Archived: Lodge Lane Nursing Home

Updated 3 October 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. 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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Lodge Lane Nursing Home is a ‘care home’. People in care homes receive accommodation, nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with CQC at the time of the inspection. Registered managers and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A manager had been appointed and was awaiting confirmation from CQC that they had officially been registered.

Notice of inspection

We gave 48 hours’ notice of the inspection because infection prevention control arrangements had to be agreed with the provider and put in place prior to our visit; this helped to mitigate the risk of any cross contamination or transmission of COVID-19.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority 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 and formulate a ‘planning tool’.

During the inspection

We spoke with two people who lived at the home, two relatives about their experiences of the care provided, five members of staff including the new manager, one kitchen assistant and a quality and safeguarding manager.

We reviewed a range of records during the inspection and remotely. Records included three people’s care records and several medication administration records, two staff personnel files in relation to recruitment and staff supervision. As well as a variety of records relating to the management and governance of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at audit data, infection prevention control measures and quality assurance tools and checks that were in place.

Updated 3 October 2020

About the service

Lodge Lane Nursing Home is a residential ‘care home’ providing accommodation, nursing and personal care to 20 older people and people who are living with mental health support needs. At the time of the inspection 17 people were living at the home.

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

Risk management procedures and support measures were in place. However, these were not always consistently completed as a measure of monitoring and managing risk.

Risk assessments and care plans had been reviewed and updated since the last inspection. However, they did not always contain the most up to date and consistent information required.

Governance procedures had improved since the last inspection. New systems and processes had been implemented to monitor, assess and improve the quality and safety of care people received. However, further progress and development in this area is encouraged. We have made a recommendation regarding this.

People were supported to maintain maximum choice and control of their lives, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, processes and systems need to be reviewed in relation to legal documentation. We have made a recommendation regarding this.

Safeguarding measures and reporting procedures had improved. Staff had received safeguarding training, were familiar with reporting procedures and investigations were carried out accordingly. The manager had systems in place to review and monitor safeguarding incidents and referrals.

Staff told us they received an effective level of support from the management team. Supervision and training opportunities had improved, staff were supported to complete required training courses that could help develop their skills and qualities.

Staff were observed providing safe care and treatment in a dignified and respectful manner. The manager confirmed that improvements had taken in place in relation to the culture of the home. We noted that there was no longer an ‘institutional’ feel but a warm, homely and inviting atmosphere.

Staffing levels were routinely monitored. Levels of staff were reviewed and determined in relation to people’s dependency needs. However, we did receive feedback that agency staff have been supporting the home whilst a recruitment drive is carried out.

The provider followed ‘safe’ recruitment practices meaning that people received safe, effective and compassionate care by staff who were able to work in health and social care environments.

Medication processes and procedures were safely in place. Staff received medication administration training and had their competency levels checked. Medication audits were carried out, errors were identified, and lessons were learnt.

Infection prevention control (IPC) measures were in place. The manager and staff followed COVID-19 advice and guidance to minimise the risk of the spread of infection and to keep people safe. Control measures, policies and procedures were rigorously followed; the environment was safe, clean and well maintained.

Rating at last inspection and update:

The last rating for this service was ‘inadequate’ (report published August 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection, which identified the improvements they would make and when actions would be completed. At this inspection we found improvements had been made but the provider was still in breach of regulation 12 (safe care and treatment).

During this inspection the provider demonstrated that improvements have been made and the service was no longer rated as ‘inadequate’ overall, however improvements are still required.

This service has been in 'Special Measures' since February 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as 'inadequate' overall or in any of the key questions. Therefore, this service is no longer in 'Special Measures'.

Why we inspected

A decision was made for us to inspect and follow up on the actions taken following the last inspection and to see whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

Due to the COVID-19 pandemic, we undertook a focused inspection to only review the 'Safe', 'Effective' and 'Well-led' domains. Our report is only based on the findings in those areas at this inspection. The ratings from the previous comprehensive inspection for the ‘Caring’ and ‘Responsive’ key questions were not looked at during this visit.

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 to calculate the overall rating at this inspection.

The overall rating for the service has changed from ‘inadequate’ to ‘requires improvement’. 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 Lodge Lane Nursing 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.

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

Follow up

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

We will also 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.