Archived: Pennine Lodge

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We found that care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare. This was because care plans were not based on Pennine Lodge staff's assessments of people's needs. We saw that there was insufficient staff available during busy periods throughout the day. People were protected from abuse because the provider had taken all reasonable steps to ensure that staff were able to identify and report issues that concerned them.

Is the service effective?

We saw that staff had received sufficient training, supervision and appraisal, the manager was aware of the importance of supervision and appraisal being kept up to date.

Is the service caring?

We observed that people were cared for by warm and friendly staff, however they did not always have sufficient time to interact with people who used the service.

Is the service responsive?

Records confirmed that although people's preferences, interests, aspirations and diverse needs had been recorded this was not correctly reflected in care plans.

Is the service well-led?

Staff had a good understanding of the ethos of the service and quality assurance processes that were in place. The manager, provided leadership and was aware of areas that required improvement. The provider had an effective system to regularly assess and monitor the quality of service that people received.

We arrived at the home at 06.45 AM. There was one qualified nurse and six carers. We were told by staff this was the usual amount, however, we saw from the records that on some nights there were eight staff in total. On the day of our visit there were 69 people living at Pennine Lodge. Staff we spoke with, on both the night and day shift, told us there had been an increase in staffing. They also told us they could now meet people's needs in a timely manner. The staff working nights on the upper floor told us, 'It's a lot better.

At this inspection we saw that more information had been added to the administration records to assist staff in how the records should be completed. The records had been audited regularly to ensure they had been completed correctly and where any errors had occurred this was noted quickly and corrected accordingly. This meant that it was possible to confirm that where medicines had not been given an explanation had been appropriately recorded.

Staff told us there had been no senior care workers on the night shift as one was off sick and one was on annual leave. We were also told that because of the low numbers of staff they found it difficult to keep a check on people because of the layout of the building. All the staff we spoke with told us there should be seven staff on the shift. Staff told us they had previously raised their concerns about the level of staffing with the management. They felt their concerns had not been acted on and frequently there were less than seven staff on the night shift. They were concerned about the lack of time to spend with the people using the service to meet their individual needs.

We looked at the records of regular audit checks in key areas of care delivery such as medication, health and safety, care plans, and the environment. We also saw that regular quality and safety monitoring visits had taken place by visiting senior staff from the company. We saw that where any actions had been identified there was information provided to confirm that matters had been resolved in a timely manner.

The care plans we saw were person centred. We saw information about life histories and personal preferences had been recorded. One relative we spoke with told us, ' I'm informed of any changes every time I visit'.

One relative we spoke with told us' The staff are very good and I would not be worried or afraid to raise concerns or complaints with the nurses or the manager.

When we checked the records for two completed courses of antibiotics we found that the number of recorded administrations did not match up with the number of doses of antibiotic supplied. This means that we were not able to confirm that these medicines had been given to people as prescribed.

Throughout the day we noted that the call bells were not answered very quickly and one resident we spoke with, whose bell had rung a long time told us, 'The girls are very good but they are busy'. She also told us. 'Everything is fine but I don't think there is enough staff'.

We found that the internal auditing system was not sufficient to consistently identify matters of concern. The inconsistencies of completion of documentation had not been identified through an auditing process.

We found that records were stored securely and they were able to be located promptly when required. Staff we spoke with told us they had received training on confidentiality as part of their induction training.

The manager told us that they were aware of the issues which had been identified to us and had taken actions to investigate these. They had conducted two unannounced night visits during the past five months and had worked a number of night shifts themselves. They told us that they had not witnessed any of these concerns during these times.

With regards to staffing issues the manager told us that they were in the process of recruiting four new carers to support the existing staff compliment. When we looked at staffing levels in the home, and discussed the needs of people who received care, we found that adequate staffing was in place at all times. We looked at the care records of five people who received support and found that care plans were generated from the initial care needs assessment and covered all aspects of activities of daily living, health care needs and medication. From observing individuals in the communal areas we saw that the care plans gave an accurate reflection of the individual, the things that were important to them in their lives and the care they required from staff in the home.

People we spoke with told us, 'This is a good home, we're well looked after'.

The people we spoke with told us they had been included in making decisions about the care they received and the services provided in the home.

People told us the manager and staff in the home listened to them and asked for their views about the service provided.