7 August 2019
During a routine inspection
Lindhurst Lodge Residential Home is a residential care home providing personal care to 28 people at the time of the inspection. The service can support up to 37 people. The care home is purpose built with bedrooms on the ground and first floors.
People’s experience of using this service and what we found
People told us they felt safe and liked living at the home. Relatives confirmed they thought their loved ones were safe. Systems were in place to record safeguarding incidents and staff were aware of safeguarding procedures and had confidence in the new manager. Risks to people were assessed and positive risk taking was encouraged, which supported people’s independence. However, risk assessments were not always individualised. People’s needs were reviewed, and this information was used to inform staffing levels. However, feedback from people and staff, and our observations suggested staffing levels would benefit from review.
We made a recommendation about this.
Medicines management processes were in place and staff were trained and had their competencies checked. Information to support people to receive ‘as and when’ medicines, when they were unable to say whether they were in pain, were not documented. Records did not identify where people’s prescribed creams should be administered, however staff were knowledgeable about this. Staff were diligent about identifying where additional information was needed from GPs to ensure medicines were administered safely.
Not all staff had been recruited in a robust and safe manner. Infection control procedures were in place. The service analysed information from checks and audits and used this to improve and learn and shared this information with staff.
People’s needs and choices about their care and support were assessed in line with legislation. Not all new staff had received appropriate training. People told us they liked the food. People were encouraged to eat and drink, a good variety of snacks, including fresh fruit was offered. People were supported to eat where they needed this.
Care notes were detailed and a handover between staff took place each day. Staff confirmed they found out about changes to people’s needs, however care plans were not updated thoroughly. Professionals we spoke with told us staff were responsive to their requests. Care plans showed health professionals were involved in people’s care when they needed to be. People had recently been asked about their preferences for activities and food choices.
Consent to care and support was sought and recorded. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff interactions were kind and caring, with good use of eye contact and appropriate touch. People told us staff respected their privacy and dignity. People and relatives were generally involved in their care and support plans, however recording of this could be improved.
We made a recommendation about this.
People’s care plans were detailed about the level of care they needed, however in some instances this had not been updated. Activities were very limited. Concerns and complaints were recorded and responded to appropriately. Action plans and lessons learnt were considered and implemented where appropriate as a result of any findings from these. People were supported during their end of life care however more detail was required in care plans to consider and support people’s wishes.
The new manager was clear about their challenges and plans to make improvements to the home. There was a plan of regular audits, these had not taken place for a period of time, but these had recently recommenced. People and staff spoke positively about the new manager, the supporting manager and registered provider. Regular satisfaction surveys took place, these were analysed and used to consider improvements to the home. The provider had explored options of working in partnership with other agencies and community groups.
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 last rating for this service was requires improvement (published 14 August 2018) and there were multiple breaches of regulation. The provider had completed an action plan after the last inspection 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. This service has been rated requires improvement for the last three consecutive inspections. We will describe what we will do about the repeat requires improvement in the follow up section below.
Why we inspected
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to safe administration of medicines and provider oversight of the service at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.