Archived: Francis Lodge Residential Home

Updated 5 February 2016

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 provide a rating for the service under the Care Act 2014.

This inspection was carried out by two inspectors. Before we visited the home we checked the information we held about the service and the service provider including notifications and incidents affecting the safety and well-being of people.

There were four people using the service who had a range of significant and complex needs including one person who was deaf. People’s communication was limited due to their complex needs. Because of this, we spent time at the home observing the experience of the people and their care, how the staff interacted with people and how they supported people during the day and meal times.

We spoke with the provider and one care worker. We also spoke with one relative. We reviewed four people’s care plans, three staff files, training records and records relating to the management of the service such as audits, policies and procedures

Updated 5 February 2016

Francis Lodge Residential Home is a privately owned residential care home. It provides personal care and accommodation for a maximum of four older people who may have dementia. During this inspection, there were four people using the service.

There was manager in post who is the registered provider of this service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. As the provider is an individual they are not required to also have a registered manager. At this service the registered provider is also the manager. We call the registered provider / manager “the provider” throughout the report.

At our last inspection of 23 December 2014, the provider had not taken appropriate steps to ensure there were sufficient staff numbers in the home. This meant the provider was in breach of Regulation 22 HSCA 2008 (Regulated Activities) Regulations 2010 which corresponds to Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the inspection the provider sent us an action plan setting out the actions they would take to meet the regulation. At this inspection, we found that the provider had followed their action plan and met the regulation. We observed and records showed two members of staff were allocated during the morning and there were sufficient staff available during the day.

Although there were some positive aspects to the service such as people were being cared for and supported to have access to healthcare services, we found failings in each of the five domains resulting in people who used the service receiving lower standards of care than they should.

Individual risk assessments were completed for each person. However, the assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments. For example three people using the service all need support with their mobility however there were no risk assessments in place to prevent the risks of falls occurring.

Care plans were not person centred and did not reflect people’s current needs. Complete and contemporaneous records had not been kept about people’s care and support they needed and were receiving.

There were suitable arrangements in place to manage medicines safely and appropriately.

Training records showed staff did not receive regular and appropriate training for them to gain the necessary knowledge and skills they needed to carry out their roles and responsibilities effectively.

We saw people being treated with respect. Care workers had a good understanding and were aware of the importance of treating people with respect and dignity and respecting their privacy.

People were supported to maintain good health and have access to healthcare services and received on going healthcare support.

Although the provider had contact with people’s relatives, there had been no formal review meetings with people using the service and relatives in which people’s care was discussed and reviewed to ensure people’s needs were still being met and to assess and monitor whether there had been any changes.

Three people using the service were elderly with dementia care needs, however, there were no reasonable adjustments made to the environment of the home to ensure it was a dementia friendly and help people to recognise and navigate around the home.

The management structure of the home consisted of the provider and a team of care workers including two volunteers. However, the roles of the volunteers were not clearly defined which could place people at risk of receiving support which is inappropriate.

We made three recommendations about reviewing safe recruitment practices, surveillance being operated in line with current guidance and reasonable adjustments for people with dementia.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.