Background to this inspection
Updated
4 April 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of four inspectors and a specialist nurse advisor. One of the inspectors acted as an 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.
Service and service type
Crest Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed information we had received about the service since the last inspection. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who lived at the service, one relative and nine members of staff including the chef, carers, the activities coordinator and registered manager. We also spent time observing people and the care they received in communal areas, such as the lounge and dining room. We reviewed a range of documents including seven care plans, administration records, accident and incidents records, policies and procedures and internal audits that had been completed.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records.
Updated
4 April 2020
About the service
Crest Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Crest Lodge provides nursing care for people with mental health diagnoses. The service accommodates up to 47 people across two separate floors. At the time of our inspection, the service was supporting 40 people.
People’s experience of using this service and what we found
People were supported to fulfil wishes and goals that were personal to them, telling us of the positive impact this had had on their mental health and wellbeing. Activities within the service were engaging, including for those who preferred to spend time in their rooms to ensure they did not become socially isolated. People were able to continue practicing their faith, with the registered manager supporting one person to attend church with them and their family. People were encouraged to be part and give back to the local community, raising money for local charities and raising awareness of environmental issues. Staff supported people through times of bereavement, ensuring people that were special to them were remembered.
There was a very strong culture of empowerment within the service, with people being supported to feel ‘human’ rather than the focus being on their mental health conditions. This included educating and promoting people to feel safe in their local community. This was led from the top from the registered manager who people, relatives and staff praised for their approachability and warmth. People and their relatives felt staff were kind and compassionate towards them and respected their privacy and dignity. Any complaints or concerns raised were appropriately handled, with good outcomes being reached for all.
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 involved in reviews and day to day decisions around their care, and encouraged to be as independent as safely possible. The registered manager actively sought feedback from people, relatives and staff, and acted upon suggestions made to improve the service.
Staff were safely recruited and were aware of their responsibility to safeguard people from abuse. Regular training, supervisions and appraisals ensured staff were effective in their roles and able to provide the support people required.
Regular quality audits were completed to identify any issues within the service that were then resolved by staff. Risks to people were appropriately recorded and managed by staff, and medicines were safely stored, administered and recorded. The service was clean with no malodours as staff adhered to infection control practices. Accidents and incidents that had occurred with recorded, with actions taken to prevent reoccurrence which had proven successful. People were supported to maintain their nutrition and hydration, with their individual dietary needs being known and supported by staff. Referrals to healthcare professionals had been completed where required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 28 April 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection based on the previous rating.
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.