Archived: The Lodge Care Home

Updated 26 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service against two key questions that we ask. Is it safe? Is it well-led? This focused inspection took place on 1 August 2017 and was unannounced. The inspection was conducted by one adult social care inspector.

Prior to the inspection we reviewed all of the information we held about The Lodge Care Home, including any statutory notifications that the provider had sent us and the additional safeguarding information we had received. Notifications are made to us by providers in line with their obligations under the Care Quality Commission (Registration) Regulations 2009. These are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of.

Additionally, we spoke with staff from South Tyneside Council’s contracts monitoring team and safeguarding team and from South Tyneside Clinical Commissioning Group (CCG). We used this information to help with the planning of our inspection.

During the inspection we spoke with four people who used the service. We spoke with five members of staff, including the registered manager, the deputy manager, two senior care workers and a care worker. Four representatives from the provider’s organisation were also visiting the home during the inspection and we were able to talk to them about their involvement and the governance of the service. We reviewed a range of care records and the records kept regarding the quality and safety management of the service. This included looking at three people’s care records in depth, eight people’s medicine administration records and three people’s food and fluid intake charts.

Updated 26 September 2017

We carried out an unannounced comprehensive inspection of this service on 11 and 13 April 2017 and rated it ‘Good’. After that inspection we received some concerns in relation to the safety and governance of the service. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Lodge Care Home on our website at www.cqc.org.uk.

The Lodge is a residential care home situated in South Shields. It provides accommodation and personal care for up to 53 people with physical and mental health related conditions. The service does not provide nursing care. At the time of our inspection 44 people used at the service.

There was an established registered manager in post who was employed to manage the service and had been registered with the Care Quality Commission (CQC) to provide regulated activities since October 2010. A registered manager is a person who has registered with the CQC 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.

In May 2017, CQC received some information of concern from a relative of a person who used the service. The concerns related to general care issues which we shared with the local authority safeguarding team and contracts monitoring team. Subsequently the local authority conducted an unannounced visit to the service and fed back some further concerns to us at a multidisciplinary information sharing meeting. These concerns related to several aspects of the service including updating care plans and assessments, daily recording, communication and governance.

Following the local authority’s visit to the service, a multi-agency decision was made to place the service under South Tyneside Council’s ‘Provider Concerns’ process. This meant the provider had to produce an action plan to address the issues which would be closely monitored by the local authority contracts monitoring and safeguarding teams. The provider also agreed not to admit any new residents for a period of time.

Additionally, in June 2017 we received an adult protection alert from the Fire Service, following an incident they had attended when one person was accidentally locked in a bedroom.

A follow up visit was conducted by the local authority on 26 July 2017 where improvements were noted but some actions were yet to be completed or sustained. It was acknowledged that new processes had been implemented to improve the service and reduce the identified risks. However, the local authority raised further concerns about safety. This related to medicine management, people using a wheelchair without the lap strap fastened and people not wearing appropriate footwear.

The CCG reported no additional concerns had been raised by their staff and the link GP for the home had provided positive feedback about better communication. The local district nursing team had also shared positive feedback and had noted a more proactive approach being taken by the staff to monitor and manage health conditions.

The improvements and the additional matters were discussed at a further multi-disciplinary meeting and a decision was made to remove the service from the ‘Provider Concerns’ process as the level of risk was considered to be minor. It was agreed by the multi-disciplinary team that the home’s ongoing improvements should be closely monitored in line with the local authority’s quality assurance programme.

CQC used all of this information to inform their decision to conduct an urgent focussed inspection to check the safety and governance of the service.

At our inspection, we found that the service had made further progress with the newly implemented processes and procedures. We discussed the additional safety matters with the registered manager and were satisfied with their explanation and the action they had taken to reduce risks.

Overall medicines were managed safely; however we found some discrepancies with the records related to topical medicines, such as prescribed creams and medicines which are required ‘as and when needed’ such as pain relief. We have made a recommendation about this.

The governance of the service was robust. Additional audits and checks of the service had been implemented by the provider and registered manager. We were able to review the most recent documentation which demonstrated that the senior management team had thorough oversight of the service and that they had been proactive with their response to the concerns raised.