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Inspection Summary


Overall summary & rating

Inadequate

Updated 21 March 2019

This inspection took place on the 9, 10 January and 11 February 2019. The inspection was unannounced.

Lakeside Care Centre 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 service provides nursing care for up to 53 older people. At the time of the inspection there were 45 people living at the service. The home is set in beautiful surroundings overlooking a lake. It is made up of three floors with six bedrooms and the communal lounge and dining room on the ground floor. The remaining bedrooms are situated on the first and second floor. The main kitchen, laundry room and offices are situated on the ground floor.

There was a registered manager in post. 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 our previous comprehensive inspection in August 2015 the service was rated as good overall, with a requires improvement rating in the responsive domain. At this inspection we found multiple breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. Following this inspection, the service has been rated inadequate.

Some people and relatives were happy with the care provided. However, some people raised concerns about the skills of staff and some relatives and professionals were dissatisfied with the way the home was run and managed.

The delivery of high-quality care was not assured by the leadership, governance or culture in the service. People's records and other records such as staff files were not suitably maintained, accessible and accurate. The service was not effectively managed or audited. The service had systems in place to audit the service but the auditing failed to address the issues we found. There was no external auditing carried out which meant the service was not working to best practice in relation to the delivery of care.

Risks to people and people’s medicines were not appropriately managed. New staff were not inducted and staff were not suitably trained. Their competencies were not properly assessed for their role and tasks they performed. Most staff told us they felt supported but the records did not support that staff had the one to one supervisions recorded on the supervision matrix.

Systems were in place to safeguard people. However, we saw practices and concerns which should have been reported to the local authority safeguarding team to safeguard individuals had not been reported.

People were supported to make day to day choices and decisions. However, the service was not working to the Mental Capacity Act 2005 and procedures were carried out which were not agreed as part of a best interest decision.

Staffing levels varied and some people felt the staffing levels were sufficient. Whilst other people and their relatives told us staff were rushed, call bells were not answered in a timely manner and there was a delay in people being supported with their personal care needs such as toileting and meals.

People had care plans in place but they failed to provide the detail around how person centred care was to be delivered and how people’s communication needs were to be met in line with the Accessible Information Standard. .

Systems were not in place to comply with the Duty of Candour Regulation and the registered manager failed to notify the Commission of issues that they were required to.

People had access to other health professionals to meet their needs however, the service did not always

Inspection areas

Safe

Inadequate

Updated 21 March 2019

The service was not safe. .

People’s medicines were not appropriately managed.

Risks to people were not mitigated and safe care was not promoted.

People were not safeguarded from abuse.

Effective

Inadequate

Updated 21 March 2019

The service was not effective.

People were supported by staff who were not suitably inducted, trained and supervised in their roles.

People were consulted about their day to day care but the principles of the Mental Capacity Act 2005 were not followed for a person who was assessed as having limited capacity.

People’s health and nutrition needs were identified.

Caring

Requires improvement

Updated 21 March 2019

The service was not always caring.

Some people described staff as kind and caring. However, some staff did not always demonstrate those qualities and did promote people’s dignity and show respect.

People’s privacy was promoted.

Responsive

Requires improvement

Updated 21 March 2019

The service was not always responsive. .

People’s care plans were not person centred and their needs were not clearly identified and met.

People were not provided with information suitable to their needs in line with the Accessible Information standard.

People’s had access to activities.

Well-led

Inadequate

Updated 21 March 2019

The service was not well-led

The service was not appropriately managed and monitored to ensure that safe care was provided.

The registered manager did not make the required notifications to the Commission and did not work in line with the Duty of Candour Regulation.

People’s records and other records were not suitably maintained, accessible, accurate and up to date.