Background to this inspection
Updated
14 December 2019
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.
Inspection team
The inspection was carried out by two inspectors.
Service and service type
Nickleby Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service about their experience of the care provided. We spoke with four members of staff including the registered manager.
We reviewed a range of records. This included two people’s care records and medication administration 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. The registered manager sent us training information and evidence of recruitment references for one staff member.
Updated
14 December 2019
About the service
Nickleby Lodge is a residential care home providing accommodation and personal care for up to 10 people with a mental health condition. People receive care in one adapted building that had a communal lounge and kitchen facility. At the time of our inspection five people were living at the service.
People’s experience of using this service and what we found
People were at risk because of a lack of staff, particularly at night, available to care for them. People told us there were times they could not go out when they wished due to staff shortages. Although people received the medicines they required, improvements were needed to medicine practices to ensure they were safe. People lived in an environment that was not well maintained or clean and as such could present a potential risk to them. People were cared for by staff who did not always feel supported or have the opportunity to discuss their role with their line manager. 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. However, despite staff following the principles of the Mental Capacity Act 2005, they did not have a good knowledge of the code of conduct with regard to this.
Despite quality monitoring audits taking place, these were not robust and had not led to an improved service for people. The service did not give people the opportunity to achieve goals and aspirations.
People were assisted to remain healthy and access health professional involvement when needed. They told us they were cared for by kind and caring staff and this was evident to us during our inspection. People said they could attend activities outside of the service and they liked living at Nickleby Lodge. People said they felt safe and they knew who to speak to should they have any concerns. People were supported to choose their meals and had input suggestions into the general running of their home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (report published 6 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvement. We found three breaches of regulation. Please see the Safe, Effective and Well-Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.