Archived: Lindhurst Lodge Residential Home

Updated 14 September 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 comprised two inspectors and an assistant inspector.

Service and service type

Lindhurst Lodge Residential Home 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. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A new manager had recently started at the home and had applied to become the registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with nine members of staff including the new manager, the supporting manager, senior care workers, care workers, domestic staff, maintenance staff and the cook. We also spoke with a visiting professional. We reviewed a range of records. This included three people’s care records in full and multiple medicines records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 September 2019

About the service

Lindhurst Lodge Residential Home is a residential care home providing personal care to 28 people at the time of the inspection. The service can support up to 37 people. The care home is purpose built with bedrooms on the ground and first floors.

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

People told us they felt safe and liked living at the home. Relatives confirmed they thought their loved ones were safe. Systems were in place to record safeguarding incidents and staff were aware of safeguarding procedures and had confidence in the new manager. Risks to people were assessed and positive risk taking was encouraged, which supported people’s independence. However, risk assessments were not always individualised. People’s needs were reviewed, and this information was used to inform staffing levels. However, feedback from people and staff, and our observations suggested staffing levels would benefit from review.

We made a recommendation about this.

Medicines management processes were in place and staff were trained and had their competencies checked. Information to support people to receive ‘as and when’ medicines, when they were unable to say whether they were in pain, were not documented. Records did not identify where people’s prescribed creams should be administered, however staff were knowledgeable about this. Staff were diligent about identifying where additional information was needed from GPs to ensure medicines were administered safely.

Not all staff had been recruited in a robust and safe manner. Infection control procedures were in place. The service analysed information from checks and audits and used this to improve and learn and shared this information with staff.

People’s needs and choices about their care and support were assessed in line with legislation. Not all new staff had received appropriate training. People told us they liked the food. People were encouraged to eat and drink, a good variety of snacks, including fresh fruit was offered. People were supported to eat where they needed this.

Care notes were detailed and a handover between staff took place each day. Staff confirmed they found out about changes to people’s needs, however care plans were not updated thoroughly. Professionals we spoke with told us staff were responsive to their requests. Care plans showed health professionals were involved in people’s care when they needed to be. People had recently been asked about their preferences for activities and food choices.

Consent to care and support was sought and recorded. People were 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; the policies and systems in the service supported this practice.

Staff interactions were kind and caring, with good use of eye contact and appropriate touch. People told us staff respected their privacy and dignity. People and relatives were generally involved in their care and support plans, however recording of this could be improved.

We made a recommendation about this.

People’s care plans were detailed about the level of care they needed, however in some instances this had not been updated. Activities were very limited. Concerns and complaints were recorded and responded to appropriately. Action plans and lessons learnt were considered and implemented where appropriate as a result of any findings from these. People were supported during their end of life care however more detail was required in care plans to consider and support people’s wishes.

The new manager was clear about their challenges and plans to make improvements to the home. There was a plan of regular audits, these had not taken place for a period of time, but these had recently recommenced. People and staff spoke positively about the new manager, the supporting manager and registered provider. Regular satisfaction surveys took place, these were analysed and used to consider improvements to the home. The provider had explored options of working in partnership with other agencies and community groups.

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 requires improvement (published 14 August 2018) and there were multiple breaches of regulation. The provider had completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations. This service has been rated requires improvement for the last three consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe administration of medicines and provider oversight of the service 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.