Archived: Pilgrims Lodge Residential Home

The inspection took place on 17 March 2015 and was unannounced. At the previous inspection in December 2013, we found that there were no breaches of legal requirements.

Pilgrims Lodge Residential Home provides accommodation and personal care for up to 26 older people, some of whom are living with dementia. There were 23 people living at the home at the time of inspection. The accommodation is divided into two main living areas and people are free to choose where they wish to spend their time. Both areas have separate lounges and dining areas and there is a small kitchen available where people are able to get drinks and snacks.

The home is run by a registered manager who was present on the day of our visit. 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.

Risks to people’s safety were assessed and managed appropriately. Assessments identified people’s specific needs, and showed how risks could be minimised. The registered manager also carried out regular environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements as a result. We have made a recommendation about ensuring that everyone’s safety is taken into consideration when leaving the building in the event of a fire.

Staff had been trained in safeguarding adults and knew what action to take in the event of any suspicion of abuse. Relatives felt that Pilgrims Lodge Residential home was a safe place to live.

Comprehensive checks were carried out for all staff at the home, to ensure that they were fit and suitable for their role. Applicants were interviewed, two employment or character references were received, the reason for any gaps in their employment history were questioned and criminal record checks were undertaken.

Staffing levels were assessed monthly to make sure that there were enough staff on duty during the day and night to meet people’s individual needs.

Medicines were managed and stored appropriately. Staff received training in how to give medicines safely and their competency in administering medicines was checked to ensure that people received their medicines as intended by their doctor.

Meal times were relaxed and people were able to eat at their own pace. When people required support to eat, this was undertaken discreetly. People were given choices and staff understood people’s likes and dislikes and dietary requirements.

People’s health needs were assessed, such as if they were at risk of poor nutrition or developing pressure sores. Guidance was in place for staff to respond to and monitor people’s health needs, and professional advice was sought when it was needed.

New staff received a comprehensive induction, which included shadowing more senior staff. Staff were trained in areas necessary to their roles and also completed a wide variety of additional specialist training to make sure that they had the right knowledge and skills to meet people’s needs effectively.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards which apply to care homes. The manager understood when an application should be made and was aware of the recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. As a result DoLS applications were being made for people who lived in the home to ensure that they were not deprived of their liberty unnecessarily.

Staff were kind, caring and compassionate and treated people with dignity and respect. Staff knew people well and encouraged people to be as independent as possible. Staff understood people’s likes, dislikes and past histories, so they could support them to make decisions and engage them in conversation about topics that they enjoyed.

People’s care, treatment and support needs were clearly identified in their plans of care. Guidance was in place for staff to follow to meet people’s needs and it included information about people’s choices and preferences and past histories. Staff had knowledge of aspects of people’s life stories, which they were able to apply positively to the care and support they offered people on a daily basis.

People were offered an appropriate range of activities. An activities co-ordinator was employed to support people in a range of hobbies and activities. This included individual and group activities as well as spending time talking with people on an individual basis. Trips out into the community were arranged monthly and entertainers visited the home.

The manager had an open door policy and so was able to rectify any minor niggles before they became more serious complaints. Relatives said that they felt confident that if they made a complaint, that action would be taken to resolve it.

The home was well led. Relatives told us that the manager was approachable. She led by example and was clear about the aims and values of the home. Staff were motivated, had confidence in the management of the home and put the values of the home into practice on a day to day basis. Staff said that there was good communication in the staff team and it was a good place to work.

Systems were in place to review the quality of the service which included feedback from people who lived in the home, their relatives and staff. The results of these surveys were that people were satisfied with the care provided at the home. The registered manager and provider regularly assessed aspects of the service to monitor its quality.