• Care Home
  • Care home

Archived: Clarence Lodge

Overall: Inadequate read more about inspection ratings

49-50 Clarence Road, Gorleston, Great Yarmouth, Norfolk, NR31 6DR (01493) 662486

Provided and run by:
Clarence Lodge (Great Yarmouth) Limited

Latest inspection summary

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Background to this inspection

Updated 13 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector, one inspection manager, and one Expert by Experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The service did not have a manager registered with the Care Quality Commission. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The service had a new manager who had been in post since July 2019. They had applied to be registered with the Care Quality Commission, and this was still in progress.

Clarence Lodge 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service, and one relative about their experience of the care provided. We carried out observations of people receiving support and staff interactions. We spoke with the manager, provider, and three members of care staff who worked at the service. We

looked at six care records in relation to people who used the service. This included medicines records. We also looked at three staff files, as well as records relating to the management of the service, and systems for monitoring quality.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with two professionals who regularly visit the service.

Overall inspection

Inadequate

Updated 13 December 2019

About the service

Clarence Lodge is a residential home registered to provide accommodation and personal care to a maximum of 28 people. At the time of our inspection, 11 older people were living there, some of whom were living with dementia. The home accommodates people across a ground, first and second floor.

People's experience of using this service and what we found

Most of the people we spoke with were accepting of the service provided to them. Some told us the approach of staff could be improved, and that sometimes they had to wait for a response from staff when they needed support.

This is the fifth consecutive inspection that this service will be rated inadequate overall.

Risks to people were not always assessed and managed in a way which ensured people's safety. Actions had not always been taken to minimise risks. This put people at risk of injury or their health deteriorating.

There were not always sufficient staff with suitable skills, knowledge and experience deployed to meet the needs of people. The provider had not ensured that staff received the training they needed to be able to support people effectively, based on people's needs. Staff recruitment checks were still not sufficiently robust to ensure staff were suitable to work with vulnerable older people.

Each person had a care plan in place although there was not always sufficient detail to guide staff. Some care plans contained inaccuracies and contradictory information. Some areas of people’s care hadn’t been planned to reduce risk, such as risks associated with urinary tract infections and environmental risks.

The provider's systems for monitoring and improving the quality of the service had not been effective, because people were not always receiving a good quality of service and some risks had not been mitigated. This placed people at continued risk of harm.

There was a poor understanding of what constituted a safeguarding concern. Three incidents had not been reported to the local authority or CQC, which placed people at on-going risk of harm. This also meant there was no independent oversight to ensure people were fully protected.

Further improvements were still needed to ensure the views of relevant people were sought where people lacked capacity to consent. Though best interest decisions were in place for some people, not all aspects of their care were considered fully. For example, environmental risks.

There had been improvements in medicines management, but it was unclear whether the service could sustain these improvements, given only four staff were trained to administer medicines.

There was improved recording of people’s participation in activities. However, we were still not assured that the provision of activity was meeting individual and specialist needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 7 October 2019) and there were multiple breaches of regulation. At this inspection we found that sufficient improvements had not been made, and the provider remained in breach of six regulations. We also found two new breaches in relation to reporting procedures and safeguarding people from the risk of abuse.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 21 August 2019. Breaches of legal requirements were found in relation to safe care and treatment, governance, nutrition and hydration, person centred care, recruitment, and staffing.

We undertook this focused inspection to check they had now met legal requirements. This report only covers our findings in relation to the key questions of safe, effective, responsive, and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service is inadequate. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clarence Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, reporting procedures, governance, staffing, nutrition and hydration, safeguarding people from the risk of abuse, and person-centred care.

CQC used its powers to keep people safe, and a Notice of Proposal to cancel the Registered Providers registration was sent to the Registered Provider on 11 December 2018. On 19 February 2019 the Notice of Decision was sent to the provider advising that we had decided to adopt the proposal to cancel registration.

The provider appealed against this decision to the First Tier Tribunal (Care Standards) under section 32 (1) (b) of the Health and Social Care Act 2008. The appeal hearing was held on 29, 30 and 31 October 2019, and the decision was made that CQC’s action “was (and remains) lawful, fair, reasonable and proportionate.” The appeal was dismissed by the tribunal judge. This means that the provider can no longer provide any regulated activities and the service is closed.

Just prior to the tribunal hearing the local authority took action to ensure that all people living in the service were supported to move to alternative accommodation.

This service is therefore no longer in operation.