Clapham Lodge Care Home

Updated 22 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector and an assistant inspector.

Service and service type

Clapham Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Clapham Lodge Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. Following our inspection, the current manager has submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced. Inspection activity started on 7 February 2023 and ended on 28 February. We visited the service on 7 February 2023 and spoke with the provider and nominated individual on 28 February. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 5 people who used the service and 6 relatives about their experience of the care provided. We spoke with 11 members of staff including the manager and 3 visiting professionals.

We reviewed a range of records. This included people’s care records and medication records. We looked at records in relation to recruitment, staff supervision, audits, accident and incident records, staffing rotas and a sample of policies and procedures.

Following our visit to the service we looked at additional documents the manger and provider sent us. This included a variety of records relating to the management of the service.

Updated 22 April 2023

About the service

Clapham Lodge Care Home is a residential care home providing personal care to up to 27 people. The service provides support to people who have a diagnosis of a dementia, Parkinson's disease and other conditions which included diabetes. At the time of our inspection there were 20 people using the service.

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

Systems to identify and mitigate people’s risk of falls was not effective, records were incomplete and there was no evidence of actions taken to prevent repeated incidents. People told us there were times when the care staff were under pressure. The deployment of care staff added to this pressure as additional tasks, such as cooking, routinely fell to them. Staff told us the administration of medicines did not feel safe, as they were constantly interrupted. Staff were recruited safely.

The service was not effectively managed, records were not fully completed, complaints were not recorded, and CQC was not notified of significant events. There was a lack of oversight and governance by the manager. Checks and audits were not effective to monitor the quality and safety of the service. Systems were not in place to demonstrate the service operated effectively to ensure compliance with the regulations. People and staff and had limited opportunity to feedback about the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published on 6 December 2018).

Why we inspected

The inspection was prompted in part due to concerns received about accidents and incidents, staffing levels, medicines management and infection control practices. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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 have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clapham Lodge Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, good governance and failure to notify CQC of significant events at this inspection

Please see the action we have told the provider to take at the end of this report.

Follow up

We met with the provider to discuss the findings of this inspection and how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to further understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.