Archived: Alness Lodge Limited

Updated 14 November 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by an inspector from the Care Quality Commission (CQC) and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Alness 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.

The service had a manager registered with the CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. Alness Lodge is a family run business. The provider (and a company director) was also the registered manager. Throughout this report, we simply make reference to the provider.

Notice of inspection:

The first day was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection. We also liaised the local authority and other external agencies who work with the service.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection:

We spoke with seven people who lived in the service and a visiting relative to understand their experience of the care provided. We spoke with five members of staff including the registered manager, assistant manager and care workers.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included nine care plans and associated documentation. We looked at three staff files in relation to recruitment and three to review staff supervision records. We reviewed multiple records relating to the management of the service and a variety of policies and procedures.

After the inspection:

We continued to seek clarification from the registered manager to validate evidence found.

Updated 14 November 2019

About the service:

Alness Lodge is a residential care home for up to 10 people living with mental health needs. Single occupancy accommodation is provided over two floors; the service does not have a passenger lift. Bathing, showering and toilet facilities are shared.

At the time of this inspection there were nine people living at service and one person was away staying with relatives.

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

The service did not have effective systems in place which sought to protect people from abuse or improper treatment. This exposed people who used the service, and others, to a risk of harm.

The provider considered the majority of people who used the service to be either independent or semi-independent. This meant there was a distinct lack of person-centred care and support. The service did not always provide support to people that was appropriate, met their needs, and reflected personal preferences.

Some people were able to access the community independently and instigate their own social activities, many people were not. There was no evidence of activities organised by the service and people simply spent the majority of their time watching TV in the communal lounge or remaining in their private room, only coming out at meal times.

Potential new admissions into the service were offered an opportunity to participate in trial visits. However, the provider did not complete a specific pre-admission assessment and there was an overreliance on the information provided by other external professionals, some of which was historical.

There was no regular schedule of audit and quality assurance which meant the provider lacked oversight and was reactive, rather than proactive.

Since our last inspection, 14 incidents had been recorded in the accident book, one of which resulted in a serious injury. However, no overarching analysis had been completed to identify themes or trends and action needed to reduce the likelihood of such incidents occurring again in future.

Staff prioritised completing tasks rather than assisting people to be as independent as they could. Staff we spoke with told us they would like to spend more time with individuals, but the daily routine of the home meant this was not always possible.

During this inspection we observed staff speak openly about people's care needs in front of other people. This did not respect their privacy and confidentiality.

People who used the service were from diverse backgrounds and the workforce was reflective of this. However, the provider had no clear philosophy or approach round equality and diversity, and how the needs of people from different backgrounds would be met.

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 rating for this service was requires improvement (published 23 July 2018) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found insufficient improvements had been made.

Why we inspected:

This was a planned inspection based on the previous rating.

Enforcement:

At this inspection we have identified new and continued breaches in relation to providing person-centred care, safeguarding people from abuse, good governance, and staffing. Please see the action we have told the provider to take at the end of this report.

Follow up:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.