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Sovereign Lodge Care Centre Requires improvement


Inspection carried out on 16 October 2018

During a routine inspection

Sovereign 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 inspection took place on the 16 October 2018. This visit was unannounced. A second inspection day took place on the 17 October 2018 and was announced.

Sovereign Lodge is situated in Eastbourne and provides accommodation, nursing and personal care for up to 64 older people. Some people lived at the home whilst others were there for short stays, otherwise known as respite. There were 60 people using the service at the time of inspection; 56 living there and four staying for respite.

Sovereign Lodge provided accommodation across three separate floors, each of which had separate adapted facilities. The ground floor provided care to people with mainly physical health needs, while the first floor specialised in providing care to people living with dementia. People that lived on the second floor were more independent and required less support from staff. There were numerous communal areas for people to relax in and a hairdresser on site. There was also ample and well-maintained garden space which we saw people enjoying during inspection.

At our last inspection in August 2017, the service was rated 'Requires Improvement'. During this inspection, we found some areas still required improvement. This is therefore the second inspection where the service has been rated Requires Improvement.

There was not a registered manager at the time of 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 2008 and associated Regulations about how the service is run. There was a home manager who had only been at the service for 8 weeks. They had already applied to be the registered manager and were currently going through the registration process with us.

A number of shortfalls were found within record keeping which demonstrated current auditing processes needed to be further developed. Although there was a care plan audit, this had not identified all of the issues we found on inspection. People's support needs were not consistently identified in their care plans, which were hand written and often difficult to read. There were limited assessments with regard to specific support needs, such as diabetes, swallowing difficulties and positive behaviour support. Documentation that was missing or incomplete was not always identified. Staff we spoke with had a thorough knowledge of people and their support needs, which meant where shortfalls were identified, there was limited impact to people. However, there was a potential risk that if unfamiliar or new staff were to read care plans, they would not have all the information they required to support people.

During observations of the lunch-time experience, we found staff were not always responsive to people, particularly if they became anxious or required support with food. Meal-times were task-focused and once staff had served people their meals, there was less interaction. This had already been identified by the home manager, however more improvements were needed to ensure people were always engaged with. For one person, changes in their health had not been responded to effectively or in a timely way.

People told us they felt safe. Staff demonstrated a good knowledge of how to safeguard people and there were suitable numbers of staff to meet people's support needs. Medicines were managed in such a way that people received them safely. Checks of the building and equipment were completed regularly by the maintenance person and ensured the environment remained safe.

People were supported to have maximum choice an

Inspection carried out on 10 August 2017

During a routine inspection

Sovereign Lodge Care Centre provides facilities and services for up to 64 older people who require personal or nursing care. The service is purpose built and provides accommodation and facilities over three floors. The ground floor provides care for up to 26 people whose main nursing needs are related to physical health needs. This includes people who have had a stroke or lived with a chronic health condition such as multiple sclerosis, diabetes or chronic obstructive airways disease. The first floor provides nursing care for up to 27 people who are living with a dementia or a mental health need. Both nursing units can provide care for people at the end of their lives and used community specialist support when providing this care. The second floor provides personal care for people with health and mobility problems related to older age. People on this floor can be independent requiring minimal support from care staff.

At the time of this inspection 62 people were living in the service with 24 people on the ground floor 27 people on the first floor and 11 people living on the second floor. This inspection took place on 10 and 11 of August 2017 and was unannounced.

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. Sovereign Lodge Care Centre was registered under new ownership in May 2016 and this is the first inspection since that change.

The management systems did not always ensure safe and best practice was followed in all areas. The provider could not demonstrate that all medicines were administered in a consistent way and accident reporting did not allow for auditing. Some care records did not ensure clear guidelines were provided for staff to follow. This meant important care instructions may not be passed on to all staff and could impact on the care provided. These areas were identified to the registered manager for improvement.

Staff did not always engage with people on a regular basis. They did not take all opportunities to engage with people in communal areas or in individual rooms in order to prevent the possibility of social isolation and promote person centred care. People were aware of how to make a complaint and felt that they had their views listened to, however complaints were not clearly recorded to confirm that they were used to improve the service. All these areas were identified to the registered manager for improvement.

People were looked after by staff who knew and understood their individual needs well. Staff were kind and treated people with respect, promoted their individuality and independence whenever possible.

Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. Recruitment records showed there were systems which ensured as far as possible staff were suitable and safe to work with people living in the service. Staff understood the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Senior staff had an understanding of DoLS and what may constitute a deprivation of liberty and followed correct procedures to protect people’s rights.

Staff were provided with a full induction and training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people's needs could be met in a timely and safe fashion. The registered nurses attended additional training to update and ensure their nursing competency. Medicines were stored, administered and disposed of safely by staff who were suitably trained.

Staff monitored people's nutritional needs and responded to them. Preferences and spec