Mendip Lodge

Mendip Lodge is a residential service providing personal care for up to 16 older people some of whom are living with dementia. The service consists of an adapted building, which includes individual bedrooms, communal spaces and an accessible outdoor space. At the time of our inspection there were 16 people using the service.

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

People and their relatives spoke positively of the service and told us they felt safe with the staff that supported them.

Systems were in place to assess risks to people, however we found some examples where risks had not been sufficiently assessed or documented.

Most areas of the service were clean and maintained, we identified some surfaces and equipment which were in need of repair or replacement.

People received their medicines safely and as prescribed. Appropriate staff recruitment procedures were in place and there were enough staff to keep people safe and meet their needs.

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.

Systems were in place to monitor the quality and safety of the service. There was a positive culture within the home and staff told us they felt supported. People and their relatives told us they were satisfied with the service.

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 April 2018). There was a targeted inspection since this inspection, published March 2021. This did not change the rating.

At our inspection published April 2018 we made a recommendation regarding medicines management. At this inspection we found improvements had been made in this area.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The home had followed current public health advice regarding visiting arrangements since the start of the pandemic but acknowledged the importance for people to have contact with their families and loved ones. Although there had been very few actual visits the staff team had helped people with making telephone calls and digital communications (video calls and text messaging for example). If a person had end of life care needs, they were able to have face to face visits from their family. Any visitors had to have a COVID-19 negative lateral flow test result (LFT) before being allowed to enter the home. The home did not have any waiting area therefore visitors had to be able to wait outside or in their car. The provider’s visiting policy was shared with each person’s family and they were updated as necessary regarding changes to this.

Any visitors were escorted to the person they were visiting and at the end of the visit they were escorted away from Mendip Lodge. They were not allowed to access any other parts of the home and entered the home via the best entrance, (patio door in bedrooms, side gate and rear of the home or main front door). After the visit, all touchpoints were cleaned and sanitised.

Staff entered the home via the front door. They were required to wear a face mask and use hand sanitising gel before entering. Hand sanitising gels were also placed in various places throughout the home, along with other personal protective equipment (known as PPE). Staff were being tested for COVID-19 each week three times – one full PCR test and two LFTs. Thirteen (of 17) staff had already had their first dose of the vaccine.

Visits from healthcare professionals such as GPs and community-based nurses and allied healthcare professionals were kept to a minimum. People’s health care needs were being met because the registered manager used telephone calls and emails to share information and gain advice. All 16 people had received their COVID-19 vaccination – 15 had already had the two doses with one just needing their second dose.

We looked around the home. All areas of the home were clean and tidy. Housekeeping hours had been increased since the start of the pandemic in order to maintain the cleanliness of the home. Extra attention had been paid towards touchpoints (door handles, furniture and toilet facilities), and the service had a sanitising machine. This machine was used when a whole room needed to be sanitised. The registered manager and senior care staff monitored work practice, the cleanliness of all areas of the home, and staff compliance with wearing PPE.

People continued to be supported with their social and emotional needs. The activities coordinator and care staff provided a programme of nostalgic, musical and physical activities in either group activities or one-to one. The registered manager had been exploring other ways for people to stay connected with their community. They had used video calls which were connected to the television so people could watch whilst they were out and about in the community, for example shopping.

Staff socially distanced from their colleagues and people as much as they were able. When they were delivering personal care, they wore their face masks and an apron as well. The staff supported people to leave space between themselves and others when in communal areas, to the best of their ability. The home has three reception rooms therefore there was plenty of space for people to spread out.

The home had admitted three people since the start of the pandemic; two people from their own home and one from another care home. The person had to have had a negative COVID-19 result before admission and was then isolated in their bedroom for a 14-day period. If a person was hospitalised, upon return to the home, these procedures would be followed.

If the home had an outbreak of COVID-19, people would have to be isolated in their bedrooms. The registered manager explained there could be a need for 1:1 care if a person could not remember to self-isolate.

Infection prevention and control training was part of the provider’s mandatory training programme, but extra training had been delivered because of the pandemic. This had included hand hygiene, donning and doffing of PPE and LFT device training. The registered manager observed the staff using PPE and completed competency assessments.

The provider had updated their infection prevention and control policies, this now included Business Continuity Procedures and Pandemic Recovery Planning. The registered manager had regular contact with the local authority COVID team and kept abreast of any changes in policy provided by Public Health England, CQC and the Department of Health and Social Care.

Mendip Lodge as a care home provides accommodation and personal care to people as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home can accommodate 16 older people, some of whom are living with dementia. On the days of our inspection there were 14 people and a new admission into the home on our second day making it 15. The home is a detached property set out over two floors and is situated in a residential area of the village of Claverham.

The service has a registered manager. This 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.

All the people we spoke with said they felt safe at Mendip Lodge. Staff supported people to be as independent as they wanted to be and protected them from risks to their safety. Staff were trained in protecting people from abuse and understood their responsibilities to keep people safe.

There were enough staff to keep people safe and to support them with activities. The provider's recruitment procedures ensured as far as possible that only staff suited to work at the service were employed.

People received their medicines at the right times but the arrangements for the management of medicines were not always safe. Medicine records were not accurate and some medicines had gone missing.

The premises were clean and hygienic. Staff practised effective infection control.

People's choices were respected and they were not restricted in any way. People spent their time the way they wanted. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. The service ensured peoples human rights were protected and their cultural needs promoted.

Staff completed a range of training to help ensure they had the skills and knowledge they needed to provide effective care. The registered manager and staff had a working knowledge of the Mental Capacity Act 2005 and understood the importance of people consenting to their care.

People had a choice of meals which they said they enjoyed. Mendip Lodge was decorated to people's taste and their personal accommodation was personalised.

People told us the staff were caring and kind. Staff communicated with people in a positive and compassionate manner and in ways that met people's communication needs.

People and their relative’s views were sought and acted upon. People were treated with dignity and their privacy was respected. People consistently experienced care and support that was planned to meet their present and future needs.

People experienced positive outcomes as a result of the support they received. The registered manager and staff shared the same vision which placed people using the service at the centre of decision making.

The service worked closely in partnership with other services to support people to achieve their aspirations. The registered manager worked on making people feel the service was their home.

Overall people we spoke with who used the service were happy with the service they received. Comments included; 'I am treated with respect', 'I am happy here' and 'I am very happy with my care here, staff are very nice'. People we spoke with were aware of how to make a complaint should the need arise.

Staff we spoke with told us they felt supported by the management team and received the training required to support people that used the service. Comments included; 'we are a good team, we support each other just like a family extension'. 'We are proud of the care we can provide here'.

We found the provider had systems in place to effectively monitor the service provided and gain people's views on the quality of the service.