The Lodge - Dementia Care with Nursing

Updated 7 February 2024

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.

Inspection team

The inspection was undertaken by 2 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

The Lodge – Dementia Care with Nursing 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. The Lodge – Dementia Care with Nursing is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The registered manager was supported by a deputy manager.

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 (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 spoke with 2 people that used the service and 19 relatives. We spoke with 12 members of staff including the registered manager, deputy manager and care staff.

We looked at a range of records including 4 sets of care plans, risk assessments and medicine records. We looked at audits, policies and procedures and health and safety information. We looked at staff rotas and 3 staff recruitment files.

Updated 7 February 2024

About the service

The Lodge – Dementia Care with Nursing is a residential care home providing personal and nursing care to up to 96 people. The service provides support to older people, people who may be living with dementia, and people who may have mental health needs. At the time of our inspection there were 85 people using the service.

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

People were supported to take their medicines however improvements were required to make sure this was managed safely. We have made a recommendation about making specific guidance available for staff regarding some care interventions. The home was clean and comfortable and there were enough staff to meet people’s needs. People were protected from the risk of abuse and the risk of mistakes being repeated due to effective systems. Relatives told us staff were caring, 1 relative said, “Staff are very kind and caring, I am happy with the staff.”

People’s needs were assessed according to guidance and staff were well trained in their roles. People were supported to eat and drink via a local meals delivery service. Staff worked well with other health care agencies and supported people to live healthy lives. There was good awareness of the needs of people with dementia and mental health issues.

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.

Improvements were required to make sure there were effective governance systems to monitor outcomes and make improvements. The registered manager was supported by a deputy manager and team leaders. People were supported by staff that enjoyed their jobs and staff told us they received good support from managers.

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 3 September 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At our last inspection we recommended that the provider consider guidance regarding the safe management in medicines. At this inspection we found improvements were still required and were now in breach of the regulation.

Why we inspected

We received concerns in relation to the safe management of people’s health needs, including medicines. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

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

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

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for The Lodge – Dementia Care with Nursing on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the safe management of medicines and governance 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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.