Archived: West Lodge Care Home

At our last inspection we rated the service as good overall with improvements required in the Effective domain related to implementing care recommendations made by visiting professionals. We found that improvements had been made and maintained in this respect.

At this inspection we found the evidence continued to support the rating of good with some improvements required for people’s consent. However there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

.

At this inspection we found the service Good overall.

People were supported to have maximum choice and control of their lives however some restrictions on their freedom had not been considered.

Staff knew how to recognise abuse and understood the actions they should take to report concerns. There were risk assessments and management plans in place to support people safely. Medicines were managed to ensure people had the treatments which were prescribed for them. There were sufficient suitably recruited, trained and supported staff who were aware of infection control requirements to protect people from harm.

People were provided with food and drinks which met their needs and cultural preferences. People’s health and wellbeing needs were monitored and other healthcare professionals contributed to their care whenever necessary.

People were treated in a kind and caring way and were happy with the support they received from staff. They and their relatives were involved with reviewing their care. People were encouraged to be independent and make choices on how to spend their day. People’s privacy and dignity was recognised and upheld. People were supported to maintain their preferences related to their ethnicity, language, culture and religious beliefs. There were activities provided to people who enjoyed them.

There were systems in place to monitor the quality of the home and action was taken to drive improvements. People were complimentary about the management of West Lodge Care Home. People and staff and were given opportunities to share their views of the service. There were audits in place to review the care and identify shortfalls. The registered manager was fulfilling the requirements of their role

Further information is in the detailed findings below

West Lodge is registered as a care home with nursing and provides accommodation up to 27 older people over three floors. At the time of the inspection there were 22 people using the service.

On the day of our inspection there was a registered manager in place. 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.

All the people we spoke with told us they felt safe. Staff demonstrated a good awareness of their role and responsibilities regarding protecting people and were confident a member of the management team would deal with any concerns reported.

Sufficient staff were on duty to meet people’s needs. Staff were recruited through safe recruitment practices. Medicines were safely administered and stored.

Staff received an induction, training and supervision and felt supported by the management team. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink. People had access to healthcare services when required but advice from external professionals was not always followed.

Staff were caring and people felt listened to. People received personalised care by staff that protected their privacy and dignity. People and their relatives where appropriate were involved in decisions about the care and support provided. Relatives regularly attended reviews of their family members. Information was available for people about how to access and receive support from an independent advocate..

People had the opportunity to take part in a variety of activities. Care plans were developed with people, their relatives or advocates as appropriate. Staff knew people’s likes and dislikes. Complaints were dealt with in a timely manner.

There were links with the local community and people accessed local services. People, relatives and staff said the management team were approachable and listened to them. People and their relatives were involved or had opportunities to be involved in the development of the service. There were systems in place to monitor and improve the quality of the service provided.

.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

This was an unannounced inspection. We spoke with three people who lived at the home. We could not speak with some people due to their needs. We also spoke with the manager and three other members of staff. We looked at written records, which included copies of people's care records, medication systems, staff personnel files and quality assurance documentation.

Is the service safe?

We found the home to be warm and clean. The accommodation was adapted to meet the needs of people living there and was appropriately maintained.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. People were protected by safe recruitment practices. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

The home was well known in the community for its diversity and its atmosphere. People we spoke with were satisfied with the care and support they received and had chosen to live at the home.

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care.

Is the service caring?

We spoke with three people who used the service. We were unable to speak with other people due to their communication needs. One person said to us, "It's very, very good. I used to come here to visit and now I choose to live here. The food is good and my bedroom is comfortable." Another person said to us, "The staff are kind and respectful to me. It's much better than struggling at home." Another person said, "They make me feel comfortable."

We observed a positive rapport between staff and the people who lived at the home. We witnessed the care and attention people received from staff. Staff were friendly, were attentive to people's needs and people were treated with dignity and respect.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.

Three staff members told us that the manager was approachable, as were all their colleagues, and they would have no difficulty speaking to them if they had any concerns.

Is the service well led?

Three staff members said that they felt well supported by the management team and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

We found people who used the service were respected and involved in their care. A person who used the service told us, 'The care here is very very good. If you ask them they do anything for you.'

We found people were provided with a varied and nutritional diet. A person who used the service told us, 'We have a mixture of English, Caribbean and Asian food. I like them all.' A staff member said, 'I try to get people to eat well, I beg people to eat well.'

We found people were protected from abuse and from the risk of abuse. A person who used the service told us, 'I feel quite safe and quite happy here. If I didn't I would call the nurse.'

We found there were sufficient and suitable staff employed who were supported through training. A person who used the service told us, 'They are very good staff. They are always there when you want them. At night I ring the buzzer if I need anything, and they are always there quickly.' Another person told us, 'I trust these staff, they know how to meet my needs.'

We used a number of different methods to help us understand the experiences of people using the service, because they had complex needs which meant not all were able to tell us their experience. We spoke to friends and relatives of three people, who told us they were happy with the service provided.

One person told us their relative always looked comfortable. Another person said, 'I visit at all different times of the day, no matter when I arrive there are always staff supporting people.' We saw staff supporting people in different way to meet their individual needs.

There were systems in place to check the nurses' personal identification numbers (PIN).

The home was less cluttered and relatives told us they had seen an improvement. There was no offensive smell when we entered the home, all the non essential equipment had been removed from the areas we identified at our last visit.

All repairs that were identified at our visit in July had been completed and signs had been put up to notify people the floor were uneven. There were risk assessments in place.

We looked at the care files for six people and found that improvements had been made. Staff had completed care plan training and the records were more detailed and held confidentially and stored in an office, accessible only by staff.