Archived: Hopwood Lodge (MCR)

Updated 19 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.’

The inspection activity started on 15 November 2017 and finished on the 15 November 2017. The inspection was unannounced.

Prior to the inspection we reviewed the completed provider information return (PIR) that had been sent to us. This is a form that asks the provider to give us some key information about the service, what the service does well and what improvements they plan to make. We also looked at the previous inspection report and information we held about the service and provider, including notifications the provider had sent to us. A notification is information about important events which the provider is required to send us by law.

We did not contact the local authority or local health care commissioners as we were aware the commissioners were not entering into any contractual agreement with the registered provider due to the previous rating of Inadequate. The two people who used the service required personal care and were privately funded.

During the inspection we spoke with one person who used the service, six visitors, two care staff, the registered manager and the nominated individual. We looked around all areas of the home, looked at food provision, two people's care records, two medicine administration records and the medicine management system, three staff recruitment files, training records and records about the management of the home.

Updated 19 January 2018

We inspected Hopwood Lodge on 15 November 2017 and the inspection was unannounced. There were two people using the service at the time of the inspection; both requiring personal care. This meant the service was not fully operational and therefore we did not have enough information about the experiences of a sufficient number of people using the service to accurately award a rating.Previously the home was registered as Ashbourne House Nursing Home. The registered provider made a decision to change the name of the home to Hopwood Lodge and a new certificate of registration was issued on 28 June 2017 to reflect the change of name.

During the last inspection of Ashbourne House Nursing Home, undertaken on 21 June 2016 we identified several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated Inadequate and placed into ‘Special measures.’ This means that 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 that time frame.

When we propose to take enforcement action our decision is open to challenge by the provider through a variety of internal and external appeal processes. We will publish a further report when other action we have taken is concluded.

We did not inspect the service within the six month time frame. This was because the Local Authority Commissioners and the Clinical Commissioning Group, responsible for funding the care of the people living at the home, withdrew their contract with the registered provider. This meant that people living at the home were found alternative accommodation. The home then remained empty.

Following significant investment in the environment by the registered provider and with new staffing and management in place the registered provider commenced trading in June 2017.

Prior to the registered provider commencing trading the Care Quality Commission (CQC) imposed a number of conditions of registration in relation to the service, now known as Hopwood Lodge. These are detailed on the certificate of registration. Information about the conditions imposed are referred to in the Safe section of this report and are detailed in the Well-led section.

Several of the conditions had to be met before any occupancy could commence. These were that an application for a registered manager had to be submitted to the CQC before any person could be admitted to the home. This condition was complied with; the service has a manager registered with CQC. During this inspection we found that the registered provider had complied with all the imposed conditions of registration.

The previous breaches were in relation to unsafe medication management, people were not kept safe from abuse, records for the safe management of the home were not in place, the premises were not kept safe and there was inadequate equipment, recruitment of staff was not safe, there was a lack of training, support and development for staff, people’s dignity was not respected, there was a lack of activities for people, complaints were not addressed appropriately and there was an inadequate quality assurance system in place.

During this inspection we found the registered provider was meeting all the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found there had been a significant improvement and the registered provider had met all the previously breached regulations. Due to the improvements seen on this inspection the registered provider has been taken out of Special Measures.

One of the conditions imposed on the registered provider was that they must provide to the CQC a monthly action plan, including informing us of how many people have been admitted to the home during that month. The condition states that only two service users per week may be admitted for the first four weeks from the date of the order of June 2017. Thereafter, only two further people per week may be admitted until full capacity of people who use the service is reached.

In view of the fact however that the judgements made during this inspection were made on the care provision to only two people who used the service, it is the intention of the CQC to undertake unannounced inspections as the occupancy increases.

Hopwood 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.

Hopwood Lodge is registered to provide care, accommodation and nursing care for up to 29 older people. Due however to the continued refurbishment of the top floor of the premises the home was not able to admit to full capacity at the time of the publishing of this report.

Hopwood Lodge is a detached converted building situated on the main road which connects the towns of Middleton and Rochdale. There is a frequent bus service that passes the home and there is a small car park to the front of the home. Bedrooms are provided on the ground and first floor and are accessible by a small passenger lift. People have access to a large lounge and adjacent conservatory, a small lounge and a dining room ; all situated on the ground floor.

A new registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘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 service is run.

We found that suitable arrangements were in place to help safeguard people from abuse. Staff knew what to do if an allegation of abuse was made to them or if they suspected that abuse had occurred. Staff were able to demonstrate their understanding of the whistle blowing procedures (the reporting of unsafe and/or poor practice).

We found people were cared for by sufficient numbers of suitably skilled and experienced staff who were safely recruited. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely.

The medication system was safe and we saw how the staff worked in cooperation with other healthcare professionals to ensure that people received appropriate care and treatment.

Procedures were in place to prevent and control the spread of infection and risk assessments were in place for the safety of the premises. All areas of the home were secure, clean, well maintained and accessible for people with limited mobility; making it a safe environment for people to live and work in.

We saw that appropriate environmental risk assessments had been completed in order to promote the safety of people who used the service, members of staff and visitors. Systems were in place for carrying out regular health and safety checks and equipment was serviced and maintained regularly.

Procedures were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity or gas supply.

People told us they received the care they needed when they needed it. They told us they considered staff were kind, had a caring attitude and felt they had the right skills and knowledge to care for them safely and properly. We saw that staff treated people with dignity, respect and patience.

A major refurbishment had been undertaken. The corridors, bedrooms, lounges, conservatory and the dining room on the ground floor had been re-decorated and re-carpeted to a good standard. New beds and bedroom furniture, plus new bed linen and soft furnishings had been provided. We saw that consideration had been given to the layout of the environment to help promote the well-being of people living with dementia.

Specialised training was provided to help ensure that staff were able to care for people who were very ill and needed end of life care.

We saw people looked well cared for and there was enough equipment available to ensure people's safety, comfort and independence were protected.

People's care records contained enough information to guide staff on the care and support required. The records showed that risks to people's health and well-being had been identified and plans were in place to help reduce or eliminate the risk.

Staff were also able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were provided with a choice of suitable and nutritious food and drink to ensure their health care needs were met. We saw that food stocks were good and people were able to choose what they wanted for their meals.

Records we looked at showed there was a system in place for recording complaints and any action taken to remedy the concerns raised.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. Regular checks were undertaken on all aspects of the running of the home.