Archived: Freckleton Lodge

Freckleton Lodge is registered to provide care and accommodation for up to 28 people who require assistance with personal care. Bedrooms are of single occupancy with ensuite facilities. Bathrooms are located throughout the home. A variety of sitting rooms are accessible and a separate dining room is provided. Freckleton Lodge is close to public transport links and car parking space is available at the home. There are gardens and a patio area at the rear of the home. At the time of the inspection Freckleton Lodge provided care and support to twenty people.

There was a manager in place who was registered with the Care Quality Commission. 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 last inspected Freckleton Lodge on the 09 March 2016. We identified several breaches of regulation. We found care and treatment was not always provided in a safe way and the registered provider did not have suitable arrangements to ensure people were effectively safeguarded. We also identified that people were not always involved in the planning of their care and systems to assess and quality assure the service were ineffective. In addition we found the registered provider did not comply with the requirements of the Mental Capacity Act 2005 and notifications were not made as required, to the Care Quality Commission.

At the last inspection on the 09 March 2016 we asked the registered provider to take action to make improvements. We were provided with an action plan which detailed how the registered provider intended to ensure improvements were made. The action plan recorded improvements would be made by June 2016.

We undertook this comprehensive inspection to check they had followed their plan and to confirm they now met legal requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Freckleton Lodge on our website at www.cqc.org.uk.

During this inspection carried out in January 2017 we found improvements had been made. We found the registered provider was working in line with the principles of the Mental Capacity Act 2005. Appropriate applications to deprive people of their liberty were made to the local authorities as required. We observed care and support being provided in a safe way and documentation recorded the care and support people required to maintain their safety.

We looked at the systems to identify shortfalls at the home and drive improvement. We found that when accidents or incidents occurred, the registered manager reviewed these. We spoke with staff who were able to explain the steps taken to minimise the risk of reoccurrence. The registered manager carried out checks of medicines, care records and the environment. We were informed these were not formally recorded. We have made a recommendation regarding this

Documentation we viewed evidenced people were involved in the planning of their care and people we spoke with confirmed this. People told us they were supported to see health professionals if the need arose and we found this was recorded in care documentation.

Staff were able to explain the actions to take if they were concerned someone was at risk of harm or abuse. People who lived at the home told us they felt safe. One person told us, “I can honestly say I feel safer here than if I was living at home.” We found the registered provider had notified the Care Quality Commission of any reportable incidents as required by regulation.

We found medicines were managed safely. We saw documentation that evidenced staff competence was assessed to ensure they were knowledgeable of their role and how to manage medicines safely.

We reviewed staff files and found there were processes that ensured staff were suitably recruited. Staff we spoke with confirmed checks had been carried out on their suitability for employment prior to starting work at the home.

Staff told us they met with the registered manager on an individual basis to discuss their performance. Staff with were complimentary of the training provided and told us they received a variety of training to enable them to work at Freckleton Lodge.

We discussed staffing with people who lived at the home, the manager and relatives. We received mixed feedback. Three people told us they felt staff were busy. Two people told us they considered there were sufficient staff available to meet people’s needs. None of the relatives or staff we spoke with raised any concerns regarding the staffing arrangements at the home.

People who lived at Freckleton Lodge told us they considered staff were caring. One person told us, “Staff are marvellous. They let you take your time.” We observed people being supported with kindness and compassion.

During the inspection we saw a range of activities being provided. We observed people joining in a choir activity and some ‘armchair exercises.' We also saw people were supported to access the local community if they wished to do so. The activities were seen to be enjoyed by people who lived at Freckleton Lodge.

There was a complaints policy available at the home. People told us they would talk to staff if they had any concerns.

People told us they had no concerns with the food at the home. We observed the lunchtime meal and saw this was a positive experience for people who lived at Freckleton Lodge. Staff gently encouraged people to eat and we saw people enjoyed their meal.

People who lived at Freckleton Lodge told us they could speak with the registered manager if they wished to do so. Staff we spoke with also gave positive feedback. They told us they found the registered manager to be approachable and supportive. Relatives we spoke with also told us they found the registered manager to be approachable.

This was the first inspection of Freckleton Lodge. The service was registered in September 2015.

Freckleton Lodge is a newly refurbished care home for older adults. The home provides personal care for up to 28 adults. Nursing care is not available at this location. The home is situated in a rural area close to the towns of Preston and Kirkham.

All the bedrooms have en-suite facilities. There is a large dining room and communal areas, available for people living at the home. The grounds are well maintained with seating and patio areas. These are accessible for those who use wheelchairs. Public transport links are available and ample car parking spaces are provided.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These included; Regulation 9- person centred care, Regulation 11 – Need for consent, Regulation 12 – Safe care and treatment, Regulation 13 (5) Safeguarding, Regulation 17-Good governance, Regulation 18- Care Quality Commission (Registration) regulations 2009- Notifications of other incidents.

You can see what action we have taken at the end of this report.

The registered manager was present throughout our inspection. 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 and associated regulations about how the service is run.

At the time of this inspection there were 11 people who lived at Freckleton Lodge. We spoke with six people living at the home. We spent time observing care delivery and spoke with people who visited the service. People told us that they felt safe.

We looked at how the service protected people against bullying, harassment, avoidable harm and abuse. We found that some staff had received training in safeguarding adults and demonstrated a good understanding about what abuse meant.

We found there was no formal recording of safeguarding incidents. The provider was recording accidents and incidents however it was not clear what support people were getting after experiencing multiple falls. We found evidence staff sought advice from ambulance services in some instances however this was not consistent.

We found people’s medication was being managed safely however this was not consistent. Staff had received appropriate medication training. We found no building fire risk assessment on the premises on the day of our inspection; the provider however sent us a copy two days after our inspection visit.

Residents did not have personal emergency evacuation plans to enable safe evacuation in case of emergency.

There was no formal staff dependency tool however we found no concerns over staffing levels.

We saw evidence of safe recruitment practices.

We found no evidence of staff disciplinary warnings being recorded.

The service was not always following the Mental Capacity Act, 2005 for people who lacked capacity to make particular decisions. For example, the provider had not ensured that people’s rights were actively assessed under the Mental Capacity Act or Deprivation of Liberty Safeguards, even though their liberties were being restricted.

Although some people told us they felt safe and their privacy and dignity was respected, we found people’s privacy and dignity had been compromised by installation of CCTV in communal areas without their consent or sufficient consultation with their loved ones.

We found that people’s health care needs were not effectively assessed on admission to the service.

Consent was not always sought from people.

The home did not consistently involve people in decisions made around the care they received. Care plans did not evidence involvement.

We did not find evidence of robust management systems in the home and quality assurance was not effective in order to protect people living at the service from risk.

Staff were provided with effective support, induction, supervision, appraisal and/ training.

We found people’s medicines were safely managed.

We found the service had effective systems to deal with complaints about care and treatment. And found that the manager had kept robust records to show how complaints were resolved.