Background to this inspection
Updated
3 August 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and three Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Lakeview 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The first day of inspection on 17 June 2021 was unannounced and conducted out of hours. The second day on 18 June 2021 was announced and involved making telephone calls to relatives.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
We spoke with fifteen people who used the service and three relatives about their experience of the care provided. We spoke with 15 members of staff, which included day and night, care workers and senior care workers, deputy manager, administration assistant, hostess and activity staff, the registered manager, the regional manager and the area manager.
We reviewed a range of records, which included six people’s care records and several medication records. Two staff recruitment files, staff training and supervision records, staff timesheets and staff rotas, and a variety of other records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
After the site visit, we carried out telephone interviews with three relatives and reviewed further information received from the provider towards the inspection.
Updated
3 August 2021
Lakeview Lodge Care Home is a residential care home providing personal and nursing care for up to 66 people aged 65 and over. At the time of the inspection the service was providing care for 62 people, including people living with dementia.
The service is purpose built and has accommodation over three floors. Facilities within the service include a spa area, a cinema room, a fine dining room and a bistro café and shop.
People’s experience of using this service and what we found
Since the last inspection the provider had improved the systems to monitor accidents and incidents and the incidents of falls had significantly reduced. People’s care plans had been improved to include more information about how they preferred to take their medicines. This demonstrated a commitment to lessons learnt, to continuously improve the care of people living at the service.
Most of the people living at the service, relatives and staff spoken during the inspection confirmed staffing levels were good and staff were available when needed. Whilst some people that required the support of two staff for moving and handling and personal care told us sometimes, they had to wait longer periods for two staff to be available.
The provider used a dependency tool to calculate the number of care staff hours needed to meet the dependency levels of people using the service. Records showed that staffing hours and dependency levels were regularly reviewed and updated by the registered manager and senior management team.
The registered manager confirmed they and the human resources department were now closely monitoring staff sickness and absence management systems were being followed. Staff rota’s and timesheets evidenced that enough numbers of staff were available to meet people’s needs. On the day of the inspection staff were observed to spend time with people and work unrushed.
Robust staff recruitment procedures were followed. At the time of the inspection the provider was actively recruiting more staff for the service. Some new staff had been recruited and were undertaking induction training.
People using the service told us the staff administered their medicines safely. Medicines were stored securely and administered to people as prescribed. Staff were trained in the safe administration of medicines and their competency was assessed before they administered medicines to people.
The environment was clean, and people were protected from the spread of infection including COVID -19. Staff used personal protective equipment such as gloves and aprons, which were readily available. Staff undertook routine COVID -19 testing and government guidance regarding isolation was followed in response to any positive results. Upon arrival at the service visitors were asked to undertake a rapid flow COVID-19 test and provided with personal protective equipment (PPE) before entering the service.
The registered manager acted in line with the duty of candour requirements. People confirmed they felt supported to raise any concerns or complaints. CQC had been kept informed of notifiable events that had happened at the service. A notification is information about important events, which the provider is required to send us by law in a timely way. The ratings from the last comprehensive inspection were displayed in the front entrance of the service and on the provider website.
Records showed that rigorous management quality assurance processes were followed. Audits were carried out on all aspects of the service to identify areas for further development, and action plans were completed in a timely way.
Feedback on people’s experiences and the quality of the service was sought. Quality assurance surveys had been sent out to people using the service, relatives, staff and healthcare professionals. At the time of the inspection the provider was waiting on the results to complete their six-monthly quality evaluation.
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 (report published 29 October 2020).
Why we inspected
The inspection was prompted in part due to anonymous whistle-blower concerns received about staffing levels. The registered manager had responded promptly to all the concerns raised and fully co-operated with CQC and the local safeguarding authority in providing information and in carry out safeguarding investigations. A decision was made for us to inspect and examine those risks and we found no evidence that people were at risk of harm from the concerns. Please see the Safe and Well-Led sections of this report.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lakeview Lodge Care Home on our website at www.cqc.org.uk
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.