We carried out a review of the data available to us about Lydgate Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lydgate Lodge, you can give feedback on this service.
Lydgate Lodge is a residential care home providing personal and nursing care to 57 people aged 65 and over at the time of the inspection. The service can support up to 64 people.
Lydgate Lodge comprises of four individual units over two floors. Two of the units provided support to people who are living with dementia.
People’s experience of using this service and what we found
Recruitment procedures were thorough and there were enough staff on duty to meet people’s needs. New staff received induction and there was an on-going programme of training and supervision for all staff.
People were safe from the risk of avoidable harm, risks were assessed and monitored. People were supported to eat and drink and were enabled to access other health care professionals as required.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff were kind and caring. People’s right to privacy was respected and staff ensured people were treated with dignity and respect. Staff involved people in making decisions about their care and support. There was a range of activities for people to participate in if they chose to. Links had been formed within the local community.
Care records were detailed, and person centred. Care records were reviewed and updated at regular intervals. Information about people’s communication needs were clearly recorded.
People and visitors were aware of how to complain in the event they were dissatisfied with any aspect of the service they received. The registered manager had not received any formal complaints in recent months.
The service was consistently managed and well led. Systems of governance were effective in continually monitoring the quality of the service people received. Monthly meetings were held with people who lived at the home and staff. The registered manager and staff at Lydgate Lodge worked in partnership with other healthcare professionals.
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 June 2019).
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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Lydgate Lodge is registered to provide personal care and ensuite accommodation for up to 64 older people, some of whom live with dementia. There were 54 people living at the home at the time of the inspection. The home has two floors accessed by passenger lifts. Each floor has one unit for people with residential care needs and one unit for people living with dementia. Units contain communal bathrooms, a lounge and dining area. Outside there is an enclosed garden with seating areas.
Lydgate Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The home had a registered manager. 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.
At the last inspection in January 2017, the service was rated ‘requires improvement’ and there were three breaches identified in the regulations for staffing, safe care and treatment, and good governance. At this inspection we found improvements were ongoing but there were still areas in need of improvement, some of which were featured in the previous inspection. These were understood by the management team and there was evidence these were being addressed.
Lydgate Lodge had a welcoming and professional approach; the environment was pleasant and homely, people said they felt happy and safe and staff reported good morale in the teams.
Systems for managing risks were in place, but were not sufficiently robust or individualised for some aspects of people’s care. Not all staff were confident in the fire evacuation procedures.
People said that they felt safe at all times and were really clear about who they could turn to if they were worried or had any concerns. The staff were also aware of the role they played in keeping people safe by reporting any concerns. Staff understood procedures to follow to ensure people were safeguarded against abuse.
Staffing deployment at times did not ensure people’s needs were met in a person-centred way; the rotating deployment of staff did not ensure consistent understanding of people’s needs. Relatives felt that there were times when the team were short staffed although staff did not share this view.
The home was visibly clean in most areas, although the kitchenettes within each unit were not cleaned thoroughly and some equipment was not cleaned or stored appropriately.
The administration and management of medicines at Lydgate Lodge was safe. An issue with topical medicines recording had been identified prior to this inspection and a solution identified.
There was effective teamwork and staff communicated well with one another about people’s needs. Staff understood people’s rights and the legislation which supported this, such as the Mental Capacity Act.
Staff felt supported through training and supervision, although training records were cumbersome.
People enjoyed their meals on the whole, although where some people had received specialist advice this was not always followed properly.
Staff used new technology to update information about people’s care as it happened, although there were some inconsistencies in recording identified at this inspection.
People were aware of the complaints procedure and we saw complaints were responded to. Some relatives raised concerns about the laundry system and the provider was working to address these.
There was a range of suitable activities available for people at Lydgate Lodge, although not all people were able to participate in these.
