Archived: Somerset Lodge

Updated 26 August 2016

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 31 May 2016 and was unannounced. It was carried out by two adult social care inspectors. This was a focussed inspection to look at areas where the home had been found in breach of regulations; we did not inspect against every key line of enquiry therefore the rating awarded from the last inspection remains unchanged until the next comprehensive inspection. At the last inspection on 07 and 09 December 2015, Somerset Lodge was breaching seven regulations of the Health and Social Care Act 2008.

1. Good governance (Regulation 17). The required improvements had been made.

2. Meeting nutritional and hydration needs (Regulation 14). The required improvements had been made.

3. Staffing (Regulation 18). We saw partial improvements had been made.

4. Need for consent (Regulation 11). The required improvements had been made.

5. Dignity and respect (Regulation 10). The required improvements had been made.

6. Receiving and acting on complaints (Regulation 16). The required improvements had been made.

7. Person-centred care (Regulation 9). The required improvements had been made.

Before our inspection we reviewed all of the information we held about the home, including the provider’s action plan following the last inspection and notifications of incidents that the provider had sent us. We looked at the Provider Information Return (PIR). 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.

During the inspection spoke with two people and observed the care of others. Although speaking with only two people seems a small percentage given there were two inspectors, most people were unable to fully express their views verbally. However, people but appeared comfortable and relaxed with staff. We also spoke with six members of staff, the manager of the home and the clinical lead, two relatives and one visiting healthcare professional. We observed care and support in communal areas, spoke with some people in private and looked at the care records for five people. We also looked at records that related to how the home was managed.

Updated 26 August 2016

The last inspection of the home was carried out in December 2015 and the home was rated inadequate. Five breaches of regulations 17, 14, 18, 10, 16 and 9 of the Health and Social Care Act 2008 were made. The provider sent us an action plan describing how they would improve.

This inspection was unannounced and was a focussed inspection to check what improvements the home had made regarding the breaches of regulations. This meant we did not check all key lines of enquiry which meant we cannot change the rating of the service until the next comprehensive inspection.

The home was divided into two units. One unit known as Bluebell supported people living with dementia. The other called Snowdrop cared for people with long term mental health needs. At the time of the inspection there were 24 people living at the home.

There is a manager in post who has applied to become registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the previous inspection we found people’s daily records were not maintained accurately. Quality assurance systems did not identify the shortfalls we found. During this inspection, we saw records were well written and the manager monitored care plans and other records.

People were supported by staff who were kind and caring. People were very comfortable with the staff who supported them. Staff respected people’s privacy and dignity, and gave people choices.

A number of fire drills had taken place. Staff had access to records which gave them information about the support people would need in the event of an emergency.

Where agency staff were used, the home had a block booking which meant staff worked in the home regularly. Most care staff were employed directly by the home. The home had identified the need for five nurses; however staff for two of these posts had been identified. Staff said there were enough staff on duty to provide the support people needed.

People were given choices of meals and where they ate their meals. Snacks were readily available. Staff provided appropriate support where people needed this. If people needed specialist diets, these were available.

Staff had been provided with a range of training courses, including specialist training such as understanding dementia, mental capacity and deprivation of liberty. Staff were able to undertake nationally recognised training if they wished.

Where people had made complaints, these were listened to and changes made.

Care plans were personalised to the individual and gave details about their likes and dislikes. Staff had information they needed to be able to give people the support to meet their needs.

Work was underway to improve the environment. Re-decoration of the home was ongoing and people had been able to choose the wallpaper in the lounge.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.