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The Lodge Retirement Home Requires improvement

Reports


Inspection carried out on 6 June 2019

During a routine inspection

About the service

The Lodge Retirement Home is a residential care home providing personal care to up to 14 people aged 65 and over. At the time of the inspection, 13 people were living in the home. The home provides accommodation over two floors and there is a stair lift available to access the first floor.

People’s experience of using this service and what we found

The provider lacked effective governance systems to identify concerns in the service and drive the necessary improvement. At times, there was a lack of detailed records regarding people's support needs and any potential risks posed to them. Records were not always in place to demonstrate effective monitoring of environmental safety systems such as fire and legionella.

The oversight of infection control procedures needed improving and medicines were not always managed safely. People told us there was enough staff to meet their needs but the provider did not use a systematic approach to ensure sufficient staff were deployed to meet people’s needs at all times. We have made a recommendation about this.

Although people told us they were able to make choices about their care, the application of the Mental Capacity Act was not always clear. We have made a recommendation about this.

The planning and provision of meaningful activities for people needed to improve and we have made a recommendation about this.

Despite this, people were happy living at The Lodge Retirement Home and people told us they felt safe. People were positive about the food and were supported to access health care professionals to maintain their health. People were supported by staff who were kind, caring and who understood their likes, dislikes and preferences. There was a dedicated and consistent staff team, most staff had worked at the service for a considerable length of time and they had got to know people well.

The provider was responsive to our concerns and began taking action to make improvements in the service.

Rating at last inspection and update

The last rating for this service was Good (report published 4 October 2016).

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

We have identified a breach in relation to the governance of the service. We also identified breaches in relation to the management of medicines and the management of risk.

Please see the action we have told the provider to take at the end of this report.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 6 September 2016

During a routine inspection

The Lodge Retirement Home is registered to provide accommodation for 14 older people who require assistance with everyday living. Nursing care is not provided. The home provides accommodation over two floors and there is a stair lift available to access the first floor. On the day of our visit there were 12 people living at The Lodge Retirement Home, which is set in its own grounds and is situated in a quiet area of Bedhampton.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People told us they felt safe with the home’s staff. Relatives we spoke with had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

Risk assessments were in place to protect people from any identified risks and help keep them safe. There were also risk assessments in place to help keep people safe in the event of an unforeseen emergency such as fire or flood.

Thorough recruitment processes were in place for newly appointed staff to check they were suitable to work with people. There were sufficient numbers of staff to meet people’s needs safely. People told us there were enough staff on duty and records and staff confirmed this.

People were supported to take their medicines as directed by their GP. Records showed that medicines were obtained, stored, administered and disposed of safely.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the home was currently subject to DoLS, we found the registered manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. There were no restrictions imposed on people and they were able to make individual decisions for themselves. The registered manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.

Each person had a plan of care which provided the information staff needed to provide effective support to people. Staff received training to help them meet people’s needs. Staff received an induction and regular supervision including monitoring of staff performance. Staff were supported to develop their skills through additional training such as National Vocational Qualification (NVQ) or care diplomas. All staff completed an induction before working unsupervised. People were well supported and relatives said staff were knowledgeable about their family member’s care needs.

People told us the food at the home was good and they were offered a choice at mealtimes.

People’s privacy and dignity were respected. Staff had a caring attitude towards people. We saw staff smiling and laughing with people and offering support. There was a good rapport between people and staff.

People were involved as much as possible in planning their care. The registered manager and staff were flexible and responsive to people's individual preferences and ensured people were supported in accordance with their needs and abilities. People were encouraged to maintain their independence and to participate in activities that interested them.

The registered manager operated an open door policy and welcomed feedback on any aspect of the service. The registered manager and deputy manager monitored the delivery of care.

There was a stable staff team who said that communication in the home was good and they always felt able to make suggestions. They confirmed management were open and

Inspection carried out on 10 February 2014

During a routine inspection

The Lodge Retirement Home can accommodate up to 14 people. At the time of our visit we were informed that there were currently 12 people living at the home.

We looked around the home which was clean and free of unpleasant odours. All the room were single occupancy with hand basins and eight rooms had ensuite hand basins and toilets. We saw that individuals had personalised their room with photographs, books, TV�s and pictures. There was a chair lift so people could access the first floor.

During our visit we spoke with three people who use the service and four staff including the registered manager. We spent time observing how staff interacted and supported people. We saw staff treat people in a sensitive, respectful and professional manner.

One person told us that they were �very happy and the food was excellent� and �that when I first came to the home I was feeling very low�. Other people told us that they had no complaints. People told us that staff would always knock when they entered their room.

We saw that care plans looked at all aspects of people's care needs and that people's assessment looked at their goals and the support required.

Inspection carried out on 28 January 2013

During a routine inspection

We spoke to four of the 14 people who used the service and asked if they received the care they needed and they told us they did. They had all been made aware of their care needs but they were not regularly referred to.

We looked at four of people's care records and noted that assessments had been carried out by the home but the care plans did not identify how needs were met or choices of activities. One care staff told us that they did not look at people�s care plans because they knew the people at the home and knew what they needed.

Another person we spoke with said that they felt safe in the home and that they would "have no problem" to speak to a member of staff if they felt concerned, the same person added that "I feel safe and happy here."

The people we spoke with about staff having regard to hygiene and infection control measures when they were working told us staff wore gloves and aprons, and "always cleaned up after themselves." There were no concerns raised by the people we spoke to about cleanliness or infection control.

The last care quality commission inspection had identified some minor action regarding having a locked box chained to the wall and the use of a metal box for medication storage which had been implemented.

We saw evidence of residents and relatives meetings, this showed us that the residents and relatives were being informed of changes; a record in the minutes told us that their view on food choices and activities had been sought.

Inspection carried out on 13 June 2011

During a routine inspection

People told us they were very happy living at The Lodge and felt lucky to be living there. They reported they felt they belonged to a large family where everybody looked after each other. They stated the staff were �wonderful, kind and caring�. People told us the home and their rooms were always clean. People told us the meals were nice in the home and they had a choice at meals times. People told us they were free to spend the day how they wished, if they wanted they could stay in their room or go into the communal rooms of sit in the garden.

Reports under our old system of regulation (including those from before CQC was created)