Archived: Earlfield Lodge

Updated 1 February 2020

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by three inspectors and a member of the Care Quality Commission medicines team.

Service and service type:

Earlfield Lodge is a ‘care home’. People in care homes receive accommodation and personal care as 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 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:

The inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We reviewed 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.

During the inspection

During the inspection we spoke with four people using the service and two relatives. We spoke with 14 staff members which included senior staff, the registered manager and the former provider’s personal representative.

We reviewed five people’s care and support records and five staff recruitment files. We reviewed 18 Medicine Administration Records (MAR). We also looked at records relating to the management of the service such as incident and accident records, meeting minutes, training records, policies, and quality monitoring systems.

After the inspection

We continued to seek clarification to validate evidence found. We looked at training, staffing and health and safety data.

Updated 1 February 2020

About the service

Earlfield Lodge is a residential care home providing accommodation and personal care to older people, some of whom are living with dementia. The service can support up to 72 people. There were 52 people living at the service at the time of the inspection.

The service provides period accommodation in several adjoining premises. The service is over five floors. There are four areas to the service Bluebell, Lilly, Poppy and Buttercup. There is access to a garden and patio area.

At the time of the inspection the service had an additional seven beds registered in the adjacent property. There was no one living in this building and no service was operating from this site.

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

People received unsafe care as the service had not made improvements or met legal requirements. In areas such as risk management, medicines, recruitment and staffing. Issues previously identified and highlighted had not always been addressed. The systems to monitor and oversee the safety and quality of the service were not effective. This put people at risk as improvements were not made in areas required.

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 Inadequate (published 29 October 2019). There were five breaches of regulations identified and a recommendation made. Previous to this, the service had been rated requires improvement for the last four consecutive comprehensive inspections (published 12 August 2015, 17 November 2016, 12 January 2018, 15 September 2018).

At this inspection not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 5, 6 and 12 September 2019. Breaches of legal requirements were found in regulation 12, 13, 17, 18 and 19 and a recommendation was made in relation to end of life care planning.

We undertook this focused inspection to check their action plan had been followed, improvements were in progress and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led.

The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remained the same and is inadequate. This is based on the findings at this inspection.

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

Enforcement

We have identified four continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in regulation 12; safe care and treatment, regulation 18; staffing, regulation 19; fit and proper persons employed and regulation 17; good governance.

At the last inspection a recommendation in the Responsive domain was made in end of life care planning. This domain was not reviewed during this focused inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow Up

The overall rating for this service is ‘Inadequate’ and the service therefore remains in ‘special measures’.