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Nayland Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 May 2021

About the service

Nayland Lodge is a residential care home providing care and support to people who have a mental health disorder. Nayland Lodge accommodates up to eight people in one adapted building and there were eight people using the service at the time of our inspection.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help or prompting with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

There was a lack of consistency in how well the service was managed and led with no stable management for over three years. This had impacted on the provider’s ability to influence the service positively, support the delivery of person-centred care, and drive improvement.

The provider was open and transparent with us; they recognised serious issues had not been picked up and a failure in their systems to provide effective oversight and governance. They have started to be responsive, listen to staff and know what they need to do to improve.

People had not been supported to take an active role in their care and support and general blanket restrictions had been put in place and imposed without an assessment of individual’s needs. The provider had taken action to lift blanket restrictions and to consult and support people to make choices and promote independence.

People’s care records held on the home’s electronic system were in parts brief. Improvement was needed to ensure care records showed how the service was fully supporting people and how they were responding to the risks people faced.

At the time of our visit the service was at the end of an outbreak of Covid-19. The service was working closely with the local authority, Public Health England and the Clinical Commissioning Group (CCG) infection control team to ensure their infection prevention and control (IPC) practice was safe and people’s needs were being met. Recommendations for improvement had been addressed by the provider. There was plentiful supply of personal protective equipment (PPE) and staff had received training in IPC. National guidance was being followed on the use of PPE and care home visiting.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 20 November 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/sustained, and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. We also received concerns in relation to restrictive practice. The provider has taken some action to address restrictive practice, but further improvement is needed.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed from requires improvement. Th

Inspection areas

Safe

Requires improvement

Updated 13 May 2021

This service was not always safe.

Effective

Requires improvement

Updated 13 May 2021

Caring

Good

Updated 13 May 2021

Responsive

Requires improvement

Updated 13 May 2021

Well-led

Requires improvement

Updated 13 May 2021

The service is not always well-led.