9 October 2017
During a routine inspection
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.