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Reports


Inspection carried out on 14 May 2018

During a routine inspection

We previously inspected Portchester Lodge on 6 and 7 April 2017. We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Health and Social Care Act 2008 (Registration) Regulations 2009. We rated the service requires improvement. At this inspection we found improvements had been made and the provider had met the requirement notices. At this inspection we rated the service as good.

Portchester Lodge provides care and support for up to ten people who are living with mental health issues, a learning disability or dementia. There were seven people living at the home at the time of the inspection.

A new registered manager had been employed since our previous 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.

People were safeguarded from avoidable harm. Staff adhered to safeguarding adults procedures and reported any concerns to their manager and the local authority.

Staff assessed, managed and reduced risks to people’s safety at the service and in the community. There were sufficient staff on duty to meet people’s needs.

Safe medicines management was followed and people received their medicines appropriately.

Staff protected people from the risk of infection and followed procedures to prevent and control the spread of infections.

Staff completed regular refresher training to ensure their knowledge and skills stayed in line with best practice guidance. Staff shared knowledge with their colleagues to ensure any learning was shared throughout the team.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff liaised with other health and social care professionals and ensured people received effective, coordinated care in regards to any health needs.

Staff applied the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

An appropriate, well maintained environment was provided that met people’s needs.

Staff treated people with kindness, respect and compassion. They were aware of people’s communication methods and how they expressed themselves. Staff empowered people to make choices about their care.

Staff supported people to maintain relationships with families. People’s privacy and dignity was respected and promoted.

People received personalised care that met their needs. Assessments were undertaken to identify people’s support needs and these were regularly reviewed.

People participated in a range of activities.

A complaints process ensured any concerns raised were listened to and investigated.

The registered manager adhered to the requirements of their Care Quality Commission registration, including submitting notifications about key events that occurred.

An inclusive and open culture had been established and the provider welcomed feedback from staff, relatives and health and social care professionals in order to improve service delivery.

A programme of audits and checks were in place to monitor the quality of the service and improvements were made where required.

The provider had learnt lessons from our last inspection and had improved.

Inspection carried out on 6 April 2017

During a routine inspection

The inspection took place on the 6 and 7 April 2017 and was unannounced. The inspection was prompted in part by notification of an incident following which a person using the service died. This incident was subject to a police investigation and as a result this inspection did not examine the circumstances of the incident. The information shared with CQC about the incident indicated potential concerns about the assessment and management of risk for people. This inspection examined those risks as well as other areas.

Portchester Lodge provides care and support for up to ten people who are living with mental health issues, a learning disability or dementia. There were seven people living at the home at the time of the inspection.

There was 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.

However, the registered manager had resigned in March 2017. The provider had moved a registered manager from another of their services to manage Portchester Lodge on a permanent basis and this person had started at the end of March 2017, a week before the inspection. The report will refer to the registered manager (the one who had resigned) and the new manager (who had been in post a week at the time of the inspection).

People told us they mainly felt safe and happy living at the home especially since the new manager had started work there.

Risks to people's health conditions were not fully assessed in order to minimise risks, and staff had variable awareness and understanding of people's individual risks.

People were supported by adequate numbers of staff, most of the time.

People received their medicines safely, although the new manager identified the need to update administering staff’s training.

People's consent was sought before staff provided care, however there were no mental capacity assessments in place where there were concerns about people’s capacity to consent.

There were concerns with lack of a robust recruitment process to ensure people were being cared for safely. Staff had not all received adequate induction and training and a concern was raised regarding the validity of the training information given to us that had been compiled by the previous registered manager.

People were relaxed and comfortable around staff and had their dignity and privacy respected. People were supported to be as independent as possible.

People had not always been involved in developing their care plans. People had not had regular meetings with staff regarding their recovery using the Recovery Star model, to be used alongside care planning in helping people to set goals.

People told us if they had any concerns they had been dealt with appropriately by the new manager.

People and staff had not always felt listened to by the registered manager however they felt very differently about the new manager.

We were concerned about the management of the home and lack of quality assurance/monitoring of the service, poor records in a number of areas, particularly care plans, staff training and staff recruitment. The new manager had plans in place to address the shortfalls we had identified.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of the Health and Social Care Act 2008 (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.