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Cheybassa Lodge Rest Home Requires improvement

Reports


Inspection carried out on 15 September 2020

During an inspection looking at part of the service

About the service

Cheybassa Lodge Rest Home is a 'care home'. Cheybassa Lodge Rest Home accommodates up to 18 people living with dementia and physical frailty in one building. At the time of our inspection 14 people were living at the home.

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

Quality assurance systems had not always been effective in identifying the concerns we found at this inspection or fully addressed concerns from our last inspection.

The provider had not always notified CQC about important events that happened in the service which meant these could not be monitored.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The lack of robust infection control practices placed people at risk of being exposed to infections. This included known risks associated with the current Covid-19 pandemic. We made a recommendation about this. Some risks to people’s safety had not been safely managed and the registered manager had plans in place to address this.

We made a recommendation that the provider reviews their safeguarding systems and processes to ensure people are fully protected from the risk of harm and abuse.

People, staff and relatives felt there was enough staff for people to be safely supported. However, some staff and people felt there was not always enough staff to undertake other tasks such as cleaning and supporting people with social engagement. The registered manager told us of their plans to improve this by recruiting activities and cleaning staff. Recruitment processes were safe.

The management of medicines was mostly safe although further work was required to ensure people received their ‘as required’ medicines in the most effective way.

Staff felt well supported through training and supervision. Staff in the service worked well with each other and external professionals to ensure good health outcomes for people. People were provided with a nutritious and balanced diet that met their needs and preferences.

Care plans were not consistently detailed, or person centred, however, there was a consistent staff team in place, and they had got to know people well which meant they understood people’s needs and preferences. People were well supported at the end of their lives.

The provider had made some effort since our last inspection to improve social engagement for people, but this was not enough to ensure people’s social needs were always met. The registered manager had plans in place to improve this.

The provider had not always worked in line with the duty of candour requirements and we have made a recommendation about this.

People and their relatives knew the registered manager and felt able to speak to them if they had any concerns. Staff felt well supported by the registered manager and felt they provided them with good leadership. Relatives and staff told us they would recommend the home to others.

The registered manager demonstrated a willingness to make improvements and during the inspection began reviewing their systems and process to ensure the service consistently provided good, safe, quality care and support.

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 requires improvement (published 10 April 2019). There was one breach of regulation in relation to regulation 17 Good Governance. We met with the provider and they completed an action plan after the last inspection to show what they would do and by when to improve.

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

At this inspection enough improvement had not been made and the provider was st

Inspection carried out on 12 February 2019

During a routine inspection

About the service:

Cheybassa Lodge Rest Home is a ‘care home’. Cheybassa Lodge Rest Home accommodates up to 18 people living with dementia and physical frailty in one building. At the time of our inspection 14 people were living at the home.

People’s experience of using this service:

•The provider lacked effective governance systems to identify concerns in the service and drive the necessary improvement. At times there was a lack of clear and accurate records regarding people’s medicines and support needs.

•Accidents and incidents were not analysed at a service level which meant overarching trends and patterns could not be identified. We have made a recommendation about this.

•The provider was not meeting the requirements of the Accessible Information Standard (AIS), we recommended that the provider seeks reputable guidance to ensure this was met.

•We found that activities were not always reflective of people’s preference and we made a recommendation that the provider seeks reputable guidance in order to provide personalised support for people

•Despite this, people were happy living at Cheybassa Lodge Rest Home and people told us they felt safe. People were supported by staff who were kind, caring and who understood their support needs, likes and dislikes. Where they needed external health input they were supported to receive this.

•Staff were not always supported with regular supervision or appraisal but staff told us they felt well supported by the registered manager and had enough training to undertake their roles effectively.

•People and their relatives knew the registered manager and felt able to speak to her if they had any concerns. Staff felt the registered manager had improved the culture of the service. The registered manager demonstrated a willingness to make improvements and during the inspection began reviewing their systems and process to ensure the service consistently provided good, safe, quality care and support.

Rating at last inspection: Requires Improvement (Report published 13 February 2018)

Why we inspected: This was a planned inspection based on our last rating. At the last inspection the provider was rated as Requires Improvement.

Follow up: The overall rating of the service remains Requires Improvement. At the last inspection, the provider was found to be in breach of Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection, we found the provider had met the requirements of Regulation 12 but remained in breach of Regulation 17. This is the second consecutive time the service has been rated as Requires Improvement and we will request a clear action plan from the registered person on how they intend to achieve good by our next inspection. We may decide to meet with the provider following receipt of this plan. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

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

Inspection carried out on 8 December 2017

During a routine inspection

Cheybassa Lodge Rest 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. Cheybassa Lodge Rest Home accommodates up to 18 people in one building. At the time of our inspection15 people were living at the home.

This inspection took place on 8 and 12 December 2017 and was unannounced.

There was a registered manager in post at the service. 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.

People who use the service and one person's relative were positive about the care they received and praised the approach of the staff and how the service was managed. Comments from people included, “Staff are good as gold, not a bad egg”, “Staff are kind” and “The staff are very nice, all of them”. One person’s relative told us, “Staff are brilliant". We observed staff interacting with people in a friendly and respectful way.

People told us they felt safe living at Cheybassa Lodge Rest Home. However risks to people were not consistently monitored and managed to ensure they received safe care. The provider did not have effective systems in place to learn from safety incidents and concerns. The provider told us they took action following our inspection to manage these risks.

Staff knew how to identify abuse and they told us they would raise any concerns with the registered manager. Not all concerns had been shared with the local authority. The provider took action to report these concerns during our inspection. We have made a recommendation about the reporting of safeguarding concerns in line with safeguarding protocols.

People did not receive all of their medicines when required and some improvements were required to the recording of prescribed creams. All staff received medicine administration training and had to be assessed as competent before they were allowed to administer people’s medicines.

The home was clean and staff understood their responsibilities for infection control.

Care plans lacked detailed information about people's needs and preferences. The registered manager had identified improvements required to ensure all care plans were detailed and relevant. We have made a recommendation about involving people and their representatives in care planning.

People’s preferences and choices for their end of life care were not discussed with them or recorded in their care plans.

People received support to ensure they had enough food and drink.

The provider had identified improvements to the systems to monitor the quality of the service provided however these improvements had not been implemented. Improvements were needed to make sure quality monitoring processes were effective in identifying and addressing shortfalls in the service and improving the service people received. The provider did not had systems in place to learn from safety incidents and concerns.

People told us they felt the service was well managed.

People were supported by staff who had been through checks on their suitability to work in the home but improvements were required to ensure staff's full employment history was checked.

Staff required additional training to ensure they had the necessary knowledge and skills to meet people's needs. We have made a recommendation about staff training on the subject of dementia.

People had access to health care professionals and were supported to maintain their health by staff.

The provider had arrangements in place to respond to complaints and a complaints procedure. Improvements were required to how complaints were responded to.

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