Lady Ida Lodge

Updated 4 March 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.

Inspection team

This inspection was carried out by 2 inspectors. Following our visit to this service, an Expert by Experience made calls to people to ask about their experience of the care they received. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care service.

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 not a registered manager in post. A housing and care manager was in post, but they were not available on the day of our inspection.

Notice of inspection

This inspection was unannounced.

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 spoke with 8 people who lived at the home, 1 relative, the regional extra care manager, the safeguarding lead and 2 members of care staff.

After the inspection

We reviewed a range of records. These included people’s care records, multiple medicine records, staff rotas, and documentation to support how the service is run.

Updated 4 March 2023

About the service

Lady Ida Lodge is an extra care scheme home which offers independent living with access to on-site assistance for people who require personal care. At the time of our inspection there were 18 people receiving this service. The service offers up to 64 apartments.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People provided mixed feedback about the reliability of their care calls. Some people described having missed calls with no prior warning and others experienced calls which were not on time. The oversight of these calls required improvement to ensure the system of recording was robust. The recruitment of staff was mostly safe.

Risks to people were not always managed well. The post falls protocol was not being followed in one case. People had risk assessments in place which explained how to reduce risks to people, but these were not being updated in response to key events.

The management of complaints was not robust. People we spoke with said they had raised complaints with regular care workers and the office staff, but these were not recorded and not always responded to.

Formal ongoing support showed training and supervision was being provided for staff, although the quality of supervision was identified by the provider as an area for improvement.

People provided mixed feedback about the quality of care provided by staff. They were largely pleased with support from regular staff, but shared examples with us around concerns over agency worker practice. People felt their privacy and dignity was respected and noted they were helped to retain their independence.

Oversight of the service was an area for improvement. A new management team had been installed in October 2022 and we saw improvements had since been made. They were aware of the ongoing challenges the service still faced.

People and staff were given opportunities to provide feedback. They gave mixed comments about whether the issues they raised were always listened to. Audits were taking place which reflected the quality of care provided.

People received their medicines as prescribed. Some people were managing their own medicines, but where staff supported others, they were trained and completed 6 competency checks before they were authorised to administer medication.

People’s healthcare needs were being met. People told us regular staff were skilled at identifying where they needed healthcare support and where needed, they helped with this being arranged.

People were mostly responsible for their own nutrition and fluids. Where staff were required to assist, this help was provided.

People had care plans which were personalised and provided guidance for staff around how people wanted to receive their care. People consistently told us they were involved in their care planning. Meaningful activities were taking place.

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

This service was registered with us on 19 April 2021 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about the culture of the service, as well as staff and management practice. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to staffing levels in the service being sufficient to meet people’s care needs and the effective management of complaints.

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.