Archived: Garden Lodge Care Home

The inspection was unannounced and took place on the 11 and 12 July 2018. At the last inspection carried out in 2016, we identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because of staff using inappropriate moving and handling techniques. At this inspection we found that improvements had been made and staff had attended training. At this inspection on day one we identified that the infection control procedures in the home required attention. The registered manager initiated actions immediately.

Garden Lodge care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to accommodate up to 48 people, there were 46 people living at the home at the time of our inspection. Garden Lodge is situated in Netherley, Liverpool and has parking facilities at the rear of the home. The service is situated across one floor that is divided into two units with an adjoining garden. The home primarily provides care and support for older people and people living with dementia and physical disabilities.

The service is run by a manager who is registered with the CQC. 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.

People were protected from the risk of abuse. Staff had received training in safeguarding vulnerable people and knew how to report their concerns to the local authority.

People were supported to take their medication as prescribed. Medication audits were carried out on a monthly basis and also by a pharmacist to help identify and address any issues. Medication records were being signed appropriately by staff and controlled drugs were being stored securely as required by law.

Staff had received the training they needed to carry out their role effectively. New staff were supported to gain the necessary skills and qualifications and shadowed experienced staff to gain knowledge of the role. Staff spoken with and records seen confirmed training had been provided to enable them to care and support the people with their specific needs. We found staff were knowledgeable about the care and support needs of people in their care. There was a happy, warm atmosphere in the home. We saw that individuality was encouraged and supported and people were able to express themselves in the way that they chose and that their well-being was enhanced by this support.

Everyone we spoke with, without exception, spoke positively about the registered manager and the staff. We observed positive interactions between people and staff using the service.

There was a complaints procedure at the home and we were told by people and relatives that they were aware of how to make a complaint and all would talk to the manager. There was information on how to make a complaint on a notice board in the reception area.

Care plans were person centred and completed with the people who lived in the home, their family members and any professonals involved in their care. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected and at all times the least restrictive option was taken.

People were supported to maintain good health and the registered manager ensured staff accompanied people to routine appointments. Care records showed that staff sought the input of health and social care professionals when needed. We spoke to two visiting health professionals during our inspection who told us that staff ‘go above and beyond’ and were prompt in recognising any deterioration in health or changes to people’s support needs.

People told us they enjoyed the food served at the home. Care records showed staff had given consideration to people’s nutritional needs and diabetic diets were catered to.

We identified that some governance procedures to assess and monitor the quality of the home were not documented. The registered manager was clearly very 'hands on' in their approach and took an active role in the daily lives of all the people using the service but admitted this sometimes meant that paperwork was not always checked effectively. The registered manager acknowledged that a more robust infection control monitoring and audit system was required as an area for further development and had initiated contact with the local authorities infection control team.

Further information is in the detailed findings below

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. The service had a manager in post who was going through the registration process with Care Quality Commission.

We found breaches of Regulation 12 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We observed unsafe moving and handling practices and which were not in accordance with the documented risk assessments.

The Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) had been adhered to in the home. The manager told us of the people at the home who lacked capacity and that the appropriate number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care.

The staff in the home knew the people they were supporting and the care they needed. We observed staff to be kind and respectful.

People who lived at the home and staff told us that the home was well led and staff told us that they felt well supported in their roles. The registered manager was a visible presence in and about the home and it was obvious that they knew the people who lived in the home extremely well.

Staff were recruited safely and there was sufficient evidence that staff had received a proper induction or suitable training to do their job role effectively. The majority of staff had been supervised and appraised.

The provider had systems in place to ensure that people were protected from the risk of harm or abuse. There were policies and procedures in place to guide staff in relation to safeguarding adults.

People told us that that since the manager had been appointed there had been significant improvements in the service.