Umika Lodge Care Home

Umika Lodge is a residential care home providing personal care to up to 29 older people, some of whom are living with dementia. At the time of our inspection there were 20 people using the service.

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

People’s care was not always personalised to reflect their individual needs and preferences. People had care plans and risk assessments in place which detailed how they liked to be supported; however, care was not always delivered in line with this guidance. People were not always supported to engage in meaningful activities of their choice and information about how people were being supported with their preferred pastimes lacked detail.

The provider had made improvements to their processes for monitoring the quality and safety of the service since the last inspection. However, these systems were still not robust and had not identified the concerns we found during the inspection. The provider’s processes for checking the administration of people’s medicines were not always effective in highlighting errors.

People were protected from the risk of infection. The provider had made improvements to their COVID-19 policy and contingency planning to ensure safe processes were in place in case of any future outbreaks of infection. Staff wore appropriate personal protective equipment [PPE] and had received training in managing the risk of infection and donning and doffing.

The provider had increased staffing levels in the service since the last inspection and staff had received an induction and training relevant to their role. Staff were safely recruited and the provider had completed the appropriate checks prior to them starting work.

People were protected from the risk of abuse and staff knew how to identify and report safeguarding concerns. The provider had a process in place for responding to complaints and people and relatives told us they felt comfortable raising any issues with the management team.

The provider worked alongside other healthcare professionals in order to support people’s health needs, making referrals and seeking additional support where appropriate. People’s end of life care wishes had been considered and the relevant information recorded.

People, relatives and staff spoke positively about the culture of the service and told us the management team were approachable and supportive.

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 March 2021) and there were breaches of regulation.

At this inspection enough improvement had not been made and the provider was still in breach of regulations and the service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We carried out an unannounced inspection of this service on 12 January 2021. Breaches of legal requirements were found. The provider was asked to complete an action plan after the last inspection to show what they would do and by when to improve the safety of people’s care, staff training and oversight of the service.

We undertook this focused inspection to follow up on the action we told the provider to take at the last inspection. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well-led. 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Umika 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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person-centred care and oversight at the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Umika Lodge Care Home provides personal care and support for up to twenty-nine older people some of whom maybe living with dementia. At the time of our inspection eleven people were using the service.

Infection prevention and control procedures were not being managed in a safe way to protect people from the risks of infection. Processes to ensure the appropriate allocation of staff, in separate areas of the service with dedicated equipment had not been implemented in-line with best practice guidance to try and prevent the spread of COVID-19.

Risk assessments needed to be individualised to identify how people could be protected from harm and risks mitigated. There was a reduction in staff numbers due to sickness and replacement staff had not been sought in a timely manner by the registered manager.

People were at risk of not receiving their medicines as prescribed as medicine practices were not always safe

Not all staff had received up to date training or a thorough induction when commencing work at the service. Individual risks assessments for staff working with people in an infectious environment had not been completed.

Governance at the service needed to be improved to ensure the registered manager had oversight of all aspects of the service.

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

Two people we spoke with indicated they were happy with the service and the support they were receiving. One person said, “I only have to look at the care worker and they know what I want. They look after me good.” Relatives also had a positive experience of using the service.

Rating at last inspection: The rating at the last inspection was Requires Improvement (Published 26 September 2019.)

Why we inspected: We undertook this focused inspection to follow up on previous breaches. Also the service wished to become a designated setting. There had been an outbreak of COVID-19 at the service and we had received a ‘whistleblowing’ on staffing. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led. 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 remained Requires Improvement.

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 Umika Lodge Care Home on our website at www.cqc.org.uk.

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

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 will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to Infection Prevention and Control, staff training and 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Though recruitment checks were completed for new staff, these were not as robust as they should be. Safety concerns relating to the service’s fire arrangements required strengthening. Whilst medication practices were generally sound, improvements were required where people were asleep and required their prescribed medication to be administered.

The service understood staff required training to meet the needs of the people they supported. However, ‘practical’ training relating to manual handling was not up to date or in line with best practice. Improvements were required to ensure staff received a robust induction.

Effective safeguarding arrangements were in place to protect people from abuse and avoidable harm. Sufficient numbers of staff were available to meet people’s needs in a timely manner. People were protected by the service’s prevention and control of infection practices. There was evidence of lessons learned and improvements made when things go wrong.

People were supported to eat and drink enough throughout the day. There was a positive dining experience, with mealtimes not rushed and suitable to meet people’s individual needs. People’s healthcare needs were monitored to ensure they received ongoing healthcare support; and the service worked jointly with other organisations.

People were treated with care, kindness, respect and dignity, and spoke positively about the caring attitude of staff. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. People were involved in decisions about their care and staff made decisions in people’s best interests.

We made a recommendation relating to recruitment practices.

Under previous ownership, the service was rated ‘Inadequate’. The then registered provider made arrangements for the current registered provider to manage Stafford Court on their behalf from December 2018. They were formally registered with the Care Quality Commission in April 2019.

This was a planned inspection.

We will continue to monitor intelligence we receive about the service until we return to visit as outlined in our inspection programme and schedule. If any concerning information is received, we may inspect sooner.

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