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Archived: Stockton Lodge Care Home Good

The provider of this service changed - see old profile

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Reports


Inspection carried out on 9 March 2015

During a routine inspection

The inspection visit took place on the 9 March 2015 and was unannounced which meant the staff and provider did not know we were visiting.

Stockton Lodge Care Home is registered to provide nursing and personal care for up to 48 people. It caters for people with general nursing and residential care needs and is situated in the Stockton area.

We last inspected the service on 5 January 2014 and found the service was compliant with regulations at that time.

There was not a registered manager in post. They had recently left the service two weeks ago and the service was currently being managed by an experienced regional 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.

There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The acting manager had the appropriate knowledge to know when an application should be made and how to submit one. The manager also ensured that capacity assessments were completed and ‘best interest’ decisions were made in line with the MCA code of practice. This meant people were safeguarded.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Most people told us they felt safe at the service, although one person and one relative raised some concerns around staffing and care by agency staff and this was discussed with the acting manager at the time of the visit. Staff told us they felt there wasn’t always enough staff on duty and people who used the service told us they sometimes had to wait for staff. We also noticed that call bells were ringing for extended periods during our visit which indicated that there were not enough staff on duty to meet the needs of people living at the service. The staff team were supportive of the acting manager and each other.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

Medicines were stored in a safe manner. We witnessed staff administering medication in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace.

There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. We spoke with kitchen staff who had a good awareness of people’s dietary needs and staff also knew people’s food preferences well. One person told us that they had raised an issue regarding the food, it was dealt with immediately and they were very satisfied with the outcome.

We saw people’s care plans were personalised and had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved, when they were able, the person. We saw people being given choices and encouraged to take part in all aspects of day to day life at the service. We witnessed staff using a communication book with one person who had difficulties in verbalising. A visiting occupational therapist was highly impressed that the service had used their initiative to source this aid and implement it themselves.

The service encouraged people to maintain their independence and the activities co-ordinator ran a full programme of events which included accessing the community with people.

The service undertook regular questionnaires not only with people who lived at the home and their family but also with visiting professionals and staff members. We also saw a regular programme of staff and resident meetings where issues where shared and raised. The service had an accessible complaints procedure and people told us they knew how to raise a complaint if they needed to. This showed the service listened to the views of people.

Any accidents and incidents were monitored by the interim manager to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks.

The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Stockton Lodge.

Inspection carried out on 6 January 2014

During a routine inspection

During the visit we spoke to ten people receiving care, four relatives, eight members of staff, one health professional and one other visitor. Not all of the people we spoke to could express themselves. The majority of people spoke highly of the care provided at Stockton Lodge but one relative had some concerns.

People had needs assessments completed and full and detailed care plans were also in place. Overall we were satisfied that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One relative told us, “We are happy that they are safe, secure and happy.”

We found that nutritious food in adequate quantities was available to people and that refreshments were freely available. One person said, “We have a choice of good food which suits me.”

We found the home to be homely, and overall clean and hygienic. "The cleaners never stop." One person said.

We found that procedures were in place to prescribe medication appropriately.

People were protected from unsafe or unsuitable equipment because the provider completed regular maintenance checks on all equipment and ensured that people remained comfortable.

Inspection carried out on 11 January 2013

During an inspection in response to concerns

We inspected Stockton Lodge Care Home in response to allegations of concern that had been raised in relation to the quality of care. There had also been a change within the management arrangements within the home.

We saw that staff were respectful to patients, and they tailored the way they spoke to individuals so they were supported to understand what was happening. We saw that staff treated people with dignity and respect. However, we did see that some staff members focussed on the tasks to be completed, rather than the person they were supporting.

We found that the home had assessed people's needs to determine if any risks were present. These assessments had been used to develop detailed person centred care plans for people. We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Inspection carried out on 7 June 2012

During an inspection to make sure that the improvements required had been made

We spoke with four people using the service and the relatives of three people using the service.

One person said, "I prefer to get up early and go to bed early. Staff know this and so that is what they help me do." They also said, "The activity coordinator is brilliant, I go out shopping with her and help her count out the money for people. She does my nails for me. My nails grow really quickly, but she always does it."

One relative told us, "I have been invited to reviews about my relative, so I know what is going on. I feel informed and involved." Another said, "They invite me to all her reviews, so I know what is happening and I can tell them what I think. They ask me which is good, as I am not always very good at speaking out, and I wouldn't always say if something wasn't right."

They also told us, "The home is good, I've not had problems. If I had to complain about anything, I would just speak to the manager. Her door is always open. I've noticed a change in the home since the new manager started. It's been better. The communication has improved." Also, "There are some good staff that the home need to hang onto."

People told us that they thought the home was good. They said they got on well with staff, and were able to talk to them if they had any concerns.

Inspection carried out on 20 December 2011

During an inspection to make sure that the improvements required had been made

The visit took place because we were following up issues we had raised during the last

inspection in August 2011. Since this inspection, new owners have taken over the home. They were aware of the issues we raised during our last visit. At this inspection we spoke with ten people who use the service and five relatives. Generally when talking with people we concentrated on the specific areas that had been raised at the last inspection. People told us that ''I like the staff but now and again the other residents do upset me'', ''We have a laugh and fun with the girls'' and ''On the whole I think it is good here''. People told us that they found the new manager was making some positive changes to the home.

Whilst we were visiting people raised some complaints about the service with us, as they had found that when they raised them with staff no action was taken. ''I have complained about the layout in the lounge, as where the chairs are you just can't be seen and therefore it is hard to catch the attention of the staff, but no one will alter the room''. One relative told us that the lack of accessible call alarms in the lounge meant people always had to wait until the staff came into the room. They said this meant that people could be waiting a long time before they managed to catch the attention of staff. Another person said ''We have no access to a public phone but the only way it got sorted was when my niece bought me a mobile phone''. We heard two people raise issues with the staff about the heating not working and the size of the portions of food. Neither issue was taken on board as a complaint. Staff appeared to feel that these issues were not real problems, so disregarded them. We found that the heating was not working in parts of the home and as three-course Christmas meals were being offered, the cook had tried to make the portion size manageable. This had meant that the starters had looked quite small.

Some of the people living at the home found it difficult to fully discuss their thoughts about the service. Therefore we used a specific way of observing care to help to understand their experience. This involved spending a substantial part of the visit observing a group of people to see how they occupied their time, appeared to feel and how staff engaged with them. From our observation staff were working in ways that supported the people. On very odd occasions staff did talk to each other, rather than the person they were helping. But staff mainly made sure individuals could follow what was being said; included people in conversations; and approached people in a caring manner.