This inspection took place on 13 and 14 March 2018. The first day of the inspection was carried out by two adult social care inspectors and an expert by experience and was unannounced. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day was carried out by two adult social care inspectors and was announced. This was the first inspection since the service registered in March 2017. No concerns were identified during the registration process.
Stockmoor 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.
Stockmoor Lodge is registered to provide personal care and accommodation to up to 90 frail older people, or people living with Dementia. Accommodation is provided in a purpose built new building. The building is divided into six units for fifteen people. This meant people could still experience a homely approach to care and support enabling them to build relationships within their community.
At the time of the inspection there was a registered manager in place. 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.
People received care that was responsive to their needs and personalised to their wishes because regular staff knew their likes, dislikes and needs. However, there was a risk that staff who were new or did not work with the people on a regular basis would not have the information they required to be responsive to people’s needs. Staff records in care plans were recorded inconsistently. We saw care plans did not contain all the information required and that some of this information was later recorded in a risk assessment. This meant there was a potential for staff not to know which area to find the information. People were able to make choices about all aspects of their day to day lives.
An activities programme was displayed within the home and people were informed of the activities available to them. However as the home occupancy had grown faster than expected the activities staff were not able to ensure all people who choose not to go to group activities would have access to other choices as they concentrated mainly on the groups. Activities staff explained that they did try to ensure one to one activities were carried out but also relied on care staff to support people on their units.
People told us they felt safe living in the home. One person said, “Yes I feel very safe”, a relative told us, “[The person] is safe here I don’t have to worry when I go home I know they will be alright.”
There was sufficient staff to safely meet the needs of people living in the home. However there were times when personal care was being carried out requiring two staff that other people living in the home needed to wait. The registered manager said staff could be used from another unit if this occurred. There was an on-going recruitment programme and the registered manager explained how they had made arrangements with the agency they used to ensure they only had regular agency staff who knew the home and the care needs of the people living there.
There were systems and processes in place to minimise risks to people. These included a robust recruitment process and making sure staff knew how to recognise and report abuse. All staff spoken with were confident action would be taken by the registered manager and provider to address any issues they may raise. They also knew they could go to external organisations to raise any concerns.
Medicines were managed safely, securely stored, correctly recorded and only administered by on duty nurses and team leaders that were trained and assessed as competent to give medicines.
To ensure the environment for people was kept safe specialist contractors were commissioned to carry out health and safety checks within the home.
Risks to people in emergency situations were reduced because, a fire risk assessment was in place which was reviewed annually. Personal emergency evacuation plans (PEEP’s) had been prepared: these detailed what room the person lived in and the support the person would require in the event of a fire.
People received effective care from staff who understood their needs. Staff were able to tell us about people’s specific likes and dislikes. People told us they thought staff were well trained and understood them well. The registered manager and staff were very pro-active in arranging for people to see health care professionals according to their individual needs.
People told us staff supported them to remain as independent as possible and only acted after they had sought consent. One person told us, “It is all about me, if I say it is ok then they can go ahead.”
People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. We saw that food and mealtimes were discussed and recorded at resident meetings.
All staff attended induction training before they started to work in the home. All staff said they had plenty of opportunities for training and the organisation also promoted dementia awareness training for all their staff.
People said they received care and support from caring and kind staff. Comments included, “The staff are very caring.” And “They are all very nice and respectful.”
People told us they could talk with staff and the registered manager if they wished to raise a concern. One person said, “The manager is about every day I can talk to them if I need to”. A relative said the manager’s door was always open and they could pop in for a chat if necessary.
People were supported at the end of their life to have a comfortable pain free death. Care plans showed people’s advance decisions were taken into consideration and acted upon.
There were formal and informal quality assurance systems in place to monitor care and plan on-going improvements. There were audits and checks in place to monitor safety and quality of care.
The registered manager had a clear understanding of the management of the home and how to lead staff by example. They had high standards that they aspired to and progress in developing the new home could be seen. They and the provider were committed to continuously improving the service. This was apparent when they spoke about future plans for the service in the local community.