Background to this inspection
Updated
15 April 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by 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.
Service and service type
Livesey Lodge is a ‘care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used this information to plan our inspection.
During the inspection
We spoke with two people who used the service and five relatives about their experience of the care provided. We spoke with seven members of staff including two senior care workers, care workers and the cook and housekeeper. The registered manager did not make themselves available for the inspection.
We reviewed a range of records. This included two people’s care records medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
15 April 2022
About the service
Livesey Lodge is a residential care home providing accommodation and personal care to 12 people aged 65 and over at the time of the inspection. The service can support up to 24 people.
People’s experience of using this service and what we found
The service was still not well-led, and lessons not learnt from previous shortfalls we identified. Serious ongoing concerns were identified in the day to day management and oversight at the service.
The registered managers attendance at Livesey Lodge was inconsistent and infrequent. They had only been present 9 of the previous 77 days to the inspection. No alternative arrangements had been put in place in their absence, instead care workers with no managerial experience were left to manage the service in their absence. This contributed to the widespread failings in the leadership and governance arrangements.
Staff did not receive adequate support and guidance from registered persons and were not listened to if they raised any issues.
Staff were assigned to multiple roles including cooking and cleaning due to a lack of consistent staff. Staffing levels meant people did not have opportunity to engage in regular meaningful activities.
A staff member was left to arrange the deployment of staff but had no authority to make changes to the levels of staff if they were needed.
The registered manager held no records staff were fully vaccinated for COVID-19 in line with government guidance. This increased the risk of a further outbreak of the virus. Protocols for visiting professionals did not include checks of their vaccination status.
Policies, such as infection control and safeguarding were not always reviewed, updated or contained the correct information.
Support, advice and guidance the service received from other agencies was not acted upon and opportunities missed to make improvements to service delivery and management.
Without exception people and relatives praised the safe care and treatment they received from care staff. Staff knew people well and held positive relationships with them. Observations during the inspection confirmed the feedback we received.
Risks to people health were safely managed. People were supported with their food and nutrition and their medicines managed safely.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 27 April 2021) and there were two breaches of regulations and a recommendation made in relation to the provision of activities. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had still not been made and the provider remains in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Livesey Lodge on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified breaches in relation to management and governance, infection control procedures, staffing and person-centred care at this inspection.
Due to the repeated breaches and failure to make improvements to exit special measures enforcement action was taken against the provider to remove their registration.