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Ernehale Lodge Care Home Good

The provider of this service changed - see old profile

Reports


Inspection carried out on 5 December 2019

During a routine inspection

About the service

Ernehale Lodge Care Home is residential care home which provides accommodation for up to 30 people who require nursing or personal care. At the time of the inspection 14 people were living at the home.

People’s experience of using this service:

Since our last inspection improvements had been made in all areas where we had highlighted significant concerns to people’s health and safety.

Improvements had been made to the way risks associated with people’s care were assessed and acted on. People were now provided with safe care and treatment. People were now protected from the risk of avoidable harm and abuse. The provider ensured the relevant authorities were now informed of all incidents that could affect people’s safety. People told us they felt safe with staff. There were enough staff to support people safely. The risk of the spread of infection was now safely managed. The provider had systems in place to help staff to learn from mistakes. People’s medicines were safely managed.

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

People received care in line with their assessed needs. Staff were well trained and felt supported to carry out their role effectively. People received the support they needed to maintain a healthy diet. People had access to other health and social care agencies where needed. The home was well-maintained and adapted to support people living with dementia or disability.

People praised the approach of staff. They liked them and had formed positive relationships with them. People and staff commented on an improved atmosphere at the home. Our observations supported this. People were treated with dignity and respect and their independence was supported and encouraged. People felt able to give their views and they would be acted on.

People now received care and treatment in accordance with their likes, dislikes and preferences. Care records were improved and provided staff with person-centred information which enabled them to care for people in their preferred way. Activity provision had improved and people no longer felt socially isolated. Efforts had been made to provide people with information in formats they could understand. People felt staff responded to complaints or concerns raised. The complaints procedure did not contain the correct details of who could investigate complaints if they were not satisfied with the outcome. End of life care was provided where required. Efforts were being made to ensure that all people had the opportunity to have their wishes recorded.

Significant improvements had been made in the way the home was managed. Quality assurance processes had improved since our last inspection. The registered manager and provider now worked together to identify and act on risks to people and the environment. We had confidence that these improvements were sustainable.

The registered manager had been in place for almost twelve months; people and staff commented on the positive impact they had had on the home. Our observations supported this. The registered manager and provider had a good knowledge of the regulatory requirement to report concerns to the CQC and had improved the reporting process. People’s views about the quality of the service provided were requested and acted on to aid continual improvement and development.

Rating at last inspection and update:

The last rating for this service was inadequate (published 10 July 2019). The service’s rating has now changed to good.

This service has been in Special Measures since 17 December 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carr

Inspection carried out on 26 April 2019

During a routine inspection

About the service: Ernehale Lodge Care Home is a care home that provides personal care for up to 30 people in one purpose-built building. It is registered to provide a service to people who may be living with dementia or physical disability. At the time of the inspection 20 people lived at the home.

People’s experience of using this service: The service was not safe. People were placed at risk of harm as risks associated with their care and support and the environment were not managed safely. Opportunities to learn from accidents had been missed which meant people had been exposed to the risk of avoidable harm. People were not protected from the risk of infection. Although people told us they felt safe, action had not always been taken to protect people from improper treatment and abuse. Overall there were enough staff, however, there were concerns about night time staffing levels. Safe recruitment practices were followed.

People’s rights under the Mental Capacity Act 2015 were not protected. Staff required more effective training and support to enable them to provide high quality care. We have made a recommendation about this. Mealtimes were positive experiences; however, more work was needed to ensure risks were managed safely. People had access to a range of health care professionals. Overall, the home was adapted to meet people’s needs, but further work was needed to ensure the environment was well maintained.

People’s right to privacy and to be treated with dignity were not always upheld. People told us that staff were kind and caring. However, care plans lacked information about people which meant staff did not always have enough information to provide person centred care. There was an inconsistent approach to involving people in decisions about their care and support.

People did not consistently receive personalised care that met their needs. People were not consistently provided with opportunity for meaningful activity. People were supported to raise issues and concerns and there were systems in place to respond to complaints.

Ernehale Lodge Care Home was not well led. There had been a failure to identify and address issues with the safety and quality of the service. Systems to monitor and improve the quality of the service were not effective. Where audits had identified areas for improvement action had not been taken to address issues. This failure to identify and address issues had a negative impact on the quality of the service and for people living there.

The service met the characteristics of Requires Improvement in three areas and Inadequate in two areas; more information is in the full report.

Rating at last inspection: Inadequate (report published on 8 January 2019). At the last inspection September 2018, we asked the provider to take action to make improvements in relation to promoting dignity and respect, risk management, staff recruitment and governance and leadership. At this inspection we found action had been taken in some areas but not others. You can see what action we told the provider to take at the back of the full version of the report.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Enforcement: You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service therefore remains in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the s

Inspection carried out on 17 September 2018

During a routine inspection

The inspection took place on 17, 19 and 25 September 2018, and the first day was unannounced. Ernehale Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Nursing care is provided at this service.

