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Princess Lodge Limited Requires improvement

All reports

Inspection report

Date of Inspection: 6 February 2014
Date of Publication: 12 March 2014
Inspection Report published 12 March 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Not met this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 6 February 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

Care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare.

Reasons for our judgement

We assessed this outcome area in our last inspection in October 2013 and we found that the provider was not meeting this standard, we set compliance actions and told the provider to improve. We found that there was a lack of meaningful activities provided for people, there was limited staff interaction with people and attention had not always been given to people’s personal care.

At this inspection all of the people we spoke with were happy about the care and support provided. One person said, "The care is good." Another person said, "I'm very happy, I like it here."

We saw that people's needs were assessed and in most cases their care was delivered in line with their individual care plan. We looked at four people's care records. These included person centred care plans and risk assessments. These showed staff how to support the person to meet their needs. Staff spoken with knew how to support people to meet their needs and told us that if there were any changes to people's needs, they were informed of this at the beginning of their shift. However, the care plan that we looked at was not sufficiently detailed to ensure that staff knew how to safely support the person to meet their needs. We also observed that one person’s catheter care was not delivered according to their care plan. This meant that the person’s care was not provided in a safe way according to their care plan. We discussed this issue with the manager and the clinical lead at the time of our inspection who stated they would ensure that the care plan was updated so that staff had the information they needed. The manager also told us that they would investigate why the care plan had not been followed to ensure consistency in practice.

Records we sampled showed that people were referred to other healthcare professionals to ensure their healthcare needs were monitored and met. Three healthcare professionals told us that staff followed their instructions to ensure people's health and wellbeing. We observed that staff followed care guidelines that health care professionals had put in place. One person told us, "I’m happy here, the care is good. Staff always make arrangements for me to see my district nurse and GP.” Another person said, "The staff are brilliant, they look after us in a lovely way. They are always available for help and they call the doctor for you if you are unwell.” Some of the staff we spoke with told us about times when they had made appointments to see a doctor or made arrangements to see other health care professionals. This meant that people could get support with their health when needed.

We saw that people were dressed in individual styles that reflected their age, gender and the weather. People told us that the hairdresser visited the home once a week and we saw they visited at the time of our inspection. We saw that staff supported people who wanted to go to the hairdresser. However, we found that attention had not always been given to people's personal care. One person said, “I have a shower once a week, I’m given a certain day once a week for a shower but I would like to have more showers.” Another person told us, “I would like to have more showers than having it once a week only.” We saw a care plan that stated the person would have a shower once a week or when needed. However, we saw that this person was unable to express their needs. Staff spoken with told us that people were supported to have a full body wash each day and that all of the people were allocated one day a week to have a shower or bath. This was discussed with the manager who told us that they had started to address this and this included consulting relatives about how to support people’s individual needs and wishes. This meant that people's personal care needs were not always met which could impact on their wellbeing and self-esteem.

We saw that the group activity programme for each day was displayed on the board. We saw that some people enjoyed the group activit