Green Heys & Kemp Lodge Care Home

Green Heys and Kemp Lodge is a residential care home which provides accommodation and nursing care for up to 75 people. The care was provided in two separate buildings, however, only one building was being used at the time of our inspection. Some people who resided at the home were living with dementia. At the time of our inspection there were 29 people living at the home.

People’s experience of using this service and what we found

Records in relation to people’s needs were not always completed accurately. Food and fluid charts did not specify how much food and fluid people had consumed which put some people at risk of unsafe care. Risk assessments in relation to bedrails did not thoroughly record or explore the risks posed to some people. This risk has now been mitigated, and the registered manager has assured us records relating to risk assessments have been completed in more detail for those needing it. Food and fluid charts have been re-organised to contain more detailed information to manage people’s risks safely.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. This was because people had bedrails in place without the appropriate assessments and some people's ability to make choices were not always clearly assessed.

Quality assurance procedures were in place, and audits took place in a range of areas. However, there were gaps in the quality assurance process as the issues we identified during our inspection were not picked up.

We have made a recommendation with regards to staff engagement and support. This is because most of the staff we spoke with told us they felt unsupported in their roles and this impacted the care they gave. Supervisions took place, however more than three members of staff told us they felt the management in the home did not always address issues and staff morale was low. We highlighted this feedback to the registered manager and provider and were assured action would be taken immediately following our inspection.

Medication was well managed, and for people requiring medication as and when required (PRN) there were clear protocols in place for staff to follow. People’s clinical needs in relation to wound care and pressure area care were well recorded. Staff were recruited safely. We received some mixed feedback regarding staffing levels which we shared with the registered provider.

The home was clean and well maintained. Infection control arrangements were in place to prevent and mitigate the risk of COVID-19. Appropriate protective and personal equipment (PPE) was in place and care staff used this appropriately. The environment was suitable for people living with dementia.

Staff were trained in mandatory subjects relating to their role and had had an induction. We received mixed feedback regarding the food and menu choice at the home. However, the registered provider assured us following our inspection this was in the process of being changed following consultation with people.

Relatives told us they felt the staff were kind and caring, some comments included; “Staff seem very nice” and “I think the staff are quite nice”. We observed staff knocking on people’s doors and speaking to people with respect and curtesy during our inspection.

The registered manger understood their role and had sent all required notifications CQC in line with regulatory requirements.

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 the service under the previous provider was Requires Improvement published on 11 December 2019.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about people’s weight and pressure area care. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Following our inspection, the registered provider took immediate action to mitigate risks. They have updated us with regard to the action they have taken.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to record keeping and governance and the application of the Mental Capacity Act.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.