Background to this inspection
Updated
3 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.
This was an unannounced inspection and took place on the 9 and 10 October 2017. It was carried out by one inspector, an expert by experience and a specialist advisor on the first day and two inspectors on the second day. An expect by experience is a person who has personal experience of using or caring for someone who uses this type of service. The specialist advisor was a nurse.
We spoke with nine people living at the home and seven relatives about the quality of the care and support provided. We also spoke with the registered manager, three nurses, the administrator, a co-ordinator and four staff. Following the inspection we spoke to two health and social care professionals.
We looked at four people’s care records and documentation in relation to the management of the home. This included seven staff files including supervisions, training, recruitment records, quality auditing processes and policies and procedures. We looked around the premises, observed care practices and the administration of medicines.
Prior to the inspection we reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.
Updated
3 January 2018
We undertook this unannounced comprehensive inspection on the 9 & 10 Oct 2017.
Argentum Lodge provides care and accommodation for up to 56 people. On the days of the inspection 53 people were living at the home. The home is on three floors, with a lift or stairs. All bedrooms have en-suite facilities. Communal areas include a lounge and dining area on each floor. There is a reception and lobby area, downstairs sitting area, car park, garden and patio area.
The service had a registered manager. 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.
Medicines were stored safely but records relating to creams administered required improving. People’s care plans did not always contain guidelines and support plans relating to people’s individual needs relating to their diabetes, skin care, suction care, bowel care, if they presented upset or agitated and management of pain.
Governance systems were not always identifying shortfalls relating to medicines management, care plans, risk assessments, support plans and equipment not accurately set as required.
People who required specialist equipment such as air mattresses did not always have them set accurately. There was no risk assessment or support plan that confirmed people’s needs.
People were supported by adequate staffing levels to meet their individual needs. The home due to vacancies was using some agency staff.
People were supported by staff who had received training to ensure they had the skills and competencies relevant to their role.
People felt safe and were supported by staff who were able to demonstrate what abuse was and who to go to if they suspected abuse.
Care plans confirmed if people lacked capacity, however where some people lacked capacity there was not always a best interest decision in place relating to their care and support.
People and relatives were happy with the meals, drinks and snacks and felt there was a good choice.
People’s care plans contained important information relating to their likes, dislikes and routines.
People were supported by staff who had suitable pre-employment checks.
Incidents were recorded, although the overview log had no record of what action had been taken to prevent a similar occurrence from happening.
People and staff felt able to talk to the registered manager and that they were accessible. People were supported to maintain relationships that were important to them.
People were not always able to access activities that were meaningful due to a shortage of activities and time.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.