Archived: Earls Lodge Care Home

We carried out the inspection with our five questions in mind; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found.

Is the service safe?

We found the systems for managing medications was still not safe in spite of warning notices having been issued following our inspection in June 2014.

Staff lacked knowledge about people's individual needs and this posed a risk of unsafe care.

Is the service caring?

We found staff were mostly kind and caring, although we observed they were still frequently too busy managing people's physical needs to provide emotional support. We saw some people were sad or anxious and staff did not take time to support them.

Is the service effective?

The service has not made sufficient improvements since the last two inspections to ensure people receive good enough care and people's basic care needs were still unmet.

Staff did not demonstrate understanding of their own roles or acknowledge the roles of others in providing care for people. Nursing staff lacked knowledge of the people to provide effective care for them.

Is the service responsive?

Sometimes staff were busy attending to people and others had to wait. A significant number of people did not have either their call bell or their drink accessible to them when they were in bed.

Is the service well led?

We found that although the provider had taken some action to address the management of the home since our last visit, this did not secure sustained improvement in the running of the home. We found staff deployment was not effective, staff morale was poor and there was evidence of instabilities in teamwork, all of which undermined people's care and welfare.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We carried out the inspection with our five questions in mind; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found.

Is the service safe?

We found the systems for managing medications was not safe. Staff lacked knowledge about people's individual needs and this posed a risk of unsafe care.

Is the service caring?

We found staff were kind and caring, although we observed they were frequently too busy managing people's physical needs to provide emotional support.

Is the service effective?

The service has not made sufficient improvements since the last inspection to ensure people receive good enough care. Staff did not always have enough knowledge of the people to provide effective care for them.

Is the service responsive?

We noticed a large proportion of people on the nursing unit were confined to bed and it was not always clear as to the reasons for this. Sometimes staff were busy attending to people and others had to wait. Some people told us they did not feel comfortable making their views known.

Is the service well led?

We found there were poor management structures to enable the effective maintenance of staffing levels and staff deployment. There was limited sustained support for the manager and there were no clear deputy arrangements in place.

We spoke with three staff and the acting manager as well as eight people who lived in the home. We spoke with four people's relatives who visited at the time of our inspection.

We found the home to be clean and staff followed appropriate infection control procedures.

We found care records were not clearly completed and information was not accurately recorded. Care was not delivered in line with people's care plans. This meant people were not sufficiently protected against the risks of receiving care that is inappropriate or unsafe.

Staff we spoke with showed they understood people's needs and we saw staff were caring and kind when managing people's care.

Most people we spoke with said they were happy, although two said they were not.

The relatives we spoke with told us they were satisfied with the standard of care for their family members overall.

We found medication was not managed in a safe way to ensure people were protected.

We saw some people engaged in activities, such as dominoes, listening to music and knitting, although some people told us there was not enough to do. We saw that people could not choose to have a shower because these facilities were out of use, although they had baths. The manager told us this was being addressed this month.

We saw there were enough staff to meet the people's needs, although some staff told us their work did not always allow enough time to chat with people. We observed how the home was meeting nutritional needs and we found that people enjoyed the food overall and they had enough to eat and drink in the day and night.

We saw that the manager ensured records were appropriately kept and systems were in place to monitor the quality of the provision for people living in the home.