Background to this inspection
Updated
19 November 2022
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 Act.
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 one inspector and one specialist nursing advisor.
Service and service type
Conifer Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was no registered manager in post.
Notice of inspection
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service. 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. We used all of this information to plan our inspection.
During the inspection
We spoke with 2 people, 3 relatives and 5 staff, including the regional support manager, national clinical lead, lead nurse and 2 support staff. We spoke with another staff member on the telephone and contacted 3 external professionals via email.
We observed interactions between staff and people. We reviewed a range of records. This included 3 people's care records and medication records. We looked at 3 staff files. We reviewed a variety of records relating to the management of the service, including policies and procedures, training records, meeting minutes.
Updated
19 November 2022
About the service
Conifer Lodge is a residential care home providing personal care and support for up to 16 adults with mental health needs or associated conditions. At the time of the inspection there were 9 people living at the home.
People's experience of using this service and what we found
People and staff had not always been able to speak up when they had concerns. Governance and auditing arrangements had not identified the service as a closed culture. The provider had made a range of significant recent improvements to address this.
The service had no registered manager at the time of inspection. The provider had recruited a new manager and planned for them to register with CQC.
The interim management team demonstrated a strong understanding of the service and the culture, and had a clear vision for how to improve the culture, which had not always empowered staff.
Risks to people's health and safety were person centred, detailed and informed by updates from external healthcare professionals.
Staff worked hard to ensure people’s needs were met and they felt comfortable and safe.
The provider had reviewed safeguarding and whistleblowing policies and procedures to ensure they were understood. Staff now knew they could raise any concerns they had. The provider had worked well recently with external partners to ensure people’s safety when concerns were raised.
The environment was well maintained and clean. All utilities, safety and fire equipment were regularly checked.
Staff were recruited safely. There were competence assessments and themed supervisions meetings in place to ensure they knew how to keep people and themselves safe. The service relied on agency staff due to recent turnover of staff but had long term plans in place to reduce agency reliance.
Medicines were stored and administered safely, in line with best practice guidance.
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 26 September 2020)
Why we inspected
We undertook a focussed inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about safeguarding and whistleblowing protocols. A decision was made for us to inspect and examine those risks.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.