George Mason Lodge

George Mason Lodge is a care home registered to provide accommodation, personal care and support for up to 39 people, some of whom were living with dementia and mental health illness. At the time of our inspection, 37 people were living in the home.

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

People told us the care they received was good, and staff treated them with dignity and respect. People and their relatives spoke positively about staff being kind and caring. People's diversity and individual needs were respected by staff.

The staff team were knowledgeable about people’s support needs and knew them well, which meant that staff were able to deliver personalised care and support to people. People were supported to maintain contact with relatives and friends. The service had a range of appropriate activities people could be involved in. Staff demonstrated they knew how to raise safeguarding concerns and were aware of the processes to follow in order to keep people safe. People told us they felt safe.

Care and support plans were developed to ensure people's needs and risks were met appropriately. Risk assessments were in place to guide staff to help people manage their identified risks. The service supported people to take positive risk taking.

The provider had appropriate staffing levels in place to ensure people's needs were met in a safe and consistent way. The service followed safe practices for infection prevention and control procedures to keep people safe. The administration of medicines was managed in a safe way and people received their medicines as prescribed.

Staff were provided with the right training and support to make sure they could carry out their roles appropriately. The service worked and communicated with other professionals in the health and social care sector. People's health care needs were being met and they had access to healthcare services where needed.

People were supported to have choice and control of their lives as much as possible. Staff supported people in the least restrictive way and in their best interests. The service had up to date policies and procedures in place to manage and respond to complaints and concerns.

The provider had comprehensive and effective governance system in place. People, relatives and staff were confident about approaching the registered manager if they needed to. A wide range of comprehensive audits took place to ensure the quality of the service was maintained.

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

Rating at last inspection

The last inspection for this service was rated good (published 17 March 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• The provider followed safe infection prevention and control practices and procedures to ensure people, staff and visitors' safety and that they were protected from the risk of infection.

• The service had systems in place to check staff and visitors' temperatures and they provided them with appropriate personal protective equipment (PPE), before they were allowed into the care home.

• The provider had implemented suitable visiting arrangements to ensure people could receive visits safely. They were also in the process of building a stand alone pod in the garden outside the care home to help minimise the risk of spread of infection. The pod would be equipped with hand washing facilities, PPE, a screen and speaker system for relatives to use during their visits. This would be up and running by end of March 2021. Where relatives were unable to visit people, staff supported them to stay in touch with people via video calls.

• People, staff and visitors were supported to follow the government's guidance on wearing PPE and social distancing.

• The premises were cleaned and disinfected frequently to help prevent the spread of infection. Hygiene stations were installed throughout the service that were adequately stocked with hand sanitisers and PPE.

• The provider followed the government's guidance on carrying out COVID-19 testing and made suitable arrangements to test people, staff and visitors.

• All staff received training and support to prevent and control the spread of infection. Staff only worked on assigned units thereby minimising the risk of cross infection. Staff wellbeing was supported if they became unwell and when they returned to work.

• The registered manager was well supported by the provider and their clinical lead. They also sought support and advice from external agencies including the local authority, the Clinical Commissioning Group, Public Health England, and local health teams to help keep people and staff safe.

George Mason Lodge is a care home registered to provide accommodation, personal care and support for up to 39 people, some of whom were living with dementia, mental health illness or had older people care needs. At the time of our inspection, 37 people were living in the home.

George Mason Lodge is a purpose built care home with 39 bedrooms across three floors with bathroom and shower facilities, and dining and lounge areas on each floor. The ground floor is a short stay and rehabilitation unit, and the first two floors accommodate people on a long term and permanent care placements. The first two floors are accessible via lift. The home has kitchen and laundry facilities and an accessible and secured garden with a patio area. There is a hair-dresser facility and a separate activity room that also doubles up as a staff training room.

The service had a registered manager who has registered with the Care Quality Commission (CQC) to manage the service. A registered manager is a person who has registered with CQC 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.

At the inspection on 9 and 14 August 2017, we found that the provider had made sufficient improvements and were no longer in breach of legal requirements.

People using the service told us they were happy living at the service and felt safe there.

The service maintained effective safeguarding procedures and staff knew signs of abuse and how to report abuse. People’s accidents and incidents were effectively monitored and systems were in place to learn from them to prevent recurrences. Risks involved in people’s care were appropriately identified and assessed, and people’s risk assessments gave information on how to mitigate those risks. Staff had a good understanding of risks involved in supporting people and how to provide safe care. The service regularly reviewed risks to people. Staffing rotas demonstrated the service had sufficient staffing levels to meeting people’s individual needs and people, relatives and staff confirmed this. People received safe medicines support. The service kept accurate records of medicines administered by staff that were well trained. The service was clean and met health and safety, fire safety and infection control requirements.