The management team were very visible in the home and gave clear directions for staff who understood their roles and responsibilities. Audits were in place although these were not all sufficiently robust enough to show what action had been taken as a result of issues identified. There were plans in place to improve the quality of the audits, both in the home and corporately.
There were two continued breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to safe care and treatment and good governance
This is the second time the service has been rated ‘requires improvement’.
You can see what action we told the provider to take at the back of the full version of the report.
Lydgate Lodge provides care and support to a maximum of 64 people. The home is purpose built over two floors with a total of four separate units, two of which provide care and support to people who are living with dementia. One the day of our inspection there were 62 people living at the home with another person being admitted on the first day of our inspection.
The service had a registered manager. 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.
People told us they felt safe and staff understood their responsibilities in keeping people safe from the risk of harm or abuse. Accidents and incidents were reviewed and analysed to enable possible trends to be identified and appropriate action taken.
People’s care plans contained a variety of risk assessments, but they were not always a precise reflection of people’s care and support needs. We also found staff had not always assessed people’s risk correctly. This raised the risk of people receiving unsafe or unsuitable care.
External contractors were used to service and maintain equipment at the home, however, the internal checks completed by the maintenance staff could not be located on the day of our inspection. Information was readily available for staff in the event of an emergency, this included contractor telephone numbers and personal emergency evacuation plans for people living at the home.
We found staff recruitment was safe, but we were concerned there were not enough staff on duty on a daily basis to meet people’s needs. Relatives and staff told us there were not enough staff on duty and we observed staff were busy and lacked time to spend with people other than part of a task related activity.
People’s medicines were managed safely, however, we could not accurately tally all the medicines we audited. Staff’s competency to administer people’s medicines was assessed and staff were also provided with training in medicines awareness.
Staff attended a handover prior to their shift although we found the information on the handover record was not always reflective of people’s current needs.
New staff completed a two weeks corporate induction programme although evidence of this was missing in two of the four staff files we reviewed. There was a programme in place to ensure staff received regular refresher training and management supervision.
Staff respected people’s right to make decisions. Where a person lacked the capacity to decide they wanted to live at the home, a capacity assessment had been completed but there was a lack of capacity assessments regarding other aspects of their care. A number of applications had been made to the local authority to ensure that where people were deprived of their liberty, this was lawful.
People were happy with the meals provided at Lydgate Lodge. We found people were offered a choice of meals but the method staff used to help people choose was not consistently appropriate to people’s needs.
People were not offered the choice of a hot drink during or immediately after their lunchtime meal and staff did not always record the date or the amount of food people had been offered on people’s food records.
People told us staff were caring. During the inspection we also observed staff to be kind and helpful. Where people became upset, staff intervened, supporting them and de-escalating the situation. Staff were knowledgeable about people’s needs and the routine of the home was led by the needs of the people and not the staff. Staff respected people’s right to privacy and maintained their dignity.
People told us there was a range of activities provided at the home. The regional activity co-ordinator organised the activity programme and events but care staff were responsible on a day to day basis for providing activities for people.
Care records and other related documentation were not always an accurate reflection of people’s current care needs. The records staff completed to evidence the support they had provided for people who were at risk of pressure sores lacked relevant information and were not always an accurate reflection of the time staff attended to people’s needs.
There was a complaints procedure in place and we saw that where a concern had been raised, the registered manager had taken action to address the issues.
People spoke positively about the registered manager and staff felt the registered manager was supportive and listened to them. The registered manager was experienced and understood their role and responsibilities.
Meetings were held on a regular basis with staff and people who lived at the home to gain feedback from them about Lydgate Lodge.
A number of audits were completed on a regular basis but it was not always clear if identified actions had been addressed. A quality monitoring report was also completed by the regional director, clearly identifying areas for improvement and an action plan was generated to evidence the action taken to address those improvements. However, as is evidenced within this report there were still a number of issues which need to be addressed in order to ensure people received safe, effective and responsive care.
You can see what action we told the provider to take at the back of the full version of the report.