Archived: Rose Lodge Care Home

Updated 19 January 2018

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.

The inspection took place on the 13, 14 and 21 September 2017. The first day of the inspection was unannounced so the home did not know we were coming to inspect.

The inspection was completed by two adult social care inspectors 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. In this instance we used an expert by experience that had knowledge of supporting older people living with dementia.

Prior to the inspection the lead inspector gathered the available information from Care Quality Commission (CQC) systems to help plan the inspection. This included the detail of any notifications received, any safeguarding alerts made to the Local Authority, any complaints or whistle-blowing information received and the detail of the Provider Information Return (PIR) received from the provider. The PIR is submitted to the CQC by the provider and includes details of the provider’s perspective on meeting the requirements of the regulations.

During the inspection we reviewed 14 people’s care files including supplementary information held in seperate files and located in people’s bedrooms. We looked in detail at five files, pathway tracking people’s needs from assessment, to care planning and the support provided. We also looked at four staff personnel files to ascertain how staff were recruited to their post and the support they received to fulfil the role for which they were employed. We looked at how staff were supported, including the induction they received when starting their role and the ongoing support they received including training and supervision.

We looked at other records including the detail of five Medicine Administration records, to inform us how people were supported with their medicines and records held by the home to show how people were supported with their diet and nutrition. We looked at management information to show us how the home was monitored by the management and provider, and how action was taken when concerns were identified.

We spoke with 16 staff including carers and nurses who worked on day and night shifts, the manager, deputy manager and operations director. We spoke with maintenance staff, domestic staff and kitchen staff including the chef.

We spoke with 17 people who lived in the home, some in detail and some just to seek clarity to specific points. We also spoke with three relatives, visiting family at the home.

We looked around the home in people’s bedrooms, communal areas and service areas including the kitchen and laundry.

Updated 19 January 2018

We inspected this service on the 13, 14 and 21 September 2017. The first day of the inspection was unannounced which meant the home were not expecting us on the date of the inspection.

Rose Lodge Care Home provides nursing and residential care for up to 40 older people. At the time of the inspection there were 26 living in the home. Nineteen of these received residential support and seven received nursing care. The home is located in the middle of a residential area in Banks a small town near Southport, Lancashire. The home is situated in its own grounds and is a large single story building with landscaped gardens to the sides and rear of the property. The accommodation is provided over three wings, with all rooms having access to their own en-suite bathroom facilities.

There are large communal areas including two lounges and a dining room. The kitchen and laundry facilities are accessible to cater for the needs of the people living in the home.

The home was last inspected on 10 July 2015. At this inspection the home was found to be in breach of one of the regulations associated with person centred care. We gave two recommendations for improvements in recruitment and the gathering of formal consent. The home was rated as requires improvement overall and requires improvement for four of the key questions, namely safe, effective, responsive and well led. We rated the home good in the caring key question.

At this inspection we have again rated the home as requires improvement overall but acknowledge the home’s new manager is beginning to address concerns noted. There had been some detrimental practices at the home since the last inspection which have impacted on the current quality of the service provided. However the provider and manager have developed action plans and ongoing evaluation to ensure concerns are addressed.

We found the home had met the previous breach in person centred care as people told us they could have baths when they wanted them and had them regularly. We did however note that records of this were poor. We found concerns with a number of the records made which included inconsistencies and contradictions. We also found the home had not effectively audited this to ensure improvements were made. We found this had not directly impacted on the support people received at the time of the inspection but there was a risk it could have. We have found the home in breach of this regulation and have asked the provider to make specific and focused improvements in this area.

At the last inspection we recommended the provider sought formal consent from the people they were supporting. We found this had not been done at this inspection and have found the home in breach of this regulation. This means the home will be required to develop an action plan on how they intend to make improvements in this area. Action plans are required for all breaches found during inspections.

We also found concerns in the management of medication and noted the home were not always following best practice guidelines. This was noted partly in the inconsistent completion of the medicine administration records.

We found the home’s staff continued to have good relationships with the people they supported and it was evidenced to us that they knew people well. When staff were new to post we saw other staff members supporting them and reviewed that they had been recruited safely.

Staff treated people with dignity and respect and people had choices in their daily lives. People told us, if they had specific requests or preferences, they would be met.

The home had taken appropriate steps to ensure the building and the equipment used was safe and secure. Risk assessments had been completed and action taken to mitigate identified risks. Professionals had tested equipment to ensure it was safe to use. The home had a plan in place in the event of an emergency.

We found the home worked within the principles of the Mental Capacity Act 2005 where people lacked the capacity to consent to their care and treatment and used the Deprivation of Liberty safeguards appropriately to ensure people were both kept safe and were supported in the least restrictive way possible.

People we spoke with liked the food provided in the home and the chef was knowledgeable on people’s needs. We saw people who had previously lost weight were now gaining it to maintain a healthy lifestyle. We also saw the chef had supported one person to lose weight and the person was happy with the support they had received.

The manager had gained the trust of the staff at the home and the people in the home including their family members. Everyone we spoke with was positive the home would improve under the new manager.

The new manager had recently registered with the commission and now had a legal responsibility to drive improvements and meet the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The home had gathered the views of the people they supported and taken action where things needed to improve. Where complaints had been made the manager had ensured lessons were learnt from the complaint and took steps to reduce the risks of similar events occurring.

You can see what action we told the provider to take at the back of the full version of the report.