Archived: Chaplin Lodge

Updated 19 October 2019

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 Care Act 2014.

Inspection team

The inspection team consisted of two inspectors and an assistant inspector on both days of inspection. An Expert by Experience accompanied the inspectors on the first day of inspection. 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

Chaplin 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.

The service did not have a manager registered with the Care Quality Commission. The service was being managed by a regional manager. This means that they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with 10 people who used the service and six family members about their experience of the care provided. We spoke with seven members of staff, including care staff, the person responsible for facilitating social activities, the deputy manager and regional manager.

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

We reviewed a range of records. This included six people’s care records and multiple medication administration records. We looked at four staff files in relation to recruitment and staff supervision records. A variety of records relating to the management of the service and their quality assurance arrangements, including policies and procedures were reviewed.

Updated 19 October 2019

About the service

Chaplin Lodge is a residential care home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can support up to 66 people in one adapted building. People are accommodated within two units, Beeches and Parkview. The latter provides care and support, primarily for people living with dementia.

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

Not all risks to people’s safety and wellbeing were assessed, recorded or followed by staff. Improvements were still required to ensure people received their medication as they should. People told us they were safe. Suitable arrangements were in place to protect people from abuse and avoidable harm. Staff understood how to raise concerns and knew what to do to safeguard people. Enough numbers of staff were available to support people living at Chaplin Lodge and to meet their needs. Recruitment practices were robust to make sure the right staff were recruited. People were protected by the prevention and control of infection. Findings from this inspection showed some lessons were being learned and improvements made when things went wrong.

Suitable arrangements were now in place to ensure staff were appropriately trained and newly appointed staff received a robust induction. The dining experience for people using the service was good. People received enough food and drink to meet their needs. People were supported to access healthcare services and receive ongoing healthcare support. The service worked with other organisations to enable people to receive effective care and support. People were in general supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. At the time of inspection, the service was undergoing redecoration and refurbishment.

People and those acting on their behalf told us they were treated with care, kindness, respect and dignity. Staff had a good rapport and relationship with the people they supported, and observations demonstrated what people told us. However, on Parkview, interactions were more task orientated and not always person-centred.

Improvements were still required to ensure information recorded clearly detailed people’s care and support needs and was followed by staff. People were supported to participate in social activities, both ‘in house’ and within the local community. The service is not fully compliant with the Accessible Information Standard to ensure it meets people’s communication needs. People and those acting on their behalf were confident to raise issues and concerns and felt listened to, though not all complaints had been responded to in a timely manner. People’s Preferred Priorities of Care [PPC] had been discussed with them and their relatives. Referrals had been made to the end of life register to ensure people’s wishes were adhered to.

Governance arrangements were much improved, but progress was still required to make sure improvements made were sustained in the longer term.

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

The rating at last inspection was requires improvement (published March 2019). There were three breaches of regulation. These related to breaches of Regulation 12 [Safe care and treatment], 17 [Good governance] and 18 [Staffing].

Conditions were imposed on the registered provider’s registration. The registered provider was requested to complete and submit a monthly report to show what they would do and by when to improve the service and to demonstrate they had oversight of the service.

At this inspection we found improvements had been made and the provider was no longer in breach of two out of three regulations. The service still remains in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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 request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.