14 December 2023
During an inspection looking at part of the service
Bowland Lodge is a residential care home providing accommodation for up to 36 people who require personal care. The service provides support to people living with mental health conditions and dementia. At the time of our inspection there were 23 people using the service.
People’s experience of using this service and what we found
A system to ensure regulatory requirements were met was not in place. We identified shortfalls in areas of the service including the assessment of risk, safeguarding procedures, management of medicines, infection control, and the governance of the service.
We identified shortfalls with the assessment of risk. This included environmental risks and risks relating to the care and support of people. Some action had been taken to improve care planning since our last inspection. However, further improvements were required to ensure care plans and risk assessments reflected people's needs. No analysis of accidents and incidents had been carried out. This meant staff were unable to identify any trends or themes to help reduce the risk of any recurrence.
Medicines were not managed safely. Action had not always been taken to ensure incidents of a safeguarding nature were always reported to the correct authorities. Some people raised concerns with us regarding the attitude of some staff. The home was subject to ‘organisational safeguarding’ procedures. This meant the local authority were monitoring the whole home. Following our inspection, we made several safeguarding referrals to the local authority to ensure information we identified during our inspection was reported to them.
Some improvements had been made to improve the cleanliness of the environment. However, ongoing shortfalls were identified regarding the maintenance of the premises, including the outdoor space. A schedule of on-going maintenance for the service was not available.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was inadequate (published 3 November 2023). At this inspection we found the provider remained in breach of regulations. The was the 8th consecutive inspection where the provider has been in breach of regulations since October 2015.
Why we inspected
We undertook this targeted inspection to check on specific concerns we had about infection control, medicines management, safeguarding, the assessment of risk and the overall governance of the service. A decision was made for us to inspect and examine those risks. The overall rating for the service has not changed following this targeted inspection and remains inadequate.
We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding, premises and equipment 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
The overall rating for this service is ‘Inadequate’ and the service remains 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.