We carried out a review of the data available to us about George Davis Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about George Davis Lodge, you can give feedback on this service.
George Davis Lodge is registered to provide personal care and support to people living in specialist ‘extra care’ housing in London Borough of Redbridge. Not everyone who lived in the housing received personal care from the service. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. People using the service lived in their own flats within a gated community where there were 44 properties. The service was providing personal care to 18 people at the time of the inspection.
People’s experience of using this service and what we found
At our last inspection we had found concerns with medicines management. At this inspection we found medicines were managed safely as improvements had been made with the registered manager following an action plan created at the last inspection. Similarly, improvement had been made to staff completion of training, management supervision of staff and quality assurance processes, both of which we had concerns about at the last inspection.
Staff had received training to safeguard people from potential abuse and the service contacted social workers when concerns arose. Risks to people were recorded and mitigated as much as possible. Staff recruitment processes were robust, and people and relatives were content with staffing levels. Staff had received training in infection prevention and control and incidents and accidents were recorded so lessons were learned.
Staff received support from the provider through induction, training and supervision. People’s needs were assessed before they began using the service so the provider could ensure they could meet their needs. Staff worked alongside other agencies to provide people with effective. This included supporting people with their health care needs. People were supported with their dietary needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service promoted a positive person-centred culture. People’s equality and diversity needs were recorded so staff could support people in culturally sensitive way. The provider had quality assurance measures in place, such as audits and spot checks which sought to assure quality at the service. People and relatives, we spoke with were positive about the service and staff working there. Staff knew their roles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The previous rating for this service was Requires Improvement (published 10 June 2021). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced focused inspection of this service on 15 April 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. 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 George Davis Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
George Davies Lodge is registered to provide personal care and support to people living in specialist ‘extra care’ housing in London Borough of Redbridge. Not everyone who lived in the housing received personal care from the service. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. People using the service lived in their own flats or bungalows within a gated community where there were 42 properties. The service was providing personal care to 17 people at the time of the inspection.
People’s experience of using this service and what we found
Systems for managing people’s medicines were unsafe. Medicines administration charts were not being completed properly by staff or checked by management. Staff had not completed all the training the provider deemed mandatory. This was a historic problem which the provider was aware of but had not addressed. Some staff had not been formally supervised for over one year though the provider expected this to occur six times a year. Spot checks, the primary source of quality assurance, were not being completed regularly. There was no governance system in place to highlight spot checks, supervision or lack of quality assurance for medicine administration. The registered manager had not notified us about an allegation of abuse that occurred at the service. This is a regulatory requirement.
There were systems in place to safeguard people from abuse. There were risk assessments in place to mitigate risks to people. Recruitment practices were robust, and staff were employed with people’s safety in mind. There were infection control measures in place. Accidents and incidents were recorded and followed up on.
People’s needs were assessed before they began using the service to see whether their needs could be met. The service worked alongside other agencies to provide effective care. People were supported with their health care needs. People were supported with their dietary needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff sought people’s permission before providing care and there were best interest meetings when people needed support to make decisions.
People and their relatives thought highly of staff and management. Staff understood their roles. The registered manager understood their regulatory requirements and were open and honest with people when things went wrong. Although pandemic lockdowns had restricted people meeting, people were able to feedback on the service directly to management and via meetings when measures were lifted. Similarly, staff could also speak with management and had the opportunity to be engaged with the service via meetings when they occurred. The service worked in partnership with other agencies to the benefit of people using the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The previous rating for this service was good (published 13 April 2018).
Why we inspected
This service had not been inspected for over three years and we had found concerns with risk assessments, training and governance at one of the providers other local services. We undertook a focused inspection to review the key questions of safe, effective and well-led only.
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 in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for George Davies Lodge 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. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to managing medicines safely, staffing with respect to training and supervision and also good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will 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.
At our last inspection on 22 December 2014, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the home is run.
People continued to receive safe care. Risks were identified and action taken to minimise risk and to support people as safely as possible. Systems were in place to ensure medicines were administered safely and when needed. There were enough staff on duty to support people.
People were supported by experienced staff who received training and support to enable them to continue to provide an effective service. The staff team worked closely with other professionals to ensure that people remained as healthy as possible and received the healthcare they needed.
People continued to be supported by kind, caring staff who treated them with respect. Their privacy and dignity were maintained.
People continued to receive individualised care and support that was responsive to their needs. They were encouraged to make choices about their daily lives and to continue to do things they enjoyed.
Management systems ensured the service continued to be well led and that people were involved in decisions about their care and about what happened in the service. People told us that any complaints or concerns were dealt with by the registered manager.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Further information is in the detailed findings below.
This inspection took place on 22 December 2014 and was announced.
At our last inspection on 24 October 2013 we found the provider was meeting all the standards reviewed.
Redbridge Care is registered as a domiciliary care agency and is part of community services provided by the London Borough of Redbridge. They provide an extra care service to people who are tenants at George Davis Lodge, which is one of the borough's sheltered housing units. The service offers individuals personal care, support and 'extra care' they require to continue to live independently.
There is a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.
People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening.
We observed members of staff interacting with people using the service in a courteous, polite and efficient manner.
Appropriate arrangements were in place in relation to the obtaining, recording and administration of medicines.
The provider had taken steps to provide care in an environment that was adequately maintained. We found that the service was clean and appropriately furnished.
People who used the service were protected against the risk of unlawful excessive control or restraint because the provider had made suitable arrangements. Training and support was in place for all staff to do their job effectively. Staff were also able to identify any training that they felt would improve the delivery of care they provided.
Management actively sought feedback as to the quality of service provided and acted upon the information where appropriate.
Information relating to people’s life history, likes and dislikes were clearly documented. We found there were clear and comprehensive guidelines for staff to follow, to ensure people’s needs were met.
We found the service had a complaints procedure in place and that people knew who they could complain to. One person said "I would tell one of the managers." The service had various quality assurance systems in place, some of which included seeking the views of people who used the service. Appropriate records were maintained by the home to ensure that people received safe care and treatment and maintained people’s confidentiality.
People told us that they received the care that they needed. A relative commented " I have no worries about her care, she is always clean and showered." "It is a good service they care for people's well being, know their likes and work hard to meet them."
People told us they felt safe when the care workers visited them and if they had concerns they would speak with a family member, friend or somebody from the office. They told us that care workers knew how to help them and were kind. People said they were asked for their views about their care and treatment and their feedback was listened to and acted upon.
We found that people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.