Archived: Red Lodge

Updated 4 July 2019

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. This inspection was planned to check 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 first day of our inspection was conducted by two adult social care inspectors, a medicines specialist advisor 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. One adult social care inspector conducted the second day of inspection.

Service and service type

Red Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is also a domiciliary care agency. It provides personal care to people living in their own flats in the adjoining building to the care home.

At the start of our inspection, the service did not have a registered manager. A registered manager is someone who, along with the provider, is legally responsible for how the service is run and for the quality and safety of the care provided. There was a manager in post who had submitted an application to register with CQC. Their application was approved shortly after our second visit to the service, so we have referred to them as the registered manager in this report.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at information we held about the service. We reviewed the provider information return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information we held about the service and sought feedback from the local authority. We used all of this information to plan the inspection.

During the inspection

We spoke with 20 people who used the service and three relatives about their experience of the care provided. We spoke with nine members of staff including the registered manager, deputy manager, interim head of care, care quality and compliance manager, the nominated individual for the provider, three care workers and a member of kitchen staff.

We looked at records related to people’s care and the management of the service. We viewed six people's care records, three staff recruitment and induction files, training and supervision information, staff rotas and records used to monitor the quality and safety of the service. We also conducted a comprehensive medication audit.

After the inspection

We continued to review evidence from the inspection. We received an update from the provider on the actions they had taken to address the key areas of risk we identified during the inspection site visits.

Updated 4 July 2019

About the service

Red Lodge is both a residential care home and a domiciliary care service for older people living in sheltered accommodation. At the time of the inspection the service was providing residential care for 30 people and domiciliary care for seven people. The care home can accommodate up to 42 people.

The domiciliary care service is for people living in their own accommodation, adjoining the care home. Not everyone using the service receives a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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

People were at risk of not receiving the care they needed, because care records had not been consistently reviewed and updated. Risks to people’s safety and wellbeing had not always been effectively assessed and mitigated. Quality assurance systems had not been effective in ensuring issues identified at our last inspection had been addressed. People had not always received their medicines in line with their prescription. The provider was taking action to address this.

People were generally happy with the care they received but had concerns about staffing levels and the quality of food. The provider had recently agreed to increase staffing levels and told us this would be kept under review.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, we made a recommendation about best practice in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were supported by caring staff, who respected their privacy and dignity. There was a good range of activities available to people.

Staff received an induction and training but had not received regular supervision. Staff told us changes over the last year had affected morale, but this was starting to improve. People and staff told us the new management team were approachable. The provider was open and responsive to our feedback.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection the service was rated requires improvement overall (published 19 June 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a scheduled inspection based on the service’s previous rating.

Enforcement

We have identified continued breaches of legal requirements in relation to safe care and treatment (risk management and medicines) and good governance (quality assurance and record keeping). Please see the action we have told the provider to take at the end of this report. We asked for a plan from the provider about the immediate actions they planned to take to address the areas of highest concern. This was sent to us within the agreed timeframe, with details of action already taken.

Follow up

We will request a further action plan from the provider to understand what they will continue to do to improve the standards of quality and safety. We will monitor the progress of the improvements working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.