Butterfly Lodge

Updated 29 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection team consisted of one inspector, a specialist advisor (SPA) in older people’s nursing care, and an expert by experience. An expert by experience is a person who has personal experience of using services or cares for someone who lives with dementia.

Service and service type: Butterfly Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 is registered to provide support to 38 people. At the time of the inspection there were 32 people living at the service.

The service had a new manager who was in the process of registering 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: This inspection was unannounced.

What we did: We looked at notifications they had made to us about important events. In addition, we reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

During the inspection we contacted and spoke with:

• 11 people and/or their relatives

• 11 members of staff

• The manager

• 1 of the directors for the service

• The operations manager

• 1 advocate for people using the service

• Plymouth City Council’s commissioning team

• Healthwatch Plymouth

We used our Short Observation Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the view of people who are not able to talk to us.

We looked at:

• Policy and procedures

• Four people's care records

• Records of complaints

• Training records for all staff

• Three personnel records

• Equipment and building servicing records

• Fire records

• Medicine administration records (MARs)

• Auditing and monitoring checks

Updated 29 June 2019

About the service: Butterfly Lodge provides care and support to older people who have a diagnosis of dementia and/or mental health. The service is registered for 38 people.

People’s experience of using this service:

Since our last inspection the service had a new manager in post. People, relatives and staff were complimentary of them and of the changes that had occurred since her appointment, including the culture. A new operations manager had been employed to ensure effective ongoing assessment and quality of the service. A ‘global’ audit was being used by the operations manager to keep on top of regulatory compliance within the service.

There was a new compliment of experienced nursing staff due to commence employment.

People told us they felt safe and received kind and respectful care. Staff were recruited safely and improved understanding of safeguarding procedures following the previous inspection.

People lived in an environment which had been assessed for its safety. People lived in a clean and odour free environment.

People now received their medicines safely and the management of risks associated with people’s care had improved. The accuracy of people’s documentation had improved, but the manager recognised their own limitations in completing this task and spoke of the positive impact that additional nursing staff would have.

People were supported by staff who had received training to meet their needs, and had their human rights respected. The provider was considering how to apply the Accessible Information Standard (AIS) design and delivery in the service.

People felt confident to complain, and complaints were seen positively and used to improve the service.

We recommend dignity and respect training considers the care of those who choose to spend time in their own rooms and about people’s personal care. In addition we recommend the provider considers the Accessible Information Standard (AIS) in respect of the production of polices and procedures and that the provider continues to strengthen their governance framework.

More information is in Detailed Findings below.

Rating at last inspection: Requires improvement (Report published 24 November 2018).

Why we inspected: This was a planned inspection.

Follow up: We will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk