Eighton Lodge Residential Care Home

Updated 8 September 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 an inspector, an inspection manager and two Experts 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

Eighton 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. Eighton 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 not a registered manager in post. Following the inspection, the provider has placed a peripatetic manager in post and they are in the process of registering with the CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 also reviewed the information we held about the service. This included any statutory notifications received. Statutory notifications are specific pieces of information about events, which the provider is required to send to us by law.

We sought feedback from the local authority contracts monitoring and safeguarding adults' teams and reviewed the information they provided. We used all of this information to plan our inspection.

During the inspection

We reviewed documentation, inspected the safety of the premises and carried out observations in communal areas.

We spoke with four people who used the service, 21 relatives, and four members of staff including the manager, regional manager, two deputy managers, two team leaders and four care staff. We received written feedback from three care staff after our site visit. We reviewed the care records for six people, medicine records for 16 people and the recruitment records for three members of staff.

We looked at a range of records. This included staffing rotas, training records, meeting minutes, policies and procedures, environmental safety and information relating to the governance of the service.

Updated 8 September 2022

About the service

Eighton Lodge is a residential care home providing personal care to up to 47 people. The service provides support to people aged 65 and over, some of whom are living with a dementia. At the time of our inspection there were 43 people using the service.

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

People’s medicines were not managed safely. Records did not provide assurances that people were getting their medicines as prescribed or when required. The manager had not completed the medicine audits for a month and issues with medicine records had not been identified during this time. Incidents relating to medicines management had not always been recorded correctly or investigated.

Quality and assurance records in place were not fully completed or were ineffective. We found that from May 2022 onwards there was no effective oversight by the manager. We made a recommendation at our last inspection that records relating to the administration of people’s creams and patches should be accurate and complete. At this inspection we found that the provider had not made improvements to record keeping.

People’s care records showed that staff had completed detailed assessments of people’s needs but care plans created from these did not include of all the information required for staff to effectively support them. We were assured that staff were meeting people’s needs and care records required reviewing to include all of the support staff provided.

Staff were not always following best practice guidance relating to infection prevention and control. People’s personal care items were accessible, for example creams, shower gels and items used for bathing were left in corridors and bathrooms.

We have made a recommendation relating to best practice guidance for infection prevention and control .

Staff followed government guidance relating to COVID-19, wore appropriate PPE and ensured all professional visitors provided a negative lateral flow test before entering the home.

People and their relatives were complementary about the support provided by staff. Relatives told us that staff had supported people throughout the pandemic and kept them safe. During the inspection we observed many positive interactions between staff and people.

Care plans did not always contain all of the information required to meet people’s needs. Staff told us what support people required and acknowledged that this information was missing from some care records. People and relatives were involved in their care planning and staff knew people’s preferences and choices for their care.

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 had received on-going training from the provider and had regular supervision sessions. There were enough staff on duty to meet people’s needs and staffing levels were reviewed at regular intervals. Permanent staff were recruited safely but we found records did not show if agency staff had received the provider’s full induction.

People were complementary about the food provided and staff supported some people to maintain a balanced diet. Staff worked in partnership with other healthcare professionals to meet people’s needs a timely way.

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 good (published 02 March 2022). At our last inspection we recommended that the provider ensured that accurate and complete records were kept regarding medicines administered in the form of a patch or cream. At this inspection we found that the provider had not acted on this recommendation and records continued to not be accurate or fully completed.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to medicines management and person-centred care. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. Following the inspection the provider has taken action to address the issues identified and is working in partnership with the CQC, North East and North Cumbria Integrated Care Board (ICB) and the Local Authority.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Eighton Lodge on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 medicines management, the quality and assurance systems in place and record keeping at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.