10 May 2016
During an inspection looking at part of the service
This unannounced inspection took place on 10 and 11 May 2016 in response to a serious incident that happened at the home and to check if people using the service were safe. The report should be read in conjunction with the report we produced after our unannounced inspection of March 2016.
Lancaster Lodge is a care home for up to 11 adults with mental health needs.
The home did not have a registered manager. The previous manager left on 18 January 2016. 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 and associated Regulations about how the service is run.
The provider did not have effective systems to manage risks and where risks were identified, comprehensive plans were not in place to ensure risks were managed appropriately and in a consistent manner.
The provider did not have proper arrangements to ensure people received their medicines as prescribed so they received the treatment prescribed by their doctor.
Some risks in relation to the safety of the premises, more specifically about the storage of cleaning products and other chemicals, were not managed appropriately to fully ensure the safety of people who use the service.
There were conflicting records meaning people were not protected from known risks. These included records associated with nutrition and hydration as staff were given conflicting directions to follow in relation to keeping people using the service safe.
The provider did not ensure appropriate skilled and experienced staff were deployed at the home to meet the various needs of people who used the service.
We found two continued breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking action against the provider in combination with the findings of our inspection in March 2016 in accordance with our enforcement policy. We shall report on this when our action is completed.
Two people said that currently they felt safe living at the home and had now got used to the new staff and felt better supported by them.
Staff said they had received appropriate support with their work including support to come to terms with a serious incident which occurred at the service.
The overall rating for this service continues to be ‘Inadequate’ and the service is still in ‘Special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.