Totham Lodge Home for the Elderly

Updated 28 November 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 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 the 10 October 2018 and was unannounced. This was the service's first inspection under its new registration.

The inspection team consisted of two 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. Our expert had personal experience of caring for someone who lived with dementia.

Prior to our inspection, we reviewed the information we held about the service. This included safeguarding information, information from members of the public and notifications. Notifications are the events happening in the service that the provider is required in law to tell us about. We used this information to plan what areas we were going to focus on.

During the inspection, we observed the interaction between staff and people who used the service especially those who could not tell us their experiences verbally. We spoke with six people and five visiting relatives and friends. We spoke with nine care, housekeeping and maintenance staff, the activities coordinator, registered manager (who was one of the providers), care manager and the other provider. A visiting GP gave us their views during the visit with a further two health care professionals providing information about the service by telephone and email.

We looked at a range of records relating to people's care and support. This included four people's care plans, four staff personnel files, training and supervision records, policies and procedures and information on how the safety and quality of the service was being monitored and managed.

Updated 28 November 2018

This comprehensive unannounced inspection was carried out on 10 October 2018. This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in September 2017 when it changed ownership.

The service is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

Totham Lodge Home for the Elderly is registered to support 28 older people, some of whom may be living with dementia. On the date of our inspection, 26 people were being supported by the service.

People and their relatives told us the service was a safe place to live. Risks to people were appropriately assessed, managed and reviewed. Staff had received training on safeguarding adults from abuse and understood their responsibilities to prevent people from experiencing harm.

Staff were recruited appropriately. Full checks had been undertaken so that people were kept safe. There were sufficient numbers of staff deployed to meet the needs of people who used the service. Medicines were managed safely and people received them as prescribed. Infection control processes were in place to minimise the risks and spread of infection.

Staff were well supported at the service and received induction, training and supervision to carry out their role. People had sufficient food and drink and were provided with choices at meal times. People had access to healthcare services to maintain their health and well-being. People’s capacity to make their own choices and decisions were assessed and reviewed and they or their representatives were involved in decisions about their lives.

The house was a Grade II listed building which had been extended and adapted to meet people's needs. However, parts of the building, bedrooms and furniture were in need of refurbishment and repair. This was being addressed by the provider.

The staff were caring, kind and considerate. They knew people well and were sensitive to their needs. People’s independence was promoted and encouraged by the staff and they were treated with dignity and courtesy. Staff ensured people’s privacy and dignity was maintained and respected.

People received a service which responded effectively to their needs. Care plans were person centred and reviewed regularly to ensure they reflected people’s current care needs, wishes and preferences. People were involved in having a voice about the service they received and feedback from them and their relatives about the service was positive. People had opportunities to participate in one to one and group activities if they wished. Information on how to raise concerns or complaints was available and people and their relatives were confident that any concerns would be listened to and acted upon.

There was a well respected management team who were visible in the service and well respected by the staff. There were systems in place to regularly assess and monitor the quality of the service. Audits of the service were undertaken and analysed to ensure the service was operating safely. The service was delivering quality care to people who used the service.

Further information is in the detailed findings below.