Carmel Lodge Care Home

Updated 22 April 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

This inspection was carried out by two inspectors.

Service and service type

Carmel Lodge 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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

People living at Carmel Lodge were isolating in their bedrooms at the time of our inspection due to a COVID-19 outbreak at the home. This meant we were unable to talk directly with people receiving care; however, we did speak with six relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, quality manager, assistant manager, senior care workers, care workers and ancillary staff. In addition, we also spoke with the regional director and operations director when providing feedback on the findings of this inspection.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a professional who regularly visits the service.

Updated 22 April 2021

About the service

Carmel Lodge Care Home is a residential care home providing personal care to 32 people aged 65 and over at the time of the inspection. The service can support up to 36 people across two separate floors, each of which has separate adapted facilities. A number of people who received care lived with dementia.

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

Governance systems to monitor the quality of care being delivered to people required improvement. Existing systems failed to identify shortfalls in care recording which placed people at risk of receiving poor care.

Staff were recruited safely. Appropriate checks were undertaken for all temporary staff (agency workers). We inspected Carmel Lodge at a difficult period as the home was experiencing an outbreak of COVID-19. This had impacted on regular staffing levels, staff morale and the ability to maintain effective communication with families. The registered manager was actively recruiting new staff and putting measures in place to improve communication and relationships with families and staff.

Although we found some improvements were needed, we did observe positive and caring interactions between staff and people living at Carmel Lodge. Staff sought consent before providing care and demonstrated an understanding of people’s preferences.

The communication needs of people were clearly documented, and people had access to appropriate healthcare services. Although activities were limited at the time of the inspection, people were supported appropriately to reduce the risk of social isolation and to keep in touch with family and friends.

Checks were in place to ensure people lived in a safe environment and this was maintained to a high standard. Ongoing refurbishment and redecoration of the home was planned.

We were assured the provider had effective measures in place to reduce the risks of infection and manage the impact of the COVID-19 pandemic.

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 13 March 2018).

Why we inspected

We received concerns in relation to staffing levels and poor management of pressure care during an outbreak of COVID-19 in the home. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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

You can see what action we have asked the provider to take at the end of this full report.

The registered manager responded during our inspection to the issues we found. Measures were put in place to improve the monitoring of peoples care needs. The provider had recently strengthened their whistleblowing procedures to encourage staff to speak up when they had concerns.

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

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 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.

We have identified a breach of regulation in relation to accurate record keeping and effectiveness of the management oversight of care records at this inspection.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.