Alma Lodge Care Home

Updated 22 June 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 was carried out by one inspector.

Service and service type

Alma 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. Alma Lodge Care Home 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. She was also the registered provider.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service and the service provider. 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 looked at the action plan from the previous inspection, notifications and any safeguarding alerts we had received for this service. Notifications are information about important events the service is required to send us by law. We also sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service, two staff members, the deputy manager and the registered manager.

We spent time observing people in areas throughout the service and could see the interaction between people and staff. We reviewed a range of records. This included three people’s care documentation and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were viewed, including health and safety records, maintenance checks and training records. We contacted and received feedback from one visiting professional and spoke with two relatives.

Updated 22 June 2022

About the service

Alma Lodge Care Home is a residential care home providing personal care up to a maximum of 14 people. The service provides support to older people with physical health needs. Some people were living with dementia. At the time of the inspection there were 10 people living at the home, one of whom was in hospital.

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

The providers’ governance and quality monitoring systems had not been effective in identifying areas of shortfall found at this inspection. This included the completion of full and accurate records. Audits had not identified the management of medicines was not safe in all areas. Environmental risk assessments had not identified some risks posed by windows and flammable items.

Systems followed had not ensured all medicines were handled safely and did not ensure people received their prescribed medicines safely and appropriately. Some medicines were not recorded within a required register. Medicines given ‘as required’ did not always have guidelines in place to support staff to give these in a consistent safe way. A loose tablet was found in the medicine’s trolley with no explanation.

The service was clean, and the managers had taken measures to minimise the risk from COVID-19. Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse or discrimination.

The staffing arrangements provided enough staff to meet people’s needs in a timely manner. The registered and deputy manager cover many of the shifts. Recruitment was ongoing and records confirmed practice ensured staff were recruited safely. People’s individual risks were assessed, and actions were taken to reduce any risks.

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.

The registered manager had established an open and honest culture where staff and people felt able to share their views. Feedback from staff, relatives and visiting professionals was positive about the leadership of the service.

The registered and deputy manager were committed to continuously improve and had plans to develop the service further. They acknowledged it had been a difficult time recently with the pandemic and were looking forward to a more settled time.

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 2 July 2019) and there were 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 the provider remained in breach of regulations. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

This inspection was prompted by our data insight that assesses potential risks at services, concerns raised and based on the previous rating. This enabled us to review the previous ratings. We also used this opportunity to look at the previous breaches of Regulation 12, 11 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and previous breaches of regulation 16 and 18 of the Care Quality Commission (Registration) Regulations 2009. As a result, we undertook a focused inspection to include the safe and well-led key questions. 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.

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 continued breaches in relation to the handling of medicines and good governance at this inspection.

The provider took immediate action to mitigate some risks which have been effective.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alma Lodge Care Home on our website at www.cqc.org.uk.

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.