Walmer Lodge Residential Home

Updated 6 July 2023

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 Health and Social Care Act 2008.

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

Two inspectors carried out the inspection.

Service and service type

Walmer Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Walmer Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The registered manager was not present during the inspection. A manager who was in day-to-day control of the service was present.

Notice of inspection

This inspection was unannounced. Inspection activity started on 18 May 2023 and ended on 2 June 2023. We visited the service on 18 and 24 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time with people in the communal areas observing the care and support provided by staff. We spoke with 5 people who used the service about their experience of the care provided. We spoke with 4 staff including the manager and care workers.

We reviewed a range of records. This included 4 people's care records and 7 people's medicine records. We looked at 2 staff recruitment files. A variety of records relating to the management of the service were reviewed.

Updated 6 July 2023

About the service

Walmer Lodge is a residential care home providing personal care for up to 12 people with mental health needs, as well as people with a learning disability and/or autism. At the time of the inspection there were 9 people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Medicines management was not safe as records were not always accurate. There was no system in place to calculate safe staffing levels. Care staff completed all cooking and cleaning tasks which impacted on the time they had to spend with people.

We have made a recommendation that the provider implements a staffing dependency tool and reviews the current staffing levels to ensure people’s needs are met.

People’s independence was promoted and they were supported to access the community safely. There was an ongoing refurbishment plan and people were involved in choosing the décor and furniture. Some people, where required, had positive behaviour support plans which helped staff support individuals and use de-escalation.

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.

Right Care: Overall risk management had improved however we identified risks relating to hot water temperatures and unguarded heaters. The manager addressed these during the inspection. People received person centred care. The staff group reflected the diversity of people using the service. Staff interactions with people were friendly, kind and respectful. People’s dignity and privacy was promoted at all times. The environment was clean and staff followed safe infection control procedures.

Right Culture: Quality assurance systems were not effective or robust. Audits had not identified or addressed the areas we found on inspection. Improvements were needed in provider oversight and governance systems. The manager was responsive in taking action to address the issues we raised.

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 (published 25 November 2019) and there were breaches 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 the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 11 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, dignity and respect and good governance.

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, Caring 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

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.

The overall rating for the service remains requires improvement based on the findings of this inspection.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified a breach in relation to good governance 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 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.