People were happy with the food and choices offered at the service and their nutrition and hydration needs were met. Staff kept detailed daily care records on how people were supported with their food and fluid intake. The service worked closely with various health and care professionals to support people with their health and care needs. People were supported to access GP services.

The service followed safe recruitment practices. Staff received induction and refresher training, and records confirmed this. Staff received regular one-to-one supervisions and yearly appraisal.

The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People told us staff asked their consent before supporting them.

People and their relatives told us staff were kind and caring and listened to their needs. Staff recognised people’s need to remain independent and encouraged and supported them wherever possible to remain independent.

People told us the service was responsive to their needs. People received person-centred care by staff who knew their likes and dislikes very well. The care plans were personalised and people’s individual needs and likes and dislikes were recorded. People were at the centre of planning their care and their relatives contributed towards care planning and were asked about their views. People actively took part in planning activities around the home and the service offered people a range of one-to-one and group activities. There were regular residents’ and relatives’ meetings where they were asked for their feedback. People told us their complaints were acted upon promptly.

People, their relatives, staff and health and care professionals told us the service was well-led by the registered manager who was knowledgeable, skilled and experienced. The registered manager worked very well with health and social care professionals and local and national organisations to improve the quality of the service and people’s lives.

The service had records of audits and monitoring checks of various aspects of the service ensuring efficient systems were maintained to improve the quality and safety of care delivery.

George Mason Lodge is a residential home that provides care for up to 39 older people some of whom may be living with dementia. There were 35 people using the service when we visited.

There was a registered manager at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People had missed doses of their prescribed medicines, which may have affected their health and well-being. The arrangements for ordering medicines for people were not always robust. Medicines records were not always completed fully and accurately and we were not assured that appropriate arrangements were in place for the recording, using and safe administration of some medicines. Individual risk assessments were in place for people, to help protect them from harm. However, the assessments and care plans were not always comprehensive.

We found the provider had not sent us any statutory notifications for people authorised for Deprivation of Liberty Safeguards (DoLS) and people who had died. You can see what action we have asked the provider to take at the end of this report.

The service had appropriate systems in place for safeguarding people. Risk assessments were in place which provided guidance on how to support people safely. There were enough staff to meet people’s needs.

Staff were well supported, received training and one to one supervision. People were able to make choices about most aspects of their daily lives. People were provided with a choice of food and drink and supported to eat healthily. People had access to health care professionals and were supported to lead healthy lifestyles.

People and their relatives told us they liked the staff. We saw staff interacting with people in a caring way and staff had a good understanding of how to promote people’s dignity.

Care plans were in place and people were involved in planning the care and support they received. People had access to a wide variety of activities within the community. The provider had appropriate complaints procedures in place.

There was a clear management structure in the home. People who lived at the home, relatives and staff felt comfortable about sharing their views and talking to the registered manager if they had any concerns. Staff told us the registered manager was always supportive.

Due to their needs, many residents that we met during our visit were unable to share their views about the standards of care. The views of residents who were able to comment on their experience can be summarised as follows. 'The staff are very good',' The staff are kind' and 'staff look after me well'.

Comments from residents were generally positive, indicating that staff were kind and helpful in meeting their care needs.

We spoke to a relative and they thought the care and support being given to residents was good.

We observed staff were aware of people's preferences and routines so they could support people in their daily lives. For example they knew at what time people preferred to eat and what time they went to bed or got up.

Most of the staff had worked at the home for a number of years and knew the residents very well.

During the course of the inspection we saw staff interacting sensitively with the residents. Staff knocked on residents doors before entering their room and asked the residents if it was alright to go in.

Although some residents may not always be able to understand the treatment, care and support options available to them their views were taken into account in the way the service was provided and delivered.

When we visited the home was being refurbished and we were informed the work was due to be completed in August 2013.

People had their needs assessed and their care files were reviewed on a monthly basis to ensure these needs were being met. One person we spoke with told us the care was "very good."

People who used the service and their relatives were involved in making decisions about their care and treatment. People were treated with respect and dignity by staff. People we spoke to told us staff treated them with respect and they were called by their preferred names.