Background to this inspection
Updated
29 April 2015
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.
The inspection visit took place over one day on 9 March 2015. This visit was unannounced which meant the staff and provider did not know we were visiting. The inspection team consisted of one adult social care inspector.
The provider was not asked to complete a 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.
We reviewed all of the information we held about the service including statutory notifications we had received from the service. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale.
During our inspection we spoke with seven people who lived in the home, three visitors, three care staff, two ancillary staff, the deputy manager and acting manager. We observed care and support in communal areas and spoke with people in private. We also looked at care records of four people to see if their records matched with the care needs they said they had or staff told us about. We also looked at records that related to how the service was managed.
As part of the inspection process we also reviewed information received from the local authority who commissioned the service.
Updated
29 April 2015
The inspection visit took place on the 9 March 2015 and was unannounced which meant the staff and provider did not know we were visiting.
Stockton Lodge Care Home is registered to provide nursing and personal care for up to 48 people. It caters for people with general nursing and residential care needs and is situated in the Stockton area.
We last inspected the service on 5 January 2014 and found the service was compliant with regulations at that time.
There was not a registered manager in post. They had recently left the service two weeks ago and the service was currently being managed by an experienced regional 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.
There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The acting manager had the appropriate knowledge to know when an application should be made and how to submit one. The manager also ensured that capacity assessments were completed and ‘best interest’ decisions were made in line with the MCA code of practice. This meant people were safeguarded.
We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
Most people told us they felt safe at the service, although one person and one relative raised some concerns around staffing and care by agency staff and this was discussed with the acting manager at the time of the visit. Staff told us they felt there wasn’t always enough staff on duty and people who used the service told us they sometimes had to wait for staff. We also noticed that call bells were ringing for extended periods during our visit which indicated that there were not enough staff on duty to meet the needs of people living at the service. The staff team were supportive of the acting manager and each other.
Appropriate systems were in place for the management of medicines so that people received their medicines safely.
Medicines were stored in a safe manner. We witnessed staff administering medication in a safe and correct way. Staff ensured people were given time to take their medicines at their own pace.
There was a regular programme of staff supervision in place and records of these were detailed and showed the service worked with staff to identify their personal and professional development. We spoke with kitchen staff who had a good awareness of people’s dietary needs and staff also knew people’s food preferences well. One person told us that they had raised an issue regarding the food, it was dealt with immediately and they were very satisfied with the outcome.
We saw people’s care plans were personalised and had been well assessed. Staff told us they referred to care plans regularly and they showed regular review that involved, when they were able, the person. We saw people being given choices and encouraged to take part in all aspects of day to day life at the service. We witnessed staff using a communication book with one person who had difficulties in verbalising. A visiting occupational therapist was highly impressed that the service had used their initiative to source this aid and implement it themselves.
The service encouraged people to maintain their independence and the activities co-ordinator ran a full programme of events which included accessing the community with people.
The service undertook regular questionnaires not only with people who lived at the home and their family but also with visiting professionals and staff members. We also saw a regular programme of staff and resident meetings where issues where shared and raised. The service had an accessible complaints procedure and people told us they knew how to raise a complaint if they needed to. This showed the service listened to the views of people.
Any accidents and incidents were monitored by the interim manager to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks.
The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Stockton Lodge.