21 and 24 July 2015
During a routine inspection
The inspection was unannounced and took place on 21 and 24 July 2015.
Lavender Lodge is a residential care home for up to 20 older people, many of whom were living with dementia. At the time of our visit there were 17 people living at the home.
The service had a registered manager. 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.’
We identified issues around the recording of medicines as medicine administration records (MAR) did not always show whether people had received their medicines or not. The provider had arrangements in place for the safe ordering, and disposal of medicines.
Consent to care and treatment was not always sought in line with legislation and guidance. Where people did not have capacity to consent, appropriate processes were not always followed to protect their rights.
Although the provider had a quality monitoring system in place this system did not cover essential areas such as the auditing of accidents and incidents or medicines. Therefore some areas of concern we identified at this inspection had not been identified by the registered manager or provider.
People and those that mattered to them told us they were satisfied with the care they received. One relative told us “this place deserves a pat on the back”. People felt safe living at the service in terms of not being harmed and being able to raise concerns with staff. Staff knew what action to take if they suspected abuse and had received training in keeping people safe. Checks were carried out to ensure that new members of staff were safe to work at the service. There were enough staff to keep people safe and ensure their needs were met. Risk assessments were in place and regularly reviewed to help protect people from harm. Where someone was identified as being at risk we saw that actions were identified on how to reduce the risk and referrals were made to health professionals as required.
Staff received the training they required to ensure that people were kept safe. Staff supervision had recently been introduced by the manager as previously staff had received informal training which involved observing their day to day practice.
People had enough to eat and drink and dietary requirements where respected. We spoke with staff about a person would need a diabetic diet and they told us “we get special bits in so if they sees residents eating she doesn’t feel left out”. Staff regularly offered people a variety of hot and cold drinks. One person’s care plan told us they needed encouragement to ensure they ate enough. However during our observation we saw this person eat a small amount of their meal and staff did not offer encouragement to try to eat a little more. People had access to healthcare professionals and all their appointments were recorded in a diary. Staff supported people to attend their healthcare appointments.
There was an open and friendly atmosphere at the home and visitors were welcomed and made to feel relaxed. People were treated with kindness and respect and were involved in deciding how they wished to spend their time. Staff were quick to notice when they required assistance or reassurance.
People were cared for by kind and caring staff who knew their needs and preferences. A member of staff told us “I like to talk to someone to get to know them. We sit and chat with the residents. You don’t realise how much they’ve done until you talk”. People were encouraged to make decisions and remain as independent as possible. People’s privacy and dignity were promoted and they were treated with respect by staff.
Care plans provided staff with comprehensive information about people and how they wished to be supported. Daily records were kept for each person and staff completed information in an individual diary. The life history information contained within people’s care plans at times was limited, however this information was dependent on information provided by relatives. Where possible people or the people who mattered to them where involved in planning their care and supported to be as independent as possible.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of the report.