Archived: Lake and Orchard Residential and Nursing Home

Updated 25 November 2020

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 site visit was carried out by one inspector. Two inspectors supported the inspection remotely by speaking to relatives and staff.

Service and service type

Lake and Orchard Residential and Nursing Home 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.

At the time of our inspection one of the units at the service was being used. The provider had taken the decision to close one of the units to refurbish it. One floor specialised in providing nursing care, the other provided residential care.

The service did not have a manager registered with the CQC. A manager was working at the service, they left the service following our site visit. We have referred to them as ‘the manager’ throughout this report. For services with a registered manager, this means 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 announced less than 24 hours prior to arriving at the service.

What we did before the inspection

We reviewed information we had received about the service and the information the provider had sent us since the last inspection. We sought feedback from the local authority, clinical commissioning group and professionals who work with the service. 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 the information we had into account when we inspected the service and made the judgements in this report. We also used all of this information to plan our inspection.

During the inspection

The inspection was carried out by conducting a site visit, speaking to relatives and staff remotely and reviewing a range of records remotely. We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with ten members of staff including the manager, the provider, nurse, care workers, housekeepers and a maintenance worker.

We reviewed a range of records. This included five people’s care records in part and three medication records. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 25 November 2020

About the service

Lake and Orchard Residential and Nursing Home provides nursing and personal care and support up to a maximum of 90 people. There are two separate units within the home divided into nursing care and residential care. At the time of our inspection, the provider was not using one of the units. At the time of this inspection 27 people were accommodated.

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

Despite service users with more complex having moved to alternative accommodation, we continued to identify risks relating to service users’ nutrition and hydration needs being met, poor pressure area care, failure to provide effective personal care, poor moving and handling practices, inadequate infection prevention and control and failure to support people appropriately to manage their health conditions.

For more details, please see the full report which is on the Care Quality Commission's (CQC) website at www.cqc.org.uk

Rating at last inspection and update:

The last overall rating for this service was inadequate (report published 19 August 2020). There were multiple breaches of regulation. We took action to require the provider to seek the express written permission of the Care Quality Commission (CQC) for any new admissions to the home. At this inspection not enough improvement had been made and the provider was still in breach of regulations. The service has been rated requires improvement or inadequate for the last eight consecutive inspections.

Why we inspected

We undertook this targeted inspection to check on specific, ongoing concerns we had about people’s eating and drinking, skin integrity, infection prevention and control and staffing. The overall rating for the service has not changed following this targeted inspection and remains inadequate.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safety, staffing, cleanliness and maintenance of the premises and safeguarding of people from abuse at this inspection.

Because of the serious concerns relating to people’s welfare and safety we have taken immediate enforcement action to prevent the provider from operating a regulated service at this location.