Archived: Coniston Lodge Care Centre

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Procedures were in place to protect people from abuse. We found staff had been trained

and were able to respond appropriately to allegations or suspicions of abuse or neglect.

We found staff recruitment procedures to be effective and safe. People were being cared

for by suitably qualified, skilled and competent staff.

Systems were in place to make sure staff reported accidents and incidents. However there was no evidence of analysis of falls or other incidents so that problems could be identified and improvements made to the service.

The provider had suitable procedures to manage emergencies. Staff had received training to enable them to respond to emergencies and were aware of the relevant contacts for help and support. However recent alerts had been raised by a third party provider in relation to staff competence in following these procedures.

The home had proper policies and procedures in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards and followed these procedures correctly when needed. There had been one application under the Deprivation of Liberty Safeguards which had been managed correctly.

Is the service effective?

People's needs had been assessed and individualised care plans were produced. These took account of people's needs and wishes. Assessments and care plans addressed people's physical, communication, emotional and social needs. Cultural, dietary and religious preferences were acknowledged, demonstrating respect for people's diversity and choice.

Daily records were maintained to ensure people's health and well-being were monitored. However we identified omissions in record keeping and failures to follow up health issues promptly in some cases.

Is the service caring?

People were supported by kind and attentive staff. We saw care staff understood people's individual needs and limitations and communicated with them in an empathetic and appropriate manner. We saw people were offered choice and their independence promoted. People we spoke with and their relatives were happy with the care and support they experienced and were complimentary about the staff. One resident commented, "I like it very much people are very kind and very nice. You can choose what you want to do. If had concerns I would tell my family." The relative of another person told us, "The staff seem caring and kind."

People using the service and their relatives completed an annual satisfaction survey. The latest report showed general satisfaction with the care provided although some problems were identified. The provider held regular meetings for people and their relatives so they could express their views.

Is the service responsive?

Care was evaluated on a monthly basis. However these records did not always reflect needs as assessed and lacked sufficient detail to monitor care effectively. Six monthly reviews of care were not always recorded and although relatives were invited to reviews, their level of involvement was not consistently documented.

There was a program of activities and entertainment organised to help to keep people involved in the daily life of the home and interact with others.

There was a documented complaints procedure to use if people or their families were unhappy about the service. However procedures and actions were not always thoroughly documented and evidenced. People could not therefore be assured complaints were investigated and actions were taken as necessary.

Is the service well-led?

The provider had a variety of systems to monitor the quality of service provided and audit their performance. People using the service and their relatives had regular opportunities to provide feedback on their care and express their views. There were appropriate procedures for dealing with complaints and reporting accidents and incidents although complaints had not always been documented properly.

Several people were having end of life care and we saw evidence of review and regular visits by the homes General Practitioner and the palliative care team.

Regular medication audits were being carried out both by the provider and the supplying pharmacist, The last internal audit was carried out in November prior to the start of the current medicines cycle. We could see from the audits that areas of concerns were identified and actioned, The manager had introduced daily checks of the MAR charts and this had improved recording. The home was currently developing individual protocols for giving medicines as and when they were needed.

Safe systems were in place for the management of medicines and the manager addressed a few concerns we observed at the time of the inspection

Overall people were protected against the unsafe management of medicines.

People said they were able to make choices and staff listened to them. They confirmed they were being well cared for and staff were available to support and assist them. One person said, 'You only have to ask and they get you something' and another said, 'I am very content here'. A relative told us, 'The home is absolutely fantastic. Staff are very patient, helpful and understanding.'

People and relatives said they were confident to raise any concerns and that these would be addressed. Staff understood safeguarding procedures and were clear about reporting incidents that could constitute abuse.

People said they received their medicines from the registered nurses. Procedures for the management of medicines were in place but were not always being followed, putting people at risk of not receiving their medicines as prescribed.

Staff said they received training and updates to keep their knowledge and skills up to date. One person said of staff, 'they are very good, 20 out of 20'.

Systems were in place for quality assurance and where shortfalls had been identified, action plans had been drawn up and action taken to address them.

People told us that they were happy with the care they were given and staff understood their needs. One person said, 'l am well looked after, everyone is ever so kind, I can not complain'. People confirmed that staff respected them at all times and they were able to make choices. People told us there was sufficient food and drink at the home, had no cause to complain and the food was served hot. We found that people were supported fully to maintain an adequate nutrition.

The environment of the home was maintained, with routine maintenance ongoing to

ensure the home was safe for the people who use the service. There was a reported bed bugs infestation, but the provider had taken all necessary action and the situation was under control. We found that there were sufficient numbers of staff to support people's needs and staff confirmed they had the knowledge and expertise to care for people. We observed that the records kept by the provider were fit for purpose, easily available when requested and were kept secure to safeguard