Harbledown Lodge

Updated 28 April 2023

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 completed by an inspector.

Service and service type

Harbledown 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. Harbledown Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was 2 registered managers in post.

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 who work with the service. 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 spoke with 7 people and 2 relatives about their experience of living at the service. We observed staff interactions with people in the communal areas. We spoke with 6 members of staff including the registered managers, the nominated individual, deputy manager, and carers. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 4 people’s care plans and all the medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including checks and audits were reviewed.

Updated 28 April 2023

About the service

Harbledown Lodge is a residential care home providing personal and nursing care to up to 56 people. The service provides support to older people who may be living with dementia in a large, adapted building. At the time of our inspection there were 40 people using the service.

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

People told us they felt safe living at the service. However, potential risks to people’s health and safety had not always been assessed. There was guidance for staff to mitigate risks, but this was not always consistent. Staff had not maintained accurate records about people’s care and support. There was a risk people had not received the care required to maintain their safety.

Medicines had not always been managed safely. People had not always been protected from the risk of infection; some areas of the service had not been maintained to reduce this risk. Checks and audits had been completed on the quality of the service, but these had not identified the shortfalls found at this inspection.

Staff were recruited safely and there were enough staff to support people and meet their needs. People and staff had been asked their opinion of the service and suggestions they may have. There were effective systems in place to protect people from abuse and discrimination.

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.

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

Rating at last inspection

The last rating for this service was good (published 2 October 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe 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.

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 Harbledown Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to record keeping and governance 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.