Lukestone Dementia Nursing Home

Updated 2 December 2021

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 team consisted of one inspector 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

Lukestone Dementia Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service and one relative about their experience of the care provided. We spoke with five members of staff including the registered manager, operations manager, deputy manager, nurses, care workers and a volunteer.

We reviewed a range of records. This included five people’s care records and associated documentation such as daily notes. We also looked at six staff files (three permanent staff and three agency staff) in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies, procedures, and incident and accidents logs were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records, staff meetings, surveys and further care records. We also spoke with five staff, four more relatives and the local authority.

Updated 2 December 2021

About the service

Lukestone Dementia Nursing Home is a residential home providing personal and nursing care for up to 43 people living with dementia. At the time of the inspection, there were 43 people living at the home. Lukestone Dementia Nursing Home is a large secure building, adapted over three floors, in a residential area of Maidstone.

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

There were not always risk assessments in place to give staff the guidance they need to keep people safe. Medicines were not always managed safely as there was a failure to ensure one person received their prescribed medicine for two weeks. Incidents were not always effectively reviewed to prevent a reoccurrence.

Staff told us there was not always enough staff to observe people and ensure their safety and meet their needs. Staff told us they did not have the training they needed to meet people’s needs around emotional distress and dementia.

Management checks and quality assurance systems had failed to identify the concerns we found at inspection and therefore necessary improvements had not been made. People and staff were not always engaged well with the service. Staff concerns were not known by the registered manager. People and their loved ones were not involved with their care planning.

People told us they felt safe and staff knew how to report incidents of avoidable harm. The prevention and control of infection was managed.

People living at Lukestone Dementia Nursing Home told us “it is a nice environment,” “staff are honest and open” and “they are good staff, nice people. I can always have a laugh.” Relative’s commented, “This place seems like a home,” “The staff are absolutely brilliant,” and “I am very happy with this care home.”

It was clear that most staff knew people well. Interactions were kind and supportive and people living at the service and their loved ones praised the care they received.

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 20th June 2018).

Why we inspected

We undertook this focused inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about the management of risk. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led section of this full report.

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.

At this inspection, we have identified breaches in safe in relation to management of risks and learning lessons from incidents and the safe management of medicines. We have identified breaches in well-led in the lack of effective management systems to ensure safe and quality of care and a lack of good record keeping.

Please see the action we have told the provider to take at the end of this report.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.