Yew Tree Lodge

Updated 27 October 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

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Yew Tree Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that 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. However, the specific date of the inspection was not disclosed to the provider.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 this into account when we inspected the service and made the judgements in this report. We asked the registered manager to provide us with electronic copies of various records such as recruitment records, care plans, complaints, surveys and staff training records. We obtained feedback from five people, four staff members, three healthcare professionals and from four relatives of people living at Yew Tree Lodge.

We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records. These included a variety of records relating to the management of the service, including health and safety records, accidents/incidents logs and records related to management of medicines.

After the inspection

We received further feedback from eight members of staff and one healthcare professional. We continued to seek clarification from the provider to validate the evidence found.

Updated 27 October 2020

About the service

Yew Tree Lodge is a residential care home that can provide the regulated activity of personal care to a maximum of 16 people. Three of the beds are crisis beds, with the remaining 13 residential (long term stay). The service provides care to people who have been diagnosed with mental health issues. There were 10 people using the service on the day of the inspection. Many of the individuals have experienced periods of stay in hospital and require a level of support prior to transitioning to community-based living.

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

Care plans and risk assessments did not contain adequate information for staff to know how to support people and manage their behaviours safely. People, their relatives and staff told us that staff were not always trained well enough to meet people’s specific needs of. Staff told us they did not always feel supported by the registered manager and they were not always listened to while raising concerns with the management team. Staff told us they were unable to spend sufficient time with people. The provider failed to make the improvements we had required at our January 2019 inspection and therefore people remained at risk of harm. The provider failed to ensure there was effective management of the service. There was a lack of effective systems to ensure risk management and oversight of the quality of care people received.

There were procedures in place to prevent visitors to the home from spreading Covid-19 at the entrance and on entering the premises. Medicines were managed safely, and people received their medicines as prescribed. Staff understood what action to take if they suspected somebody was being harmed or abused. Recruitment procedures ensured appropriate staff were employed to work with people and keep them safe as much as possible. The registration regulations were met by the registered manager. The Commission were sent notifications where required.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 11 April 2019).

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced focused inspection of this service on 29 January and 19 February 2019. Two breaches of legal requirements were found. The service needed improvement because of low quality of risk assessments, gaps in staff training and staff not being trained in specialist areas in which they were delivering support.

We undertook the latest focused inspection to check whether the service had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Yew Tree Lodge on our website at www.cqc.org.uk.

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 two breaches in relation to safe care and treatment and good governance at this inspection.

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