Charles Lodge

Updated 3 March 2021

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.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 17 February 2021 and was announced.

Updated 3 March 2021

This unannounced inspection took place on 18 December 2018. Charles Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Charles Lodge is situated in Hove, East Sussex. It is one of a group of six homes within the south of England owned by the provider, Nicholas James Care Homes Limited. Charles Lodge is registered to accommodate 27 people. At the time of the inspection there were 22 people accommodated in one adapted building, over three floors. Each person had their own room and access to communal bathrooms. The home provided accommodation for older people and those living with dementia.

The home had a registered manager. A registered manager is a ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run. The management team consisted of the registered manager and a deputy manager. An area manager regularly visited the home to conduct quality assurance audits and to offer support to the management team.

Before the previous focused inspection on 12 October 2017, we had received information that an incident had occurred. One person had sustained a serious injury. This is subject to a criminal investigation that is still ongoing and is being dealt with outside of the inspection process. As a result, the inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of the risk of falls. The previous inspection on 12 October 2017 and this unannounced inspection, on 18 December 2018, examined those risks.

At the previous focused inspection on 12 October 2017, the home was rated as ‘Requires Improvement’ and we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe, Effective and Well-led to at least good. This was because assessments of the environment had not always identified risks to people’s safety. Accidents and incidents had not always been analysed to ensure that any changes required to people’s care, were made. Records did not always contain sufficient guidance for staff and did not always accurately document their practice. When people had a health condition that had the potential to affect their decision-making abilities, an assessment of their capacity, to consent to certain practices had not been completed. Appropriate applications to the local authority to deprive people of their liberty had not always been considered.

At this inspection, on 18 December 2018, improvements had been made. The provider had reviewed their processes in relation to the management of risk and the guidance that was provided to staff within records. They were no longer in breach of the Regulation as they had made improvements to their processes with regards to mental capacity assessments and their oversight of Deprivation of Liberty Safeguards (DoLS). Further improvements were needed however, in relation to assessing people’s capacity, to ensure that the changes made continued to be embedded in practice for all decisions related to people’s care. People were not always supported to have maximum choice and control of their lives. The policies and systems at the home did not always support this practice.

The provider’s aims of creating a home-from-home environment were shared amongst the staff team and implemented in practice. People told us that they felt comfortable and at ease. People, their relatives and staff were involved in decisions related to the running of the home. They told us that their views and suggestions were listened to and respected and that they felt able to raise concerns about their care. Quality assurance processes ensured that the service people received met their needs and preferences and was effective.

The provider and registered manager saw the importance of partnership working. They worked with the local authority and external health professionals to ensure people received coordinated care. There was shared learning between the provider’s other homes and regular meetings helped ensure that good practice was shared.

People told us that they felt safe. They were protected from abuse and discrimination. Sufficient numbers of skilled staff ensured people’s physical and emotional needs were met. Risks to people’s safety were identified and mitigated. Infection control was maintained.

People’s needs were assessed and reviewed on an on-going basis. They received personalised care and were actively involved in discussions in relation to it. People were supported to maintain their health. They had access to medicines, which were managed safely, and received support from external healthcare professionals when required. People were complimentary about the care they had received and the effect this had on their health. One person told us, “I don’t think I could have found anywhere better, since I have been here all my readings are correct, they were all over the place in hospital”. People could plan for their end of life care to help ensure their comfort was maintained and their wishes were respected.

Staff were kind and caring. People were supported sensitively and their privacy and dignity were maintained. Positive relationships had developed between people as well as with staff. Compassionate and thoughtful interactions were observed and staff took time to interact with people. Staff were mindful of supporting people in a way that met their needs. When people displayed signs of apparent anxiety, staff took time to listen to them and offered distraction techniques. People were calm and settled after their interactions with staff. One person told us, “They listen to me, what I need”.

People had access to sufficient quantities of food and drink to maintain their nutrition and hydration. People told us they enjoyed the food and they were provided with choice.

People had access to an environment that met their needs. Communal areas, as well as private spaces, enabled people to spend time on their own or with others. Adaptations to the environment and facilities, to meet people’s specific needs, had been undertaken.

People were not socially isolated. Planned group activities, as well as one-to-one interaction between people and staff, enabled people’s social needs to be met. People were observed to be having fun. They were laughing, smiling and enjoying the interaction and stimulation that was provided.

People were encouraged to be independent. One person enjoyed helping staff with the household chores. Others independently accessed the local community.