Archived: Roby Lodge

Updated 28 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 30 November and 06 December 2017. The first day was unannounced.

The inspection team on the first day consisted of one adult social care inspector and 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, their area of expertise is dementia care. One adult social care inspector carried out the inspection on the second day.

We used information that we held about the service and the service provider. This included notifications we received and the provider information return (PIR). The PIR is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We requested information about Roby Lodge from the local authority commissioners and safeguarding team, they raised no concerns about the service.

During the inspection, we used a number of different methods to help us understand the experiences of people living at Roby Lodge. We spoke with a total of 11 people living there, six visiting relatives and 11 members of staff including the registered manager, the deputy manager, the activities co-ordinator, a member of domestic staff, six care staff and an area director. We also spoke with a visiting health professional.

Throughout the inspection, we observed how staff supported people with their care during the day.

We used the Short Observational Framework for Inspection (SOFI) and undertook a SOFI during the course of the inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

We looked around the service and checked a selection of records, which included care plans for four people, medication records, policies and procedures; staffing rotas; risk assessments; complaints; four staff files covering recruitment; training; maintenance records; health and safety checks; minutes of meetings and medication records.

Updated 28 December 2017

This inspection took place on 30 November and 06 December 2017. The first day was unannounced.

The last inspection of the service was carried out in March 2017 and during that inspection we found breaches of regulations in respect of infection prevention and control, management of medication, records and assessing and monitoring the quality and safety of the service. Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions; is the service safe, effective, caring, responsive and well-led, to at least good.

Roby 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. Roby Lodge accommodates up to 42 people in one adapted building over two floors. There were 32 people accommodated at Roby Lodge at the time of this inspection.

The service has a registered manager. 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.

Improvements had been made to minimise the risk of the spread of infection. The environment was clean and hygienic and smelt pleasant throughout. Staff followed safe practices when handling and disposing of clinical waste.

Improvements had been made to the management of medication. There was clear guidance in place for staff to follow on the use of PRN medication. PRN medication is prescribed for use when it is needed, for example for pain relief. Protocols in place for the use of PRN medication included important information such as the signs staff needed to look out for which indicated that a person needed their medication.

Improvements had been made to systems for checking on the quality and safety of the service and for making improvements. The service was assessed and monitored in line with the registered provider’s quality assurance framework. Where risks to people’s health, safety and welfare were identified action plans for improvements were developed and followed through promptly so that risks to people and others were mitigated.

Improvements had been made so that people received effective care. Care records reflected people’s needs and the care they received. Charts were in place to monitor aspects of people’s care such as fluid intake, skin integrity and weight. The charts recorded what the expected outcome was for the person, for example the amount of fluid people needed to consume in a 24 hour period and required settings for air flow mattresses.

Improvements had been made so that people’s personal belongings were treated with dignity and respect. A system had been put in place to ensure that items of unmarked clothing were promptly returned to people.

Improvements had been made to how complaints and concerns were dealt with. Complaints received were listened to and acted upon in line with the registered provider's policy and procedure. A clear record of complaints received was maintained which showed that they were acknowledged and actioned to achieve a satisfactory resolution.

We have made a recommendation about the environment. Although improvements had been made to the environment to make it more dementia friendly, further improvements were required. There was a lack of stimulus for people living with dementia, particularly for those who enjoyed keeping themselves busy around the environment.

Allegations of abuse were acted upon to ensure people were safe from abuse or the risk of abuse. People were protected by staff who knew about the different types of abuse and how to recognise indications of abuse. Allegations of abuse had been reported to the relevant agencies in a timely way.

Safe procedures were followed for recruiting new staff. Staff had provided details of their qualifications, skills and experience and they underwent a series of pre-employment checks to assess their suitability for the job. Staff entered onto an induction programme when they started work at the service and relevant training was provided to all staff on an ongoing basis.

People were treated with kindness and compassion and their privacy, dignity and independence was respected and promoted. Staff provided people with comfort and reassurance when they were anxious or upset and people responded positively to this. People received intimate care in private and they were encouraged to be as independent as possible.