Carlisle Lodge

Updated 3 April 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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one inspector, a specialist pharmacy advisor and expert by experience. An expert by experience is a person who has personal experience of caring for someone who uses a care home and has a dementia. A pharmacist was included in the inspection team as we had received concerns about the inappropriate management of people’s medicines. These concerns are being investigated by another regulatory authority.

Service and service type:

Carlisle 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.

The service is required to have a registered manager. The service had a registered manager who was also the registered provider. They are both legally responsible for how the service is run and for the quality and safety of the care provided. 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.

Notice of inspection:

Our site inspection was unannounced and was undertaken on the 20 and 25 February 2019.

What we did:

Before our inspection we reviewed the information, we held about the service including previous inspection reports. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we reviewed the information provided, spoke to people and staff and gathered information about the management of the service.

This included:

• Notifications we received from the service

• Staff recruitment files

• Training records

• Three people's care records

• Records of accidents, incidents and complaints

• Audits and quality assurance reports

• We spoke with ten people using the service and two relatives.

• We spoke with seven members of staff, including the registered manager, a registered nurse, care staff, activity staff and the chef.

Following our inspection, we spoke with three visiting professionals who provided their view on aspects of specialist support provided to people who lived in the service.

Updated 3 April 2019

About the service:

Carlisle Lodge is a care home that provides nursing and personal care for people over 65 and accommodates up to 19 people in an adapted building. At the time of the inspection there were 14 people accommodated who had a range of complex health care needs and some people were also living with a dementia.

People’s experience of using this service:

The service met characteristics of ‘Good’ in most areas.

•Since the previous inspection, significant improvements had been implemented to ensure the requirements of the Mental Capacity Act 2005 were being met. Quality systems had been improved to effectively monitor these requirements along with health and safety matters in the service. However, we found further improvements to the quality systems were needed to ensure suitable training programmes and records were maintained in relation to all staff training.

•The outcomes for people living at Carlisle Lodge were personalised care provided by caring and supportive staff. People lived in a safe, comfortable and homely care home. One person said, “They look after me and it’s warm and comfortable, I feel very safe here.” The emphasis was on a relaxed but a professional environment.

•Staff knew how to keep people safe. They responded to any risks and took measures to reduce these. Staff had a good understanding of how to identify and respond to any suspicion or allegation of abuse. Medicines were handled safely with people receiving their prescribed medicines in a timely fashion.

•Staff knew people really well. They had a good understanding of each person's needs and choices. People’s individuality was embraced with people’s past life’s and beliefs being recognised. Any restriction to people’s liberty were made in the least restrictive way possible to ensure people’s safety. These had been considered in line with the MCA 2005.

•The food provided was individually tailored to people’s needs and preferences. There was a strong emphasis on providing what people wanted and enjoyed. One person said, “The food is very good. We have an excellent cook and she makes the effort to find out what people like, she sees me every day. At first, I found the meals were too much for me, so they have been made smaller. I only have to ask for anything. They come around with drinks but I can ask for different drinks at any time.”

•Staff had a good relationship with people and interaction was positive and friendly. Activities and entertainment were person centred and ensured each person had the opportunity for social interaction.

•Staff worked closely with health and social care professionals to secure the best outcomes for people’s health and well-being. Visiting professionals told us staff responded to their input in a positive way and worked with them for people’s benefit.

•The registered manager supported staff development and learning. New ways of working were explored and appropriate training was given to ensure staff had the appropriate skills to look after people.

•The registered manager led by example in providing person centred care. She interacted positively with everyone at the service and ensured that relative and visitors felt welcomed and included. Staff felt appreciated and well supported. Complaints were recorded and responded to in an open and transparent way and there was a culture of learning from accidents, incidents and any feedback received.

Rating at last inspection: Requires Improvement (report published 8 March 2018).

Why we inspected: We previously inspected Carlisle Lodge in February 2018. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to make improvements. They provided us with an action plan. We inspected to follow up on the actions taken by the provider. At this inspection we found the provider was now meeting these legal requirements.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.