12 January 2017
During a routine inspection
The provider of Cadmore Lodge is registered to provide accommodation nursing and personal care for up to 14 people. At the time of this inspection 6 people lived at the home. Bedrooms, bathrooms and toilets are situated over two floors with stairs and passenger lift access to the upper floors. People have use of communal areas including lounges, and dining rooms.
There was a registered manager in post who was supported by a Clinical Nurse Lead. 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.
Improvements were required to ensure people's medicines were stored and managed safely. People's medicines were not always stored at the recommended manufacturer's temperature. There was no guidance for staff to follow when people should be offered their as required medicines (PRN). The provider and registered manager had failed to operate proper and safe medicines management processes in relation to the administration, storage and recording of medicines. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
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; the policies and systems in the service did not support this practice. Related assessments and decisions had not been taken. Continuous supervision and control, combined with lack of freedom to leave, indicated a deprivation of liberty, and the provider had not applied for this to be authorised under DoLS.
People had access to a choice of foods and drinks. However kitchen staff were not fully aware of people's individual dietary needs and preferences.
Risks to people’s health and welfare had been assessed although information in people's care plans and risk assessments did not always provide an accurate reflection of people’s requirements.
People told us that staff were caring and respectful. Staff ensured that people’s privacy and dignity was always maintained. People were spoken to in a kind and polite manner. People were able to choose how they wished to spend their time. People expressed their opinion that the amount of activities on offer did not meet their expectations and could be improved.
People were not always consulted about the care and support that was individual or personal to them to inform their care plans and risk assessments.
People had not been facilitated to provide feedback on their experience of the service to monitor the quality of service provided.
The provider had systems in place to assess and monitor the quality of the service provided but these in the process of being introduced and were not always effective in identifying shortfalls.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.