Kellan Lodge

Updated 12 February 2021

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.

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 one inspector.

Service and service type

Kellan Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. 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. The service also had a manager in post who was responsible for the day to day management of the providers locations including Kellan Lodge.

Notice of inspection

This inspection was announced. We gave a short period notice of the inspection as we were mindful of the impact and added pressures of COVID-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.

What we did before the inspection

Prior to the inspection, we reviewed the information that we held about the service and the provider, information we gathered at the inspection of one of the providers other locations and notifications affecting the safety and well-being of people who used the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We also used all of this information to plan our inspection.

During the inspection we spoke with three people using the service and two relatives to obtain their feedback on the care and support that they or their relative received. Only two people we spoke with were able to communicate and respond to the questions we asked. The other person responded through facial expressions. We also observed interactions between people and care staff. We spoke with the registered manager, one manager and four care staff.

We looked at three people’s care and medicines administration and supply records. We also looked at the personnel and training files of five staff. Other documents that we looked at relating to people's care included risk assessments, staff meeting minutes, handover notes, quality audits and policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records

Updated 12 February 2021

About the service

Kellan Lodge is a residential care home providing accommodation and personal care for people with learning and physical disabilities. Kellan Lodge accommodates up to four people in one adapted building. At the time of the inspection there was three people living at the service.

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

Throughout the inspection we observed that people were supported by staff who were caring and respectful in their approach. People knew staff well and interacted with them with confidence. However, we found concerns around how the home was managed, documentation relating to care, infection control and prevention and ensuring people were not placed at risk of harm.

Risks to people were not always comprehensively assessed. Guidance and direction to staff on how to minimise risks was not always clear and detailed. This was addressed immediately following the inspection.

The registered manager had not given any consideration to or implemented any additional policies or procedures to support infection control. A number of staff had not received any recent infection control training, which was of concern, considering the current COVID-19 pandemic.

Safe staff recruitment processes were in place to ensure suitable staff recruitment. However, certain checks were not robustly completed to ensure staff were appropriately assessed as safe to work with vulnerable adults.

Staff had not received any specialist training in response to people’s specific health and care needs.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to in part demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. However, there were some areas where the service was not meeting all elements of best practice. People were not always supported to live full and stimulating lives. Activities provision was not always individualised to people’s likes, hobbies and interests and did not always promote choice, control and independence.

Management oversight of the service was ineffective and did not identify the issues we identified as part of this inspection. Learning and development was not promoted throughout the service so that people’s experience of care could be improved.

We have made recommendations about completing comprehensive risk assessments and the management of infection prevention and control.

Staff understood safeguarding and how to keep people safe from abuse. Staff told us that they received training and supervision to support them in their role.

People received their medicines safely and as prescribed.

People were supported with maintaining a healthy and balanced diet. People were able to choose and prepare what they wanted to eat.

Relatives feedback about the registered manager and care delivery was positive stating that people’s needs were appropriately met. Relatives knew who to speak with if they had any concerns and were assured that these would be dealt with promptly.

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 14 February 2018).

Why we inspected

During the inspection of another of the provider’s locations registered we identified concerns relating to medicines management and infection prevention and control. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key question. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have identified three breaches of regulation around person centred care, staffing and good governance. The failings found are detailed in the main body of the report. Please see the safe, effective, responsive 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.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.