We carried out a review of the data available to us about Smyth Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Smyth Lodge, you can give feedback on this service.
Smyth Lodge is a care home providing personal and nursing care for up to 80 people. At the time of our inspection there were 57 people living at the service. Smyth Lodge is a large care home set over three floors. They provide care and support to people with nursing needs and people living with dementia.
People’s experience of using this service and what we found
People were safe as staff knew how to support people to keep them safe from identified risks to their safety and well-being. Appropriate recruitment checks took place before staff started work and staff were deployed effectively throughout the home to meet people’s needs. People’s medicines were managed safely. There were systems in place to monitor, investigate and learn from incidents and accidents. There were procedures in place to reduce the risk of infections and staff followed good standards of infection control and hygiene practices.
People’s needs and risks were assessed when they moved into the home to ensure they were safely met. Staff had the skills, knowledge and experience to support people appropriately. Staff were well supported through induction, training and regular supervision. People were supported to maintain a healthy balanced diet and had access to health and social care professionals when they needed them. Health and safety checks were carried out of the premises and equipment to ensure they were safe. The home environment was clean and tidy and the design of the premises met 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; the policies and systems in the service supported this practice.
People and their relatives were consulted about their care and support needs. People were supported to participate in a range of activities and events within the home. Relatives were free to visit people if they wished without any unnecessary restrictions. There was a range of comfortable spaces within the home environment where people could spend time if they chose. Staff understood the importance of working within the principles of the Equality Act and supported people in meeting their needs. There was a complaints procedure in place and people were confident their complaints would be listened to and acted on.
The registered manager and staff worked in partnership with health and social care professionals to plan and deliver an effective service to people. People’s views were taken into account to help drive service improvements. There were systems in place to monitor the quality and safety of the service and to ensure any learning was identified and acted on.
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). The provider completed an action plan after the inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.
Smyth Lodge is a large care home set over three floors. It provides personal, dementia and nursing care and support for up to 80 older people. At the time of our inspection there were 38 people using the service.
People’s experience of using this service
People and their relatives spoke positively about staff and told us they felt safe and were happy with the care and support they received. There were safeguarding policies and procedures in place and staff had a clear understanding of these procedures and the actions to take if they had any concerns. Robust recruitment checks took place before staff started work and there were enough staff to meet people’s needs safely. Risks to people were assessed, documented, reviewed and monitored to ensure their needs were safely met. The service had procedures in place to reduce the risk of the spread of infections and COVID 19 and staff had enough personal protective equipment to help keep them and people using the service safe.
There were effective systems in place to assess and monitor the quality of service that people received. The provider took people’s views into account on a regular basis and feedback was used to help drive improvements. Staff told us they received good support from the manager and provider. The service worked well with health and social care professionals to ensure people’s needs were safely met.
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 comprehensive rating for this service was Inadequate (published 7 May 2020) there were multiple breaches of regulation. The provider completed an action plan after the inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 7 May 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on the previous rating. 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 and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Smyth Lodge on our website at www.cqc.org.uk.
Follow up
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.
Smyth Lodge is a care home and respite service set over three floors which provides residential care and support, nursing care and dementia care for up to 80 older people. At the time of our inspection 29 people were living at the service.
People’s experience of using this service and what we found
There were safe systems and processes in place to ensure medicines were managed safely. Staff received the appropriate training and support to be able to administer medicines in a safe way and any errors were investigated thoroughly the management team at the service.
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 inadequate (published 14 May 2020) and there were multiple breaches of regulations. 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 improvements had been made and the provider was no longer in breach of regulation 12 in relation to medicines.
Why we inspected
We undertook this targeted inspection to check on a specific concern we had about medicines management. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report. However, the overall rating for the service has not changed following this targeted inspection and remains inadequate.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Smyth Lodge is a care home and respite service set over three floors and provides residential care and support, nursing care and dementia care for up to 80 older people. At the time of our inspection, 43 people were using the service.
People's experience of using this service
Medicines were not safely managed. Medicines were not always administered in a timely manner or in line with the prescriber’s directions. Medicine competency checks were not always carried out to ensure staff remained competent to administer medicines safely. There were not enough staff available to meet people’s needs in a timely manner. Risks to people were not always assessed or reviewed and the provider did not always have appropriate risk management plans in place to guide staff on how risks should be minimised. Accidents and incidents were not appropriately managed and learning from them was not disseminated to staff.
Where people were at risk of dehydration, fluid charts were not always completed and prompt referrals were not made to health professionals for additional support. Staff were not supported through regular supervisions. There was no appropriate signage within the home to help people orientate themselves.
Care plans and risk assessments were not always updated when there was a change in people’s needs and there was not always updated guidance in place for staff to follow. Staff meetings were held but not all staff attended these on a regular basis. The provider's quality monitoring systems were not effective. Internal audits did not identify the issues we found at this inspection.
People said they felt safe and that their needs were met. People were protected against the risk of infection. Assessments of people’s needs were carried out prior to them moving to the home to ensure their needs could be met. Staff training was up to date. Information was available to people in a format to meet their individual communication needs when required. The service was not currently supporting people who had end of life care needs, but relevant information was recorded in their care plans so this was available when people required this support. Complaints were documented and investigated in a timely manner.
People's rights were upheld with the effective use of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests. Their needs were not accurately assessed, understood and communicated.
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
This service was registered with us on 4 February 2019 and this is the first inspection.
Enforcement
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to person-centred care, dignity and respect, safe care and treatment, premises, staffing and good governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up:
We will ask the provider to complete an action plan to show what they will do and by when to improve. 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. We will also meet with the provider.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within six months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.