Shipston Lodge

Updated 6 December 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 Care Act 2014.

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 visit was carried out by four inspectors and one Expert by Experience. An Expert by Experience is someone who has experience of using this type of service.

Service and service type

Shipston 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. Shipston Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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 a registered manager in post.

Notice of inspection

This inspection visit was unannounced.

What we did before inspection

We reviewed the information we held, such as people and relatives’ feedback and statutory notifications, as well as any information shared with us by the local authority. 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 this information to plan our inspection.

During the inspection

We spoke with 8 people who received a service to get their experiences about the quality of care received. We also spoke with 10 relatives who family members received a service. We spoke with 10 members of care staff that included a nurse, a wellbeing lead, a care practitioner and a deputy manager. We spoke with the registered manager and a chief operating officer, a maintenance person and an administrator. We also spoke with an external professional from the carers trust.

We reviewed a range of records. This included examples of 7 people’s care records and samples of medicine records and associated records of their care. We looked at records that related to the management and quality assurance of the service, fire safety and environmental risks and records for infection control and risk management. We also reviewed 2 staff recruitment files. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 6 December 2022

About the service

Shipston Lodge is registered to provide accommodation, nursing and personal care for up to 70 older people, including people with dementia. At the time of our visit there were 47 people living at the home.

Shipston Lodge is a purpose-built home with care and support provided across two floors. On both floors there were communal areas, dining areas and lounges, as well as people’s bedrooms which were all ensuite. People could access both floors of the home via a lift or staircase. On the ground floor was a bistro area where people could meet each other and where the provider held a weekly dementia café.

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

At our last inspection, we found some improvements were required. People had a plan of care that provided guidance to staff in how to support them. Associated health risks were assessed, but these were not always updated and reviewed immediately when a person's needs changed, or where advice was sought to ensure the risks were not increased. Records did not always correspond with a person's specific requirements. The provider completed a range of audits, but we found during this inspection shortfalls in the service had not always been known or considered by the registered manager or provider.

At this inspection, we found the provider had made positive improvements. Since the last inspection, there was a new registered manager who had spent time adding to and increasing the oversight of the service to improve people’s outcomes.

Additional audits, checks and daily meetings with clinical staff helped ensure people received the right care and support. Heads of department meetings were held frequently which helped ensure the whole service continued to meet people’s needs. New admission information was shared with key staff, so staff were prepared to provide the right care to the person.

Care plans and risks assessments supported people’s needs and plans were personalised to individual needs.

People and relatives were complimentary of staff. Staff knew people well and we saw during our visit, staff quickly responded to situations to help promote good care outcomes.

Staff interacted with people at their pace, unrushed and talking to people with familiarity. Staff were involved and engaged, and we saw they had time to sit and chat to people which helped develop relaxed and supportive relationships.

People were safe because staff understood their responsibility to report any concerns to protect people from the risk of abuse.

The provider had their own staff team and had limited or no reliance on agency staff. This meant staff who supported people knew them well. Staff received training in key areas and staff said they felt supported to pursue additional training and opportunities to increase their knowledge and confidence. Competency checks were completed for staff to ensure they supported people safely with medicines.

Infection control systems ensured the home was clean. Housekeeping staff supported the home and staff wore personal protective equipment to help minimise the risk of cross infection. Maintenance and regular environmental checks on health and safety ensured the home remained safe for people.

People’s overall feedback to us was positive of a service they received that they felt met their needs. People and relatives could attend meetings to share any feedback about the service. Some people and relatives said when they raised some issues the responses were not always timely. However, the general view was the service had improved since our last inspection with the overall management and staff team.

Families and external health visitors were welcomed and there were no restrictions on visiting arrangements.

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 and update

The last rating for this service was requires improvement (published 19 July 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service and to check the provider had improved certain areas identified at our last visit.

This report only covers our findings in relation to the Key Questions Safe, Responsive 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. The overall rating for the service remained the same. 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 COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shipston Lodge on our 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.