We undertook an unannounced inspection of Coniston Lodge Nursing Home on 10, 11 and 12 January 2017. Coniston Lodge Nursing Home is a nursing home and is part of Lifestyle Care Management Ltd. It provides accommodation for up to 92 older people in single rooms. The service has four units but at the time of our inspection only three were in use. The home is situated within a residential area of the London Borough of Hounslow. At the time of our visit there were 55 people using the service.
At the time of the inspection the manager had been in post since October 2016. The new manager was about to start the registration process with the Care Quality Commission. A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.
At our last comprehensive inspection on the 23, 24 and 26 February 2016 we found breaches in relation to good governance in respect of information provided on 'do not attempt resuscitation' (DNAR) forms, maintenance records and equipment levels. During the inspection on 10, 11 and 12 January 2017 we found improvements had made in relation to these areas.
Risk assessments did not provide up to date information in relation to individual’s risks when receiving care.
Some people using the service did not receive appropriate support when eating and food was often cold due to delays in serving and providing support.
Care was often task led which meant staff did not always provide appropriate support for people’s emotional and social needs as they were focused on tasks.
Activities were organised at the home but some of these were not meaningful for people and when the activities coordinator was unavailable there were limited activities organised.
Care plans were not written in a way that identified each person’s wishes as to how they wanted their care provided. Daily records were focused on the tasks completed and not the person receiving the support.
The records relating to care of people using the service did not provide an accurate and complete picture of their support needs.
A range of audits were in place but some of these had not provided appropriate levels of information to identify aspects of the service requiring improvement and action had not always been taken to address issues.
People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.
The provider had processes in place for the recording and investigation of incidents and accidents. Each person using the service had an evacuation plan in place in case of an emergency.
The provider had an effective recruitment process in place. There was a policy and procedure in place for the administration of medicines and these were administered in a safe way.
The provider had policies, procedures and training in relation to the Mental Capacity Act 2005.
Care workers and nurses had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers and nurses had regular supervision with their manager and received an annual appraisal.
The care plans identified the cultural and religious needs of people using the service. The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.
We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.