Background to this inspection
Updated
20 May 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 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
The inspection consisted of two inspectors and an Expert by Experience. 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
Garden 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. Garden 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 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 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. 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 talked to four care staff, the deputy manager, registered manager, operational director, assistant operational director, and a visiting professional. We spoke to three people living at the service. We reviewed a number of records and made observations around the building.
After the inspection
We continued to review information received from the service including information about changes made due to issues found during the inspection. We spoke to six relatives of people living at the service by telephone.
Updated
20 May 2022
About the service
Garden Lodge is a residential care home providing personal care for up to 42 people. The service provides support to older people some of whom were living with dementia. At the time of our inspection there were 38 people using the service.
People’s experience of using this service and what we found
The service was generally safe however the documentation of ‘as and when required’ medicines was not in line with best practice guidance. Audits by the provider had not identified the failure to follow the medicines policy. The management team immediately acted to put the required documentation in place. Other aspects of medicines management was safe.
A number of notifications had not been submitted to CQC. Statutory notifications are specific pieces of information about events, which the provider is required to send to us by law. The provider had not identified missed notifications to CQC.
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; although the documentation in place did not always support this. The registered manager took action to rectify this during the inspection. We have made a recommendation about this.
People were safe from the risk of abuse. Risks were assessed and regularly reviewed when people’s needs changed. The building was well maintained with appropriate décor, including dementia friendly interactive decorations.
There were sufficient staff employed by the service, staff were trained appropriately and recruited safely. Staff worked effectively with visiting professionals. Staff wore PPE to keep people safe. Infection control measures were in place, management had recently introduced some new infection control processes following advice from a specialist team.
Care records were person centred. People and relatives said they were supported to have choice in their lives. People were supported to eat and drink a balanced diet.
Feedback from relatives about the registered manager was very positive. Staff said the culture of the service was open and the management team were very helpful. People and relatives were involved in their care decisions.
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 good (published 15 January 2019).
Why we inspected
We received concerns in relation to staffing and safeguarding people. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Garden Lodge on our website at www.cqc.org.uk.
Enforcement and Recommendations
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.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.