Archived: Coniston Lodge Care Centre

Updated 27 October 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook a focussed inspection in response to concerns received regarding the number of safeguarding issues raised by the service and by the local authority. We inspected against four of the five questions we ask about services: is the service safe, is the service effective, is the service caring and is the service responsive? The inspection was carried out on 21, 24 and 25 September 2015 and the first two days were unannounced.

The inspection team consisted of four inspectors, one of whom was a pharmacist inspector. Medicines management was inspected on 21 September 2015 and the other areas inspected were covered on 24 and 25 September 2015.

Before the inspection we reviewed the information we held about the service including information received from the local authority and notifications. Notifications are for certain changes, events and incidents affecting the service or the people who use it that providers are required to notify us about.

During the inspection we viewed a variety of records including ten people’s care records, some in detail and some looking at specific areas such as risk assessments or wound care, three staff files, medicine records for 32 people, 16 incident/accident reports, auditing and monitoring reports. We observed interaction between people using the service and staff throughout the inspection.

We spoke with 11 people using the service, 13 relatives, the registered manager, the deputy manager, the relief manager, the regional director, the training manager, the quality support lead, seven registered nurses, nine care staff, the chef and two domestic staff.

Updated 27 October 2015

The inspection was carried out on 21, 24 and 25 September 2015 and the first two days were unannounced. We undertook a focussed inspection in response to concerns received regarding the number of safeguarding issues raised by the service and by the local authority. We inspected against four of the five questions we ask about services: is the service safe, is the service effective, is the service caring and is the service responsive?

At the last inspection on 13, 14 and 15 January 2015 we asked the provider to take action to make improvements with areas of safeguarding training and care and welfare. We received an action plan from the provider telling us they would meet the relevant legal requirements by 30 September 2015 which had not been reached at the time of inspection.

Coniston Lodge is a nursing home providing care for a maximum of 92 people. The service has four units, three of which are for general nursing care and one for people with dementia care needs. At the time of the inspection there were 75 people using the service.

The service is required to have a registered manager in post, and the registered manager has been managing the service since June 2015 and registered with CQC on 3 September 2015. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to individuals were being identified, however staff did not always follow the care instructions to minimise risks to people. Accidents and incidents were not being effectively monitored and managed leading to people not being adequately protected from the risk of further injuries.

Staff vacancies were being covered with agency staff, however the numbers of staff deployed did not always meet people’s complex needs.

Shortfalls were identified in medicines recording and management, which could put people at risk of not receiving their medicines as needed.

We found the service was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted. Applications had not always been made to the local authority where people were being deprived of their liberty.

Care records did not always confirm that people were receiving the care and treatment their care records identified they needed.

People and relatives were confident to make complaints, however we found these were not always being recorded and responded to.

Staff understood safeguarding and whistleblowing procedures and knew which outside agencies they could report concerns to.

Staff were caring and understood people’s individual needs and how to meet these. People’s choices were respected and staff treated them in a gentle and dignified way.