Archived: Edendale Lodge

Edendale Lodge is a residential care home that accommodates up to 35 older people who may be living with dementia. At the time of inspection, there were 25 people living at the service.

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

The culture of the home was not inclusive or empowering. We saw large periods of the day where people received little or no engagement from staff.

We observed that the majority of people were not socially stimulated. There were limited activities provided for most people in the service. After the inspection, the registered manager further confirmed that people regularly left the service for planned outings such outing to Battles Big Weekend, where they hosted a stall.

People told us, “I love it here; they look after me” and “Yes, they always look after us.” However, our observation showed there were not enough staff to meet people’s needs.

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.

Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider followed safe recruitment practices.

Medicines were stored and managed safely by staff. There were policies and procedures in place for the safe administration of medicines, which staff followed.

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 requires improvement (published 24 February 2021) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found some improvements had been made in some areas. However, we found a new breach and the service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 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, responsive and well-led which contain those requirements. 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 remained requires improvement. This is based on the findings at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Edendale Lodge is a residential care home that accommodates up to 35 older people who may be living with dementia. At the time of inspection, there were 15 people living at the service, this included one person who was admitted to the home on the day of our inspection.

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

Although the service had an infection prevention and control (IPC) policy, we found that new people admitted to the home were not being supported to isolate from other people at the home in line with government guidance. People had received a negative COVID-19 test before coming to the home, but the provider had not followed government guidance that people should be supported to isolate on admission for 14 days. We received assurances after the inspection that this was now being done.

The registered manager told us the provider had admitted five people to the service in a short space of time, this had put pressure on staff and the home. Staff told us that it was difficult to get to know people when people are admitted in quick succession. Staff told us they did not feel there were enough staff to safely support people. We saw that some people’s records were not fully completed, and staff told us that this was because they did not have time.

Staff had experienced pressure in dealing with the COVID-19 outbreak. We found this had impacted on record keeping and staff needed time to catch up and reinstate their regular quality assurance checks.

Relatives told us that they were informed of accidents and incidents and that they felt their loved ones were safe. However, some relatives told us they found it hard to get hold of the registered manager and found it difficult to get general information.

Risks to people were safely managed and risk assessments were in place to identify support needs of people who were at risk of falls, behaviour that challenges, choking and skin break down. People living at the service seemed relaxed around staff and one person told us, “It’s alright here, I like it”. Relatives were positive about the care provided to their loved ones.

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 (29 March 2019)

Why we inspected

We received concerns in relation to personal care, risk management and communication between the registered manager and relatives. The service had also recently experienced an outbreak of coronavirus. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this full report.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified breaches in relation to infection prevention and control and staffing at this inspection.

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

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Edendale Lodge is registered to provide support to a maximum of 35 people and 22 people were living at the service at the time of our inspection. The service is intended for older people, who may be living with a physical disability, sensory impairment or a dementia type illness.

People’s experience of using this service:

People told us and we observed that they were safe and well cared for and their independence was encouraged. Comments included, “I like it here,” and, “I’ve settled in now.”

• Whilst the provider had a quality assurance system to review the support and care provided, there was a need to develop the audits to ensure that when issues were identified that a date and action was recorded to enable the provider to evaluate actions taken to consistently drive improvement. For example, ensuring medicine errors and discrepancies were acted on and appropriate action taken. There were policies and procedures for medicine administration but these had not always been followed by staff. Staff feedback regarding the lack of opportunity to provide meaningful activities was known but not yet acted on. Care plan audits had not identified the need to develop the care plans to provide more in-depth guidance for new staff to follow. These were areas that required improvement.

• There were safeguarding systems and processes that protected people from harm. Staff knew the signs of abuse and what to do if they suspected it. One staff member said, “We receive training in safeguarding, I wouldn’t hesitate to raise a safeguarding if our residents were at risk.”

• There were sufficient staff to meet people’s individual needs: all of whom had passed robust recruitment procedures that ensured they were suitable for the role.

• There were systems to monitor people's safety and promote their health and wellbeing, these included health and social risk assessments and care plans. The provider ensured that when things went wrong, these incidents and accidents were recorded and lessons were learned.

• Staff received appropriate training and support to enable them to perform their roles effectively. Visitors told us, “Staff seem knowledgeable, look after my relative really well,” and “The staff are approachable and keep us informed."

• People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes. People gave positive feedback about the food. Comments included, “Plenty of choice and always tasty,” and “I like the food.”

• The environment was comfortable and was adapted to meet people's needs. One person said, “Good place to live, I like being outside.”

• People and relatives told us staff were ‘kind’ and ‘caring’. They could express their views about the service and provide feedback. One person said, “We are looked after.”

• People's care was personalised to their individual needs. There was sufficient detail in people's care documentation that enabled staff to provide responsive care.

• People and relatives provided consistently positive feedback about the care, staff and management. They said the service was safe, caring and well-led. One visitor said, “I visit a lot and my relatives are very settled and happy.”

•People were supported to keep in contact with their families.

• The care was designed to ensure people's independence was encouraged and maintained.

• People and families were involved in their care planning. End of life care planning and documentation required further development but this had been identified and work was on-going.

• There was a happy workplace culture and staff provided positive feedback about the management style.

• Referrals were made appropriately to outside agencies when required. For example, GP visits, community nurses and speech and language therapists (SALT). Notifications had been completed to inform CQC and other organisations when events occurred.

The service met the characteristics for a rating of ‘Good’ in three of the five key questions we inspected with the responsive and well-led question being ‘Requires Improvement.’ Therefore, our overall rating for the service after this inspection was ‘Requires Improvement’.

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

Rating at last inspection:

• This was Edendale Lodge's first inspection. Edendale Lodge was purchased by Belmont Healthcare in 2018 as an existing service. A sister home, Edendale Care Home closed and the staff and people transferred to Edendale Lodge from if they had wished to.

Why we inspected:

This was a planned inspection based on the date of the registration of the service.

Follow up:

• All services rated as ‘Requires improvement’ are re-inspected within one year of inspection.

• 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.