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Archived: Willow Lodge Inadequate

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Inspection Summary


Overall summary & rating

Inadequate

Updated 8 December 2017

Willow Lodge is located in a residential area of Ormskirk, close to the town centre and all local amenities. The home provides support for up to 22 people who require assistance with personal or nursing care needs and who are living with a dementia related condition. Accommodation is available in both single and shared facilities on two floors served by a passenger lift and stairs. There are spacious communal areas available including lounges and two conservatories. There is parking to the front of the property and a garden area to the rear of the home. At the time of our inspection there were 19 people who lived at Willow Lodge Nursing Home.

The registered manager of Willow Lodge had left employment unexpectedly four months prior to 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 of the Health and Social Care Act and associated regulations about how the service is run. The deputy manager had taken on the role of acting manager and was on duty throughout the inspection process.

At the last inspection on 6 December 2016 we rated the service as ‘Requires Improvement’. This was because four breaches of legal requirements were found. These were in relation to person-centred care, safe care and treatment, safeguarding service users from abuse and improper treatment and good governance. At that time Willow Lodge was placed in special measures because the area of ‘safe’ was rated as ‘inadequate’. Therefore, we took steps to ensure people were made safe and the provider submitted an action plan detailing the improvements they planned to make. Comments contained in the action plan were considered during this inspection.

We found at this comprehensive inspection on 03 October and 10 October 2017 the provider had met the legal requirements in relation to person-centred care and safeguarding service users from abuse and improper treatment. However, the concerns previously raised in relation to safe care and treatment and good governance had not been adequately addressed. Therefore the provider continued to fail to meet the legal requirements of the regulations in these areas. We also found the provider did not meet the required regulations in relation to fit and proper persons employed. The domains of ‘safe’ and ‘well led’ were rated as ‘inadequate’ and therefore Willow Lodge remains ‘inadequate’ overall and in special measures.

People who lived at Willow Lodge told us they felt safe being there. Fire procedures were readily available, so that staff were aware of action they needed to take in the event of a fire. However, we found parts of the environment to be unsafe and the management of medicines was poor. There was no evidence available to demonstrate all systems and equipment within the home had been appropriately serviced to ensure they were safe and fit for use. Records were not available about how people needed to be assisted from the building, should evacuation be necessary. Therefore, this was a continuous breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that quality monitoring systems had been implemented, but these were not always effective, particularly in relation to medicines management, care planning, recruitment and safety and suitability of the premises. The plans of care were in general well written documents. However, the ones we saw had not all been reviewed and updated to reflect people’s current needs. Although the provider was aware of this; action had not been taken to address these failings. Therefore, this was a continuous breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Recruitment practices adopted by the home were poor. Appropriate background checks had not been conducted, which m

Inspection areas

Safe

Inadequate

Updated 8 December 2017

This service was not safe.

Recruitment practices adopted by the home were poor. New staff had not received formal induction and relevant checks had not been completed before staff members started to work at the home.

Although some improvements had been made to the environment, there were many areas which were unsafe and needed to be addressed.

Health and social care risk assessments had been conducted. However, medicines were not being well-managed.

Safeguarding referrals had been made to the relevant authorities. However, Personal Emergency Evacuation Plans were not in place.

Staff members were aware of the procedures to follow should they have concerns about the welfare of those who lived at the home.

Effective

Requires improvement

Updated 8 December 2017

This service was not consistently effective.

Training was provided for staff, but the training matrix was not up-to-date. Supervision sessions were arranged, but these were not structured and annual appraisals were not being conducted.

Mental capacity assessments had been conducted, in accordance with the Mental Capacity Act. Deprivation of Liberty Safeguard approvals had been requested, where necessary. The information recorded was very detailed.

Meal times were being well managed.

Caring

Good

Updated 8 December 2017

This service was caring.

Staff were seen to be kind, caring and respectful of people's needs. Those who lived at Willow Lodge were supported to access advocacy services, should they wish to use this service.

Records were retained in a confidential manner and people's privacy and dignity was respected.

Those who lived at the home were supported to maintain their independence, as far as possible and staff members communicated well with those in their care.

Responsive

Requires improvement

Updated 8 December 2017

This service was not consistently responsive.

We found the care plans and risk assessments were often linked in order to promote a holistic approach to care. However, two plans of care we saw did not accurately reflect people�s current circumstances.

The provision of activities was limited. There was no evidence to show that staff supported people to maintain their individuality and to participate in a choice of activities.

Complaints were being well managed.

Well-led

Inadequate

Updated 8 December 2017

This service was not well-led.

The home had developed systems for assessing and monitoring the quality of service provided. However, the auditing system had not consistently identified areas in need of improvement.

A wide range of policies and procedures were in place. Feedback was sought from those who used the service. However, feedback had not been gathered from staff members or community professionals.

Meetings for the staff team were evident, but not for those who lived at the home or their relatives, although an open door surgery had been arranged.