Background to this inspection
Updated
30 July 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
One inspector carried out the inspection.
Service and service type
Queens 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.
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.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received since the last inspection, including from the local authority.
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 communicated with four people who used the service and three relatives about their experience of the care provided. Some people were unable to talk with us and used different ways to communicate including gestures, vocalisations and body language. We also observed people and their interaction with staff and each other throughout the inspection visits.
We spoke with six staff including the nominated individual, deputy manager and care staff. We also spoke with two consultants who are supporting the service. We sent emails requesting feedback to eight staff, and received five responses.
We used the Short Observational Framework for Inspection (SOFI) and spent time observing people. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records and medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance audits, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We reviewed updates from the service on action taken in response to issues raised.
Updated
30 July 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Queens Lodge is a residential care home providing personal care to four people at the time of the inspection. The service can support up to four people.
People’s experience of using this service and what we found
Right Support
¿ Improvements began during the inspection to support people to spend more of their time doing things they enjoyed and spending time with people who were important to them.
¿ The process of regularly reviewing people's aspirations needed to be strengthened so people could work towards goals which were important to them.
¿ Some health needs were not consistently met, action was taken immediately to rectify this.
¿ Staff supported people to make decisions using their preferred communication styles and methods.
¿ Staff supported people with their medicines safely and in the way they preferred.
Right care
¿ Improvements were required to ensure people always received safe care and treatment. For example, in effective recording, monitoring and review of distressed behaviour and accidents/incidents. Staff assessed and knew the risks people might face.
¿ There were enough appropriately skilled staff to meet people’s needs and keep them safe. An action plan was in place to get all aspects of staff support up to date and maintained.
¿ People received kind and compassionate care. Staff protected and respected people’s privacy and dignity.
¿ Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.
Right culture
¿ Management oversight of the service had lapsed in recent months. This was identified prior to the inspection and action was underway to make improvements.
¿ Mealtime experiences were not enriching for people living in the service.
¿ Documentation to support mental capacity assessments and best interest decision making required improvement.
¿ People and those important to them were involved in planning and reviewing their care.
¿ The deputy manager and most of the care team had worked in the service for a long time, which supported people to receive consistent care from staff who knew them well.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right Support, Right Care, Right Culture.
The inspection was prompted in part due to concerns about management turnover, and food quality, as well as issues found at a nearby sister service.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.