21 September 2022
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was carried out by three inspectors and one 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
Loganberry Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Loganberry Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 6 July 2022 and ended on 22 July 2022. We visited the location’s service unannounced on 6 July 2022 and 14 July 2022, including during non-business hours.
What we did before the 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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 9 May 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.
During the inspection
We spoke with 13 people to gain their views about the service. We also spoke with 26 people’s relatives or friends about their experience of the care provided for people. We spoke with 33 members of staff including care workers, senior care workers, care team leaders, the receptionist, the administrator, a laundry assistant, domestics, the gardener, the chef, the wellbeing and activities coordinator, the care manager, the deputy manager, the registered manager and the regional operations director. We observed people’s care and support in communal areas of the service. We reviewed a range of documents including 19 people’s care records, five staff employment files, multiple medication records, audits, policies and procedures. We also sought feedback from multiple visiting professionals to gain their views about the service.
21 September 2022
About the service
Loganberry Lodge is a residential care home providing accommodation and personal care to up to 141 people, including people living with dementia. At the time of our inspection there were 139 people using the service.
Loganberry Lodge accommodates people across six distinct units, each of which has separate adapted facilities. There are four units in the main Loganberry Lodge building, as well as the laundry and kitchen, and two units in a separate adjacent building known as Huckleberry.
People’s experience of using this service and what we found
Staff were kind and caring, but observations and people’s feedback told us there were not always enough staff effectively deployed to meet people’s full range of support needs. Care plans and risk assessments were in place to support staff to deliver care safely. Whilst staff understood safeguarding responsibilities, further analysis was required to support lessons learned. Medicines were given safely and as prescribed. Infection prevention and control measures were in place. Staff recruitment and oversight was safe.
We received mixed feedback about food available at Loganberry Lodge, including the impact of staff serving meals to a large number of people at the same time. There were some improvements required to ensure best use of communal spaces. Staff received training in a range of areas to meet people’s needs and were encouraged to gain qualifications. Records showed assessments had been carried out relating to people's mental capacity and records kept of best interests decision making.
There was positive feedback about the management of the service, including approachability and good communication. However, some issues we identified during the inspection had not been previously noted or resolved. Some systems and processes required further development to show how improvements were made and sustained from feedback or analysis of themes and trends. The service worked in partnership with other health and social care professionals.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of the effective key question, the service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. This was in relation to the care setting, as the service is large, which does not follow usual best practice for accommodating people with a learning disability.
However, the registered manager told us that there were a very small minority of people with a learning disability living at Loganberry Lodge who had been accommodated for a long time at the service, were settled and happy, and that their learning disability was not their primary care and support need. They also informed us they would not be admitting any new people with a learning disability to the service and would ensure they were up to date with the guidance above. Staff had also been assigned training on autism awareness and how to support a person with a learning disability.
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 good (published 4 March 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service. This included concerns in relation to high staff turnover, high level of accidents and incidents and the admission of people with a learning disability. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.
We inspected and found there was a concern, however, with the quality of food and the use or adaptation of the environment to meet people’s needs, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Loganberry Lodge on our website at www.cqc.org.uk.
We have made a recommendation about review of staffing levels and deployment, and a recommendation about the provision of food at Loganberry Lodge.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.