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Princess Lodge Limited Requires improvement

All reports

Inspection report

Date of Inspection: 24 October 2013
Date of Publication: 4 December 2013
Inspection Report published 04 December 2013 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 24 October 2013, 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 talked with other authorities.

Our judgement

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

Reasons for our judgement

We looked at how people received safe and appropriate care that met their needs and protected their rights. We looked at five sets of care records and then spoke with some people who used the service and their relatives to see if their care and welfare needs were being met. We also spent some time observing how people were being cared for and how staff interacted with people.

People's needs were assessed and their care was delivered in line with their individual care plan. We looked at the records of three people who lived there. These included care plans that showed staff how to support the person to meet their needs. We saw care plans and risk assessments were in place that were relevant to people’s assessed needs and were reviewed regularly. This meant that care and support plans were up to date to ensure that people's needs would be met in line with the support that was needed. All staff spoken with knew how to support people so that their needs were met.

Records we sampled showed that people were referred to other healthcare professionals where needed to ensure their healthcare needs were met. One relative told us, “If my mum is unwell they would get the doctor”. We saw that staff interacted well with people using the service and treated people with kindness and dignity. One person told us, “They treat me nicely here and I like it”. Another person said, "I think the staff are alright, it is good". We saw that people were dressed in individual styles that reflected their age, gender and the weather.

We observed that several people who had high dependency needs, who could not walk independently and had no verbal communication skills had spent most of the morning sat in sofas asleep in the lounge. Most people were largely left to themselves with little or no staff interaction except on occasions when they were prompted to wake up for a drink or food. We saw staff did not take the opportunity to spend time to engage and interact with people. People were unable to inform staff if their needs were being met and had no opportunity to engage in meaningful activities.

We observed that attention had not always been given to people's personal care. Staff spoken with told us that they did not have time to support each person with a bath or shower every day and advised that most people were supported to have a bath at least once a week. One person told us, "I want to have a bath more often but I can’t." This meant that people's personal care needs were not always met as they wished which could impact on their well-being and self-esteem.

We observed a nurse administered medication to one person; they tipped the tablets on the table from the medication container and the nurse then picked up the tablets with their fingers and put them into the person’s mouth. When asked, the nurse told us that the person would not take medication if given in the container. There was no care plan or risk assessment to support this approach. This was discussed with the deputy manager who told us that they were not aware of the practice that had been used. The person who took the medication told us, “I can take my tablets on my own, at times I take them with tea or juice”. This showed that care was not delivered in a safe and appropriate way.

We saw that people generally sat around watching TV or observing passively. We only saw one activity, an exercise session taking place and only six people were engaged in that activity. No other activities were observed taking place. There was no information about activities planned for the home routinely provided, however, there was a poster informing of Halloween party planned for November and a poster showing planned events leading up to Christmas time. Three relatives we spoke with told us that the home could do with providing more activities. We saw that staff spent a lot of their time helping people with basic support needs but spent no time engaged with people in activities. Staff spoken with told us