Archived: Pennine Lodge

Updated 22 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by five 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.

Service and service type

Pennine Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Pennine Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 28 April 2022 and ended on 31 May 2022. On 28 April 2022 two inspectors visited the service and on 5 and 31 May 2022 three inspectors visited.

What we did before the inspection

We reviewed information we had received about the service since the provider registered with CQC. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time with people in the communal areas observing the care and support provided by staff. We spoke with three people who used the service and eight relatives about their experience of the care provided. We spoke with the registered manager, a senior manager and eight members of staff including team leaders, care workers and the cook. We also spoke with a visiting healthcare professional.

We reviewed a range of records. This included 13 people's care records and 16 people's medicine records. We looked at two staff recruitment files. A variety of records relating to the management of the service were reviewed.

Updated 22 July 2022

About the service

Pennine Lodge is a residential care home providing personal care to up to 38 older people some of whom are living with dementia. At the time of our inspection there were 38 people using the service. The service has three units, each of which has separate adapted facilities.

People’s experience of using this service and what we found

People were not always safe. People were at risk of harm as the provider had not identified, assessed or mitigated risks. This included risks related to people's health and care needs as well as environmental risks. Medicines were not managed safely.

There were not always enough staff to meet people’s needs and keep them safe. Some staff had not received the training and support they needed for their roles.

People did not always receive person-centred care and care records did not fully reflect their needs. There were few activities taking place and there was little to occupy and interest people. People’s dignity was not always respected.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There was a lack of effective leadership and an ineffective governance structure which meant the service was not appropriately monitored at manager or provider level.

Recruitment processes ensured staff were suitable to work in the care service. Infection control procedures were followed by staff. The home was clean and well ventilated.

Staff knew people well and understood how to support people who were distressed or anxious. Staff were kind, caring and compassionate. People were provided with a variety and choice of food and drinks. People were supported to keep in touch with family and friends. People had access to healthcare services. Relatives were satisfied with the service provided.

The registered manager and provider took action in response to the inspection findings after the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 7 October 2019 and this is the first inspection. The last rating for the service under the previous provider was good, published on 8 December 2017.

Why we inspected

The inspection was prompted in part by notification of a specific incident. This incident is subject to investigation. As a result the inspection did not examine the circumstance of the incident.

The information CQC received about the incident indicated concerns about the management of risks to people, staffing levels and the use of sensor equipment. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

During this inspection we carried out a separate thematic probe, which asked questions of the provider, people and their relatives, about the quality of oral health care support and access to dentists, for people living in the care home. This was to follow up on the findings and recommendations from our national report on oral healthcare in care homes that was published in 2019 called ‘Smiling Matters’. We will publish a follow up report to the 2019 'Smiling Matters' report, with up to date findings and recommendations about oral health, in due course.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment, staffing, consent, person-centred care and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.