About the serviceNorton Lees Hall and Lodge is a residential care home providing personal care to 43 people at the time of the inspection. The service can support up to 80 people in a purpose-built facility over two floors and four wings, each with a separate dining room and lounge. At the time of our inspection only three wings were in operation.
People’s experience of using this service and what we found
Risks to people were assessed and their safety managed, however some identified risks were not recorded consistently throughout people’s records and staff were not always aware of these. Checks concerning the environment and equipment took place, however provider oversight of these was not effective. Medicines were generally administered safely although records for creams were not always up-to-date. Not all staff had received recent medicine administration training, although competency checks on staff administering medicines were undertaken. Systems were in place to protect people from abuse. Staff were knowledgeable about safeguarding processes. People’s dependency needs were checked regularly to support staffing levels. Relatives and staff told us staffing levels were adequate. Infection control procedures were in place and regular cleaning took place. Action plans were produced as a result of accident analysis and recent staff meetings showed discussions about lessons learnt.
Most staff had not received mandatory training, recent training had taken place for some staff and plans were in place for the completion of all training by the end of September 2019. People’s needs and choices were assessed. People were supported to eat and drink and this was monitored to maintain a balanced diet. People told us the food was good. A handover took place at the start of each shift, daily flash meetings had recently taken place to share information. Staff were responsive to people’s health needs and visits from health professionals were recorded. Consent to care was sought in line with guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were treated with dignity and care. People were given choice and supported to express their views and decisions. People’s privacy and dignity were respected and promoted.
Most people’s care plans were not consistently updated to reflect their changing needs. People’s care plans recorded their likes, dislikes and preferences, however information about people’s life history was limited. Staff were generally knowledgeable about people. Concerns and complaints were recorded and responded to appropriately. People were supported at the end of their life.
It was evident there had been a lack of robust oversight and governance at the home however the new interim manager had made preparations to improve the service. Governance frameworks had recently been put in place and staff were clear about their responsibilities. Surveys asking people, relatives and staff about the care had been undertaken, however analysis had not taken place. Relatives, staff and professionals spoke positively about the current culture at the home. Regular meetings for people and relatives had recently been planned, regular staff meetings took place. The service had an action plan showing the planned improvements for the home although progress against some of these actions had not been undertaken as expected. There was evidence the home worked with other partner organisations.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This is the first inspection for this new provider, registered 17 December 2018. The last rating for this service was inadequate (published 19 May 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.
At this inspection enough improvement had not been made or sustained and the provider was still in breach of regulations.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Norton Lees Hall and Lodge on our website at www.cqc.org.uk.
Why we inspected
The inspection was prompted in part due to concerns received about delayed improvement of care quality at the service. A decision was made for us to inspect and examine those risks.
Enforcement
We have identified breaches in relation to safe care and treatment, good governance, staffing and recruitment at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.