About the service Bannatyne Lodge is a residential care home providing personal and nursing care to 38 people aged 55 and over at the time of the inspection. The service can support up to 50 people.
The service accommodates people in one purpose built building. There are two floors and people can access the first floor by use of a lift or stairs.
People’s experience of using this service and what we found
The recording and administration of medicines was not managed appropriately in the service. People did not always receive their medicines as prescribed by their GP.
The assessment and monitoring of risk for people was ineffective. Risk assessments had not been reviewed following accidents and falls. The quality of the record keeping varied and some care records we looked at did not have the right information in them to manage people’s care safely. Fire safety evacuation training was not up to date.
Notifications of serious injury had not always been sent to the Care Quality Commission (CQC) as required by regulation.
Systems and processes to assess and monitor quality were in place and had picked up some of the issues we found during the inspection. However, the monitoring and oversight of improvement actions had not been taken in some cases. This meant aspects of quality and safety within the service were ineffective.
People were put at risk as the provider and registered manager did not have formal supervision or performance management plans in place for monitoring the practice of staff where they had identified this was necessary.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did not always support this practice. We have made a recommendation in the report about this.
People felt able to raise complaints with the service and the registered manager did look into these. However, there was no evidence that the provider had information available for people, in formats they could understand, in line with the Accessible Information Standard.
The standards of hygiene within the service were usually good. However, odours were apparent in some areas of the service.
People told us they felt safe and well supported. The provider followed robust recruitment checks, and sufficient staff were employed to ensure people’s needs were met. Staff received induction and training to ensure they could carry out their roles effectively, and they received support through supervision and appraisals.
People ate nutritious, well cooked food, and said they enjoyed their meals. Their health needs were identified, and staff worked with other professionals, to ensure these needs were met.
People participated in a wide range of activities within the service and in the community, they also enjoyed the company of others in the service.
People were able to see their families as they wanted. There were no restrictions on when people could visit the service. People were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The rating for this service in June 2018 was requires improvement (published 9 August 2018) and there were two breaches of regulation. There was also an inspection on 7 August 2019 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
The provider completed an action plan after the inspection in 2018, to show what they would do and by when to improve. At this inspection, enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement.
Why we inspected
This is a planned re-inspection because of the issue highlighted above.
Enforcement
We have identified breaches in relation to medicines, staffing, risk management, record keeping and quality assurance.
Please see the action we have told the provider to take at the end of this report.
Since the inspection in August 2019 we recognised that the provider had failed to notify the Commission about serious injuries. This is a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.
Follow up
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.