Archived: Abbeyfield - Stangrove Lodge

Updated 10 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 13 May 2015 and was unannounced. The inspection team consisted of two inspectors and a specialist professional advisor, whose specialism was in Occupational Therapy.

We gathered and reviewed information about the service before the inspection, including information from the local authority and previous reports. We spoke with the safeguarding team and the commissioners of the service to gather their views of the care and service. We looked at notifications we had received from the provider. This is information the provider is required by law to tell us about.

During our inspection we spoke with two people, three people’s relatives and seven staff. We observed the support provided to people on both days of our inspection. We used the Short Observational Framework for Inspection (SOFI) because many of the people were living with dementia and could not tell us about their experiences of using the service. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care and support that people received. We looked around the premises. We looked at care records and associated risk assessments for seven people. We observed medicines being administered and inspected medicine administration records (MAR). We looked at management records including two staff recruitment records and records of staff training and support.

Updated 10 July 2015

This inspection was carried out on 12 & 13 May 2015 and was unannounced.

Abbeyfield Stangrove Lodge provides accommodation for up to 56 people who need support with their personal care. The service provides support for older people and people living with dementia. The service provides accommodation on one level arranged into separate units. The service has single bedrooms. There were 37 people living at the service at the time of our inspection.

The registered manager of the service had left in April 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. A new manager for the service had been appointed and had been in post for one month. We had not yet received an application for their registration.

We last inspected Abbeyfield Stangrove Lodge in July 2014. At this time we found that the registered provider was not compliant with the regulations. There were shortfalls in the safety, availability and suitability of equipment and in the provision of suitable staffing. At this inspection we found that the registered provider continued to breach the regulations relating to staffing and the provision of equipment. They had not ensured that sufficient numbers of suitably qualified, skilled and competent staff had been deployed to meet people’s needs. They had not taken appropriate action to ensure that suitable equipment was provided to meet people’s needs.

In addition we found a number of other breaches of regulations at this inspection.

People were not kept safe from abuse and harm and the risks to their health, safety and wellbeing had not been properly assessed and managed. In particular people were at risk of unsafe practices to help them move around the service. People had not had their mobility needs properly assessed to ensure they were provided with the equipment they needed to move around safely.

Staff had not identified concerns about people’s health to ensure that appropriate action was taken.

People were not protected from the risks of the spread of infection in the service.

Staff had not been trained properly to ensure they could meet peoples’ needs and care for them in a safe way. Staff did not understand how to support people living with dementia.

People were not consistently asked for their consent before care and treatment was provided. Where people could not give their consent the Mental Capacity Act had not been followed to ensure their rights were protected.

Some staff were not caring and kind in their approach to supporting people and did not demonstrate compassion. Staff did not treat people with respect and did not listen to them. Staff did not know how to deal with people who were distressed and they were not able to provide support that reassured and comforted them.

Staff did not always respect people’s privacy. They shared personal information about people in front of others using the service.

People did not receive a personalised service. People had not been supported to maintain their hobbies and lifestyle choices. People were bored and some were isolated. People did not have a say in many areas of their daily routines.

The service was not well led. The manager had been in post for a month. They did not know people’s names and they did not demonstrate that they promoted the rights of people living with dementia. The manager did not have a good understanding of the needs of the people using the service or how to ensure people received a personalised service. The registered provider had not adequately monitored the service to ensure it was safe and they had not identified the areas of poor practice that we found during our inspection. The registered provider had not identified that the manager lacked the skills and qualifications to effectively lead a service for people living with dementia.

The overall rating for this service is ‘Inadequate’ and the service is therefore in 'Special measures'. The service will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

We are currently taking enforcement action against the registered provider in respect of this service.