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Lindhurst Lodge Residential Home Requires improvement

All reports

Inspection report

Date of Inspection: 21 July 2014
Date of Publication: 14 August 2014
Inspection Report published 14 August 2014 PDF

Overview

Inspection carried out on 21 July 2014

During a routine inspection

An adult social care inspector carried out this inspection. At the time of this inspection Lindhurst Lodge was providing care and support to 21 people, some of whom had a diagnosis of dementia. We spoke with eight people living at the home, and three visiting relatives to obtain their views of the support provided. In addition, we spoke with the area manager and five members of staff about their roles and responsibilities.

We considered all the evidence against the outcomes we inspected to help answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We observed interactions between staff and people who lived at the home that were respectful and friendly. People were relaxed in the company of staff.

People we spoke with who lived at the home told us they felt safe living there. One person said, �It�s as safe as your own house here.� One relative said �It�s such a relief to know that [family member] is safe and being well cared for. It�s a weight off my mind.�

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We found risk assessments had been undertaken to identify any potential risk and the actions required to manage the risk. This meant that people were not put at unnecessary risk but also had access to choice and remained in control of decisions about their lives.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Although no applications had been submitted relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded.

The service had completed enhanced Disclosure and Barring Service (DBS) checks, formerly known as Criminal Records Bureau (CRB) checks for all staff working at the home. This helped to protect people who were receiving a service.

Is the service effective?

We found people were provided with nutritious food. Some people required specialised diets for health or personal reasons and these were provided.

People told us they liked the food. Comments included: �It�s all home cooked and always good. You never go hungry,� �The food is good. You can eat as much as you like� and �I�ve got no complaints about the food. It�s all good.�

During our visit, we found people were provided with the support they needed. We found staff knew people well and were aware of their individual preferences.

Care files we checked confirmed that initial assessments had been carried out by staff before people moved into the home. This was to ensure the home was able to effectively meet the needs of the people. Specialist mobility and equipment needs had been identified in care plans where required.

We looked at the staff training matrix and found significant gaps in the training provided. When we looked at staff files we found certificates for training staff had completed which was not recorded on the training matrix. This meant there remained some gaps in staff training, but until a full audit of this was completed it was not possible to assess what the gaps were. Also staff had not been provided with a yearly appraisal. This meant there was a risk staff were not properly trained and their competency appraised.

We have asked the provider to tell us what they are going to do to ensure persons employed are receiving appropriate training and appraisal.

Is the service caring?

We observed warm and respectful interactions between staff and people who used the service as well as some good humoured banter. We found staff treated people in a kind manner.

People we spoke with who lived at the home told us they were happy living there. Comments included: �I like it here. I�ve been here a while and it�s home for me,� �It�s a good place. The staff are nice and friendly and the food�s good too,� �I�ve not been here long, but I do like it here. People are friendly,� �I�m quite happy here. No complaints from me� and �I�m just here for respite (short term) care but I�d recommend it to anyone.�

One relative told us, �The staff are all really good with [family member]. They are happy here. They all know me and I know all of them, which is nice.�

Is the service responsive?

Staff told us the care and support provided was flexible to the person�s needs and adjustments could be made where required. Staff said they informed the manager if they felt any change in needs was required and the support was reviewed. For example one relative told us, �My family member prefers a late breakfast and often doesn�t eat at lunchtime but then they eat well at tea time and that suits them.�

Several people, particularly men, told us there was not a lot for them to do during the day. Three people told us they did not like activities such as bingo or quizzes or music. One person said, �There�s not much going on for me, so I watch TV most days. It does get a bit boring sometimes.� One person told us they preferred to stay in their bedroom all day and preferred to socialise out of the care home.

We observed one person who used the service preferred to spend some of their time sitting on the floor. We noted that this person was not always in the view of care staff. We saw other people had to manoeuvre their walking frames around this person at times in narrow corridors. This meant there was a risk of people using the service falling. This had not been identified and action taken to ensure their safety and welfare.

There were no outstanding complaints about the service. People who used the service said if they had any worries they would take their concerns to a member of staff or to the managers�. One person said, �You can talk to anyone here. I know they�d sort anything out for you.�

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

People who used the service and their relatives said they could not recall being asked to attend residents� or relatives� meetings. The area manager said a relative meeting had been arranged but no one had turned up. We saw the poster that had been on display in the home advertising this.

Information collated by CQC evidenced that the service had not reported the death of any person who used the service since April 2013. It is a legal requirement for services to inform CQC about the death of a person who uses the service. If services do not inform CQC they are at risk of receiving a fine or being prosecuted.

The service carried out a yearly �Quality Assurance Survey�. Feedback was sought by way of customer satisfaction surveys sent to people who used the service, their relatives and friends, staff and healthcare professionals. This showed people had the opportunity to put their views across.

The area manager explained the systems in place to assess and monitor the quality of service provision. The area manager said audits were completed each month and covered many areas, for example, infection control, environment, medication, food hygiene and care plans. We checked the audits and found they had not been completed since March 2014.

We have asked the provider to tell us what they are going to do to ensure the quality of the service is monitored so that any risks relating to the health, safety and welfare of people are identified and managed.