Accommodation for up to 30 people was provided over two floors. The service has 20 bedrooms, ten of which are intended for shared use. There were 26 people using the service at the time of our inspection. Ernehale Lodge Care Home is designed to meet the needs of older people living with or without dementia.

The last inspection was on 5 and 6 June 2017, when we rated the service as Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Caring, Responsive and Well-Led to a rating of at least Good. On this inspection, we found these improvements had not consistently been made.

People were not protected from risks associated with their health needs. Risks associated with the service environment had not always been assessed and mitigated. There was no comprehensive system to enable the registered manager or provider to review accidents and incidents. People’s medicines were not always managed safely. People were not kept safe from the risks associated with infection. The provider had not carried out thorough recruitment checks to ensure staff were suitable to provide personal and nursing care. Staff did not have training the provider identified as necessary to do personal and nursing care effectively.

People were not consistently supported to have enough to eat and drink to maintain a balanced diet. People were not always supported to have their daily personal hygiene needs met. People sharing bedrooms did not have their privacy and dignity needs considered. People did not always have their privacy and dignity considered when receiving care. Written information about people’s care was not stored securely.

People and relatives were not consistently supported to participate in making decisions about planning or reviewing of their or their family member’s care. Information in people’s care plans was not consistently kept up to date. This meant there was a risk staff did not have the information they needed to provide personal or nursing care people were assessed as needing.

There was limited evidence the provider undertook any surveys with people or staff at the service to identify what was working well and what improvements they would like to see. There was a risk that the views or people, relatives and staff were not used to drive improvements in the service.

The service was not well-led. During this inspection we identified shortfalls across all of the key questions we ask about services. Systems in place to identify whether people were receiving the care they were assessed as needing had not identified the issues we found on this inspection. Feedback had not been acted on to improve the quality of care for people living at the service. The provider had not taken steps to demonstrate the quality of the care people received was reviewed as part of an effective governance process.

People and relatives said they felt safe living at the service. People were kept safe from the risk of abuse. The systems in place to identify and deal with concerns worked to safeguard people from abuse. People and relatives had mixed views about staffing levels. The provider reviewed people's care needs and adjusted staffing levels to ensure people received the care they required. People were supported to access their GP and other external healthcare when they needed. Feedback from external healthcare professionals was positive regarding staff seeking medical advice in a timely way. People and relatives knew how t

Inspection carried out on 5 June 2017

During a routine inspection

We inspected Ernehale Lodge Care Home on 5 and 6 June 2017. The inspection was unannounced. The home is a situated in Arnold in Nottinghamshire and is operated by Ernehale Lodge Care Home Limited. The service is registered to provide accommodation for a maximum of 30 older people. The service has 20 bedrooms, ten of which are intended for shared use. There were 24 people living at the home on the days of our inspection visit.

Ernehale Lodge had been taken over by a new provider at the start of April 2017. The registered manager and staff team had been transferred over from the previous provider.

The service had a registered manager in place at the time of our inspection. 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.

During our inspection we found the systems in place to reduce the risks associated with people’s care and support were not always effective. People were not protected from risks associated with the environment and the service was not clean and hygienic in all areas. People received their medicines as prescribed; however medicines were not always stored or managed safely.

There was a risk that people may not receive the support they required as there were not always sufficient numbers of staff deployed. Safe recruitment practices were not always followed. Staff did not always receive suitable training or support to enable them carry out their duties effectively and meet people’s individual needs. Staff were provided with regular supervision.

People’s rights under the Mental Capacity Act (2005) were not respected at all times. In addition, people could not be assured that they would be supported in the least restrictive way possible. Where people had capacity they were enabled to make decisions and their choices were respected.

People were not protected from the risk of dehydration and malnutrition as people’s food and fluid intake was not always appropriately monitored. However people told us they enjoyed the food and had enough to eat and drink. People had access to healthcare and their health needs were monitored and responded to.

People’s right to privacy was not respected at all times and they were not always treated in a dignified manner.

Staff were kind and caring and had an understanding of what was important to people living at the home. People felt involved making choices relating to their care and were supported to maintain their independence. People were supported to maintain relationships with family and friends and visitors were welcomed into the home.

People could not be assured that they would receive the support they required as care plans did not always contain accurate, up to date information. People were not consistently provided with the opportunity for meaningful activity. However there were plans in place to make improvements in this area.

People were supported to raise issues and concerns and there were systems in place to respond to complaints. People and staff were involved in giving their views on how the service was run.

Systems in place to monitor and improve the quality and safety of the service were not effective. Action had not been taken to review and update important policies and documents relating to the running of the home. Sensitive personal information was not always stored securely. The provider had plans in place to improve some aspects of the service.

The above concerns in relation to the quality and safety of the service resulted in us finding multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to privacy and dignity, safe care and treatment, staffing, consent and good governance. You can see wha