Lindisfarne Birtley provides accommodation for up to 66 people who need support with their personal and health care. The home mainly provides support for older people many who are living with dementia. The home also provides support to some younger people with an acquired brain injury and/or mental health needs. The home is a large, purpose built property. Accommodation is arranged over three floors and there is a passenger lift to assist people to get to the upper and lower floor. The home has 66 single bedrooms all with an en suite facility. There were 62 people living at the home at the time of our inspection.
This was an unannounced inspection, carried out over two days on 30 October and 5 November 2014. 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.”
We last inspected Lindisfarne Birtley in June 2014. At that inspection we found the service was in breach of its legal requirement with regard to regulation 17 with regard to respecting and involving people. This was because people who lived with dementia were not provided with care that met their individual needs.
At this inspection we saw some improvements had been made, however we found further work was needed to improve the care and experiences of people who lived with dementia. We saw people who lived with dementia enjoyed a better dining experience although this could still be improved. We found people who lived with dementia were not encouraged to remain involved with their surroundings and to make choices.
We found there were not always enough staff on duty to provide individual care and support to people and to keep them safe as staffing levels were not maintained.
We saw when new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support. We found, however there were limited opportunities for staff to receive training to meet all of their care needs. For example, only the manager had an understanding and knowledge of The Deprivation of Liberty safeguards and best interest decision making when people lacked mental capacity.
We saw detailed care plans were not in place to help staff manage and provide consistent care to people who may display distressed behaviour. We saw some people records showed, there was a use of “ when required” medicines, to manage their behaviours.
We saw staff did not interact and talk with people when they had the opportunity. There was an emphasis on supervision and task centred care.
Staff did not always provide care that was responsive to people’s needs. Care records we looked at were not all up to date with evidence of regular evaluation and review to keep people safe and to ensure staff were aware of their current individual care and support needs.
We saw records were not in place for all people to make staff aware of the person’s individual preferences, likes and dislikes. This meant staff were not reminded the person was a unique individual with a history. Information was also not available for all people with regard to their end of life care wishes.
We spoke to the activities organiser, who had lots of ideas to help keep people stimulated. We saw they engaged well with people, however when they were not available, other staff did not provide activities for people to remain stimulated. Relatives we spoke with did say more activities and outings needed to be provided for people. They spoke of two outings that had taken place in the summer but said more stimulation was needed in the service. One person said; “The days can be very long.”
We found there was not an ethos from management to encourage staff to ensure people maintained some control in their lives. There was little evidence that people were helped to make choices and to be involved in every day decision making.
The audits used to assess the quality of the service provided were not effective as they had not identified the issues that we found during the inspection.
The necessary checks were carried out to ensure the building was safe and fit for purpose.
We found five breaches of the Health and Social Care Act 2008(Regulated Activities) Regulations 2010 in relation to staffing levels, respect and involvement, staff training, record keeping and monitoring the quality of service.
You can see what action we told the provider to take at the back of the full version of the report.