support they required. They told us the building was kept clean and that they were frequently asked if things could be improved at the home.

There were arrangements in place to obtain the consent on behalf of people to their care and treatment if they were unable to do so themselves.

Infection prevention and control measures were in place and the premises were kept clean and hygienic.

Staff recruitment recruitment was managed properly and pre-employment checks had been carried out before individuals started work in the home.

Staff received training and support to enable them to carry out their respective roles.

There were arrangements in place to check that the provider's procedures were followed, manage risks to people and identify if necessary where the quality of the service could be improved.

8 June 2012

During a routine inspection

Although this inspection was a scheduled visit we were also following up an improvement action and seven compliance actions made as a result of an inspection of the home carried out on 16 January 2012. This was in order to see if the registered provider had taken action to ensure they complied with the relevant regulations

At the time of our inspection visit there were 13 people accommodated at Crosby Lodge. Most of the people living at the home were too frail mentally or physically to talk to us about their experiences of living there. We were however able to speak with two people and two visiting relatives.

We also contacted two specialist healthcare professionals employed by the local Primary Care Trust. They had carried out recent visits to the home to look at infection control procedures and the management of medication. They both told us that they had found improvements in these areas.

We spoke to three care staff working in the home at the time of our visit. It was apparent from our discussions that they were familiar with and knew how to meet the needs of the people living at Crosby lodge.

People living at the home who we spoke with told us that staff were polite and respected their privacy. One person said, 'They knock on my door if they want to come into my room'.

People said that the help they needed was discussed and agreed with them and they received all the help they needed. They told us that the home made sure they received their medicines when they needed them and also arranged for them to see healthcare professionals. One person said, 'If I am unwell they arrange for me to see a doctor. We have a chiropodist who comes to see us'.

We were also told by people living in the home they felt safe and they knew how to complain if they were unhappy with anything. They said that they were asked for their views about the home and how the service they received could be improved. One person said, 'If I was unhappy I would speak to Peter" (the registered provider). Another person said, 'We have a foolscap paper in our rooms with the complaints procedure on it but it is so long I can't be bothered to read it. I have been given a questionnaire but I have not filled it in yet'.

As we were only able to speak for any length of time with two people we also used a method we call the Short Observational Framework for Inspection (SOFI) in order to help us understand the experiences of people living in the home. It is a specific way of observing the care people receive and enables us to judge the quality of relationships and the general demeanour and well being of people.

We observed a group of five people for an hour in one of the home's lounge areas. We noted that staff encouraged or helped people appropriately, and explained what they were doing when helping them. We also saw that staff were polite and generally promoted people's dignity. They responded quickly at signs of people's discomfort or distress. We did however note that most staff engagement and discussion with people was task focused and was about the help or assistance they gave to people. There was very little social chat or friendly banter with people.

16 January 2012

During an inspection in response to concerns

This was an unannounced inspection of Crosby Lodge by two inspectors, following information of concern we had received about the care of people living in the home.

We spoke with six people who live in the home, two relatives and five members of staff and the registered provider. We also observed care taking place in the home as many of the people receiving care either have dementia or were unable to tell us their opinion.

People we spoke with said that overall they receive the care they need and felt well looked after.

Relatives we spoke with had mixed opinions. Some told us they thought the care was very good whilst others expressed concerns about unexplained injuries that had been found on their relative.

We found that care records were clearly written and comprehensive assessments had taken place. However, we found inconsistencies in recording and where peoples' needs had changed, this was not reflected in the care records.

There were serious shortfalls found in the appropriate management of medicines, including controlled drugs.

Staff were well trained but there were insufficient staff to meet the needs of people living at the home.

That manager was not able to show that they were effectively reviewing the quality of the service. People living at the home and relatives told us they were unsure who was running the home since the management structure had changed.