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Archived: Stonedale Lodge Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 March 2016

Situated in the Croxteth area of Liverpool, Stonedale Lodge Residential and Nursing Home offers personal and nursing care for one hundred and eighty people. The provider is BUPA Care Homes (CFC Care) Ltd. Accommodation is provided on six units, each with 30 beds. Dalton and Anderton units provide personal care for people living with dementia, Clifton unit provides nursing care for people living with dementia, Blundell and Townley provide general nursing care and Sherburne unit provides general personal care.

This unannounced inspection of Stonedale Lodge Residential and Nursing Home took place over three days from 3 – 5 February 2016. At the time of our inspection 117 people were living in the home.

There was a registered manager in post. 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.

At the previous inspection 9-12 June 2015 the provider was found to be inadequate and the service was placed in ‘special measures’ by CQC. We found breaches of regulations in all key questions we inspect (safe, effective, caring responsive and well led).

The purpose of 'special measures' is to:

Ensure that providers found to be providing inadequate care significantly improve.

Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in 'special measures' are inspected within six months of the publication of the inspection report.

At this inspection we found improvements had been made. This meant the service was no longer rated inadequate and could be removed from 'special measures' by the Care Quality Commission (CQC).

Following the inspection in June 2015 we also issued an urgent statutory notice requiring the provider not to admit any further people to Stonedale Lodge Residential and Nursing Home. In light of the improvements we found at the February 2016 inspection we have now lifted this statutory notice which prevented people being admitted to the service.

The breaches of regulations we identified in June 2015 were now met. We have revised the rating for the home following our inspection though the service cannot be rated as ‘good’. To improve the rating to ‘good’ would require a longer term track record of consistent good practice.

Following the last inspection staffing numbers were found to be adequate so that people were supported safely; thus promoting better consistency of care and improving staff morale Our observations and feedback from people who were living at the home and relatives indicated people were now supported by sufficient numbers of staff to provide safe care and support in accordance with individual need.

The staff we spoke with were aware of what constituted abuse and how to report an alleged incident. The registered manager demonstrated they were keen to liaise and work with the local authority safeguarding team and agreed protocols had been followed in terms of reporting and ensuring any lessons had been learnt and effective action had been taken.

We found that the home was operating in accordance with the principles of the Mental Capacity Act 2005 (MCA). Although care practices were consistent and this indicated staff were generally following good practice we found some hesitancy around fully understanding the use of the ‘two stage mental capacity assessment’ and when this should be used.

We made a recommendation in the report regarding this.

Staff involved people in discussions about their care an

Inspection areas

Safe

Requires improvement

Updated 17 March 2016

The service was safe.

On this inspection the changes being made would suggest the service was actively addressing the concerns we found at the last inspection. We have revised the rating from �inadequate� to �requires improvement� for this key question based on improvements made. To improve the rating to �good� however would require a longer term track record of consistent good practice.

People we spoke and relatives told us they thought the home was safe.

There were sufficient numbers of staff on duty to help ensure people were cared for in a safe manner.

Staff recruitment procedures were robust to ensure staff were suitable to work with vulnerable people.

People living at the home were protected against the risks associated with the use and management of medicines.

Staff were aware of what constituted abuse and told us they would report an alleged incident.

Risk assessments were in place to support people and to protect them from unnecessary harm.

Standards for monitoring the control of infection were in place. We found the home to be clean at the time of the inspection.

Effective

Requires improvement

Updated 17 March 2016

The service was effective.

On this inspection the changes being made would suggest the service was actively addressing the concerns we found at the last inspection. We have not revised the rating from �requires improvement� for this key question based on improvements made. To improve the rating to �good� would require a longer term track record of consistent good practice. We have also made a recommendation around the MCA and therefore the rating cannot be �good�.

Staff followed the principles of the Mental Capacity Act (2005) for people who lacked capacity to make their own decisions. Staff were generally following good practice around this though there were some hesitancy around fully understanding the use of the �two stage mental capacity assessment� and when this should be used.

People had access to external health care professionals to monitor their health and wellbeing.

People�s health care needs were monitored effectively to ensure their care needs were met.

People�s nutritional needs were monitored by the staff. Menus were available and people�s dietary requirements and preferences were taken into account.

Staff told us they were supported through induction, regular on-going training, supervision and appraisal.

Caring

Good

Updated 17 March 2016

The service was caring.

We have revised this rating from �requires improvement� to �good� based on the improvements made.

We observed good interactions between staff and people they supported. Staff support was given in a respectful and caring manner.

Staff demonstrated a good knowledge of people�s individual care, their needs, choices and preferences. This helped to ensure people�s comfort and wellbeing.

People and relatives we spoke with told us the staff consulted them about their care and decisions around daily living.

People�s dignity was observed to be promoted in a number of ways during the inspection. Dignity champions were appointed to monitor standards of privacy and respect afforded to people living in the home.

Responsive

Requires improvement

Updated 17 March 2016

The service was responsive.

On this inspection the changes being made would suggest the service was actively addressing the concerns we found at the last inspection. We have revised the rating from �inadequate� to �requires improvement� for this key question based on improvements made. To improve the rating to �good� however would require a longer term track record of consistent good practice.

Staff we spoke with had a good understanding of people�s needs and how people wished to be supported.

We saw care was personalised, taking into account how people wished to be supported to meet their individual needs.

Care documentation was updated to reflect any change in care or treatment to ensure accuracy of the information held.

A process was in place for managing complaints. People told us they would speak with the registered manager and/or unit managers if they had a concern.

Arrangements were in place to seek the opinions of people and their relatives, so they could share their views and provide feedback about the home.

Well-led

Requires improvement

Updated 17 March 2016

The service was well led.

On this inspection the changes being made evidenced the service was actively addressing the concerns we found at the last inspection. We have revised the rating from �inadequate� to �requires improvement� for this key question based on improvements made. To improve the rating to �good� however would require a longer term track record of consistent good practice.

The home had a registered manager in post. We received positive feedback from the staff, people who lived at the home, relatives and health professionals about the leadership and overall management of the service following the appointment of a new registered manager.

Quality assurance systems and audits were in place to monitor performance and to drive continuous improvement.

The culture of the home was open and transparent and staff told us staff morale had improved.

Staff were aware of the home�s whistle blowing policy and said they would not hesitate to use it.