Archived: Conifer Lodge

Updated 24 August 2017

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 visited the service on 4 July 2017 and the inspection was unannounced. The inspection team consisted of one Adult Social Care Inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a document wherein the provider is required to give some key information about the service, what the service does well, the challenges it faces and any improvements they plan to make. This document had been completed and we used this information to inform our inspection.

We reviewed all the information we held about the service. We also examined notifications received by the CQC. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescales. We spoke with professionals in local authority commissioning teams, safeguarding teams and Healthwatch. Healthwatch are a consumer group who champion the rights of people using healthcare services.

During the inspection we spent time speaking to people who used the service and observing interactions between staff and people who used the service. We spoke with seven people who used the service and one relative. One person who used the service did not want to speak with us. We spoke with seven members of staff: the deputy manager, the area manager, the administrator, the nurse in charge, two care staff and the cook.

We looked at four people’s care plans, risk assessments, staff training and recruitment files, medicines information, a selection of the home’s policies and procedures, IT systems, meeting minutes and maintenance records.

Following the inspection day we spoke with four more relatives, one external healthcare professional and one person’s advocate.

Updated 24 August 2017

The inspection took place on 4 July 2017 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Conifer Lodge in April 2015, at which time the service was compliant with all regulatory standards and was rated Good. At this inspection the service remained Good.

Conifer Lodge is a single-story residential home in South Shields. It is registered to provide accommodation for up to 16 people who have personal care and nursing needs. There were 14 people living at Conifer Lodge at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager was on annual leave at the time of the inspection but there was a deputy manager in place.

People who used the service and their relatives told us staff helped keep them safe. Staff we spoke with had received safeguarding training and knew what to do should they have concerns about people's safety.

There were sufficient numbers of staff to meet people’s needs in a safe manner and to maintain the premises. The building was clean throughout and undergoing refurbishment in communal areas. Since our last inspection a new communal/training kitchen had been installed.

There were effective pre-employment checks of staff in place, including Disclosure and Barring Service checks, references and identity checks. Nursing staff had their Nursing and Midwifery Council (NMC) status checked regularly.

A treatment room had been refurbished and the storage, administration and disposal of medicines was safe and in line with guidance issued by the National Institute for Health and Clinical Excellence (NICE).

Risk assessments with person-centred information were in place to manage the risks people faced. These were reviewed regularly and staff demonstrated a good awareness of them.

There was regular liaison with external healthcare professionals to ensure people received the care they needed.

Staff were trained in a range of core areas such as safeguarding, health and safety, moving and handling, fire safety, nutrition and dignity. Training needs were well planned and managed.

Staff received regular supervision and appraisal support from managerial and senior staff, as well as regular team meetings.

Feedback regarding meals was generally positive and we saw people who required specialised diets had their needs met.

Group activities included games, arts and crafts, outings to museums and the theatre, day trips to the coast, as well as holidays. Weekly activities were planned in consultation with people who used the service and the registered manager had recently recruited an activities co-ordinator.

The registered manager was meeting the requirements of the Mental Capacity Act 2005 (MCA), including the Deprivation of Liberty Safeguards (DoLS). Staff we spoke with had a good understanding of the MCA and best interest decision making, when people were unable to make decisions themselves. 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 supported this practice.

The atmosphere at the home was relaxed and welcoming. People who used the service, relatives and external stakeholders told us staff were friendly, patient and compassionate.

Person-centred care plans were in place and people and their relatives were involved in the review of care plans.

The service maintained good community links, with people who used the service feeling a part of the wider community in which they lived.

Staff, people who used the service, relatives and external professionals were generally positive about the registered manager and staff at all levels. The culture was one in which people’s changing needs could be met and their preferences respected.

Quality assurance and auditing procedures were in place to ensure the registered manager and others identified where practice improvements could be made.