Penwortham Grange and Lodge

Updated 26 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 09 March 2021 and was announced.

Updated 26 March 2021

Penwortham Grange and Lodge is in a residential area of Penwortham. The home offers residential support for up to 86 people who do not require nursing care. The home is split into the Grange and The Lodge. The Grange for 44 older people, and The Lodge for 42 people living with dementia. Each area is further divided into an upstairs unit and a downstairs unit. All bedrooms are single with an en-suite shower and toilet. There is wheelchair access and a lift to all floors. Outside there are garden areas and a car park.

The inspection visit took place on 25 and 26 September 2018. It was unannounced on 25 September and announced on 26 September.

At the time of the inspection 79 people lived at the home.

At our last inspection we rated the service good in all domains. On this inspection, we found the service good in safe, caring, responsive and well led. The effective domain was requires improvement. We found the evidence continued to support the rating of overall good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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 had been a change of registered manager since the last inspection. The current manager had been in post for around one year. When we undertook this inspection the registered manager was on annual leave.

Medicines were entered stored and disposed of safely, but were not always given at the prescribed intervals. On occasions the intervals between doses of medicines were insufficient. Not leaving an adequate gap between doses of this medicine could place people at risk of unnecessary side effects. This was rectified immediately after the inspection.

People able to consent said staff checked they agreed for them to provide care and support. Where people did not have capacity to make specific decisions best interests decisions were not always clearly recorded and Deprivation of Liberty Safeguards (DoLS) applications were not always completed or renewed promptly. However, these were completed by the second day of our inspection.

We looked around the building and saw accommodation and equipment to assist people with mobility and personal care was in place, had been serviced and maintained as required. The décor in the Grange met and was appropriate for people’s needs. The Lodge had been recently been redecorated and looked clean and maintained. However social and leisure equipment aimed at encouraging interest and interaction from people with dementia was not in place.

We made a recommendation about providing access to dementia friendly equipment.

Staff had been recruited safely and received training sufficient to develop the skills and knowledge. Most people spoken with told us there were usually enough staff on duty and they didn’t have to wait for long if they called staff. However, we saw the downstairs dementia unit was busy at mealtimes and could be unsettled. We also received a number of comments that staff were very busy including, “The staff are very busy at times – too busy. My issues would be because of not enough people around.”

We made a recommendation that staffing be kept under review.

People told us they felt safe and looked after by staff. One person told us, “I feel safe because I can ring the bell and someone will come to see me.” Another person said, “Of course I feel very safe.” There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments had been developed to minimise the potential risk of harm to people. These had been kept under review and were personalised to meet people’s needs.

We observed interactions between staff and people who lived at the home. These were positive friendly and supportive. We saw staff were attentive to people’s needs and wellbeing and responded promptly to requests for assistance. Staff provided care in a personalised way, taking people’s preferences into account. One person told us, “This is definitely a very good home. I wouldn’t want to leave here it is lovely.” One relative said, “I can’t say enough or praise this home high enough. It has a wonderful feel. My relative is content and that speaks volumes.”

Staff were aware of the importance of upholding people’s rights and diverse needs and treated people with respect and care. People told us they were supported in the way they wanted. They said staff provided care in a way that respected their dignity, privacy and independence. One person told us, “The staff are very respectful. They make sure they keep my dignity intact.”

We saw people had access to healthcare professionals. People told us staff cared for them in the way they wanted and met their care needs promptly. They referred them to healthcare professionals in a timely way. Surveys and written compliments showed staff provided caring and compassionate end of life care. A relative wrote, ‘We are grateful for the dedicated care [family member] received during her time in the home. Everyone cared for her with great kindness and understood her dementia.’

People told us they could get involved in social and leisure activities although these were more limited for people with dementia. Staff were welcoming to peoples’ families and friends. People said this assisted their well-being.

People told us they enjoyed the food provided and had choice and variety. We observed the lunchtime meal. People received sufficient food and drink and the assistance they needed to meet their diverse needs. The kitchen was clean, organised and stocked with a variety of provisions and staff were trained in food safety. A relative told us, “I’ve had several meals here. It is like being in a five-star hotel.”

There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when providing personal care to people so they did not risk causing cross infection. One person said, “I am impressed by how clean the environment has been and the quality of care.”

People who lived at Penwortham Grange and Lodge, their relatives and staff were positive about the management support in the home. Relatives said the management were very responsive and helpful. “The staff have a lovely pleasant manner and are so helpful, since [registered manager] came.” A member of staff said, “It’s all down to [registered manager], she’s brilliant. She has a presence about her and inspires us.”

The management team sought people's views in a variety of ways. They assessed and monitored the quality of the service through audits, resident, relative and staff meetings and surveys. People told us the management team were approachable and willing to listen. They knew who to complain to if they were not satisfied with their care and felt appropriate action would be taken. People also had information about support from an external advocate should this be required.

Further information is in the detailed findings below.