Crofton Lodge

Updated 11 August 2023

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 Health and Social Care Act 2008.

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

This inspection was carried out by one inspector.

Service and service type

Crofton Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Crofton Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spent time with 4 people getting feedback and observing the quality of care and support they received. This helped us to understand the experiences of people who we were unable to communicate with effectively. We received feedback from 3 relatives about their experience of the care provided. We looked at 5 staff files in relation to recruitment and reviewed a variety of records relating to the management of the service, including medicines management, risk assessments and quality assurance records. We spoke with 6 members of staff including the registered manager, deputy manager, team leader and care workers. We received feedback from 2 professionals involved with the service.

Updated 11 August 2023

About the service

Crofton Lodge is a residential care home providing personal care to up to 10 people. The service provides support to people with mental health conditions and learning disabilities. At the time of our inspection there were 8 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to develop their independence. Staff were able to tell us about skills they were supporting people to develop to promote their independence. People had access to the community if they wished, with or without support from staff. We observed people being supported to choose and plan activities they wanted to do.

We observed, and staff could demonstrate, people were supported to have control and choice over their lives and staff supported them in the least restrictive way possible. However, the records did not always reflect or demonstrate this and so we could not be fully assured people were supported to have maximum choice and control of their lives and staff supported them in their best interests. We have made a recommendation about the recording of mental capacity assessments, best interest decisions and deprivations of liberties and safeguards.

Since the previous inspection the provider had reviewed and updated people