Archived: Lavender Lodge Nursing Home

Updated 16 January 2015

We inspected the home on 6 August 2014. We spoke with 12 people who lived at the home, five relatives, six care workers, two nurses, two housekeeping staff and one maintenance person. We attended the 8am shift hand over meeting and the 2pm unit managers meeting. We spoke with the home manager and the quality assurance manager. We reviewed people’s care files, staff training records, a selection of policies and procedures and records relating to the management of the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spend time observing how staff care for people on all three floors and especially on the Jasmine floor where most of the people with dementia were being cared for.

The inspection team consisted of two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the visit we looked at previous inspection reports and notifications that we had received. Services tell us about important events relating to the care they provide using a notification. We also reviewed the Provider Information Return (PIR) from the service. This 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.

At our last inspection in September 2013 we did not identify any concerns. Following our visit we sought feedback from commissioners and health care professionals to obtain their views of the service provided to people.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

Updated 16 January 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The home requires a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. There is a manager who started working in this role in February 2014. This person is not yet registered with the Care Quality Commission. The manager has submitted their application to become registered with us.

Lavender Lodge Nursing Home is a home that provides nursing care for up to 68 people who are frail or have dementia. People may need care for a period of time to recover from illness or have lived in the home on a longer term arrangement. At the time of our inspection 60 people were using the service. This was an unannounced inspection.

The service was not always caring. This showed in the way that some people with dementia were spoken to, were helped to move around, were supported to be independent and make some choices.

People’s care were not always planned and delivered to ensure their emotional needs were consistently met. Plans were not always put in place to prevent people with dementia from becoming distressed or to enhance their quality of life.

There were limited social opportunities for people who were nursed in bed or had dementia. People who found it difficult to initiate contact might not always get the support they needed to prevent them from getting bored or lonely.

The provider had identified some of the concerns we found in relation to the quality of care provided to people with dementia. The manager however had not been aware of the concerns highlighted by our mealtime observations. Though the provider had plans in place to ensure people with dementia received safe quality care, some of these plans were still to be implemented and we could therefore not judge at this visit whether they would bring about the required improvements.

People were supported to stay healthy and eat and drink enough. They received good quality nursing care consistently in line with national clinical practice guidelines. Staff were trained and supported to understand the needs of the people they supported.

People and their relatives were encouraged to plan their own care. Where people did not have the capacity to consent to their care, arrangements were in place to ensure consent was sought lawfully and protected people’s rights. We found the provider to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

The home was providing safe general nursing care. Systems were in place to identify, report and respond to safety incidents appropriately and action was taken to prevent these incidents from re-occurring. People and their relatives told us they felt safe in the home and when receiving care.

The manager reviewed all safety incidents as part of the home’s quality assurance process and had taken action to reduce the occurrence of chest and urine infections. The organisation also monitored the performance of the home and was supporting the new manager to develop their skills and make improvements to the home.

People and relatives were encouraged to give their views about the home and their feedback was used to make improvements.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.