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Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 May 2017

At our inspection on 24 October 2016 we found several breaches of legal requirements. The systems for the management of medicines were not safe and did not protect people using the service and there was a lack of planning and assessment of nutritional and hydration requirements of people.

There were issues with staff training. It was not up to date and the system for the administration of staffing levels was not effective. There were also concerns around cleanliness in the home and staff treating residents with appropriate respect.

In addition, people’s mental capacity had not been assessed in line with the Mental Capacity Act 2005 (MCA) when dealing with applications to restrict people’s liberty and there was a lack of understanding around the implications of this legislation.

We asked the provider to make improvements in all of these areas and they kept CQC informed of the changes that had been made.

At this inspection we found that significant improvements had been made in these areas. We found that people were treated with dignity and respect and the home was clean and tidy. The provider was acting in accordance with the MCA, proper assessments were being made around food and hydration and action had been taken to support people with sufficient numbers of well-trained staff. However, we still had concerns about the management of medicines and this has resulted in a continuing breach of legal requirements. You can see what action we told the provider to take at the back of the full version of the report.

Lostock Lodge is a care home located near Preston in the county of Lancashire. The home is registered to provide accommodation and support for up to 32 people and cares for elderly people including those living with dementia. At the time of our inspection 28 people were using the service.

There was a registered manager in place who had been registered since 14 December 2010. 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 using the service said they felt safe and that staff treated them well. There were enough staff on duty and deployed throughout the home to meet people’s care and support needs. Safeguarding adult’s procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. Appropriate recruitment checks took place before staff started work.

We found that people and their relatives, where appropriate, had been involved in planning for their care needs. Care plans and risk assessments provided clear information and guidance for staff on how to support people using the service with their needs. There was a range of appropriate activities available for people to enjoy. People and their relatives knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

The manager and provider conducted regular checks to make sure people were receiving appropriate care and support. The provider took into account the views of people using the service, their relatives and staff through meetings and surveys. The results were analysed and action was taken to make improvements at the home. Staff said they enjoyed working at the home and received appropriate training and good support from the manager.

Inspection areas

Safe

Requires improvement

Updated 4 May 2017

The service was not always safe.

Although medicines were securely stored, they were not always safely administered or accurately recorded.

People told us they felt safe and well cared for. There were arrangements to deal with emergencies and staff were aware of signs of abuse and what action

they should take.

There was a whistle-blowing procedure available and staff said they would use it if they needed to.

There were enough staff deployed within the service and appropriate staff recruitment procedures were in place.

There were appropriate assessments in place to support people where risks to health had been identified. Checks were carried out on equipment and the premises to reduce risk.

Effective

Good

Updated 4 May 2017

The service was effective.

Staff had completed an induction and supervision when they started work and received training relevant to the needs of the people using the service.

The manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards and acted

according to this legislation.

People told us they enjoyed the food and that there was a good choice available. We saw that people’s fluid and food intake was monitored and staff encouraged people to eat and drink with appropriate action taken if people lost weight.

People had access to a wide range of healthcare services to ensure their day to day health needs were met.

Caring

Good

Updated 4 May 2017

The service was caring.

Staff were caring and spoke with people in a respectful and dignified manner.

People’s privacy and dignity was respected.

Staff knew people well and were aware of their preferences and routines.

People and their relatives were involved in making decisions about their day to day care.

Responsive

Good

Updated 4 May 2017

The service was responsive.

People’s needs were assessed and care files included detailed information and guidance for staff about how their needs should be met.

There were activities and entertainment for people to participate in and staff encouraged participation consistent with individual’s needs and abilities.

People knew about the home’s complaint’s procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

Well-led

Requires improvement

Updated 4 May 2017

The service was not consistently well-led.

Audits and checks were not effective in ensuring that people were protected from medicine's errors.

There were other appropriate arrangements in place for monitoring the quality and safety of the service that people received.

Staff said they enjoyed working at the home and they received good support from the provider and registered manager.

There was an out of hours on call system in operation that ensured that management support and advice was available to staff when they needed it.

The manager and provider carried out checks at the home to make sure people were receiving appropriate care and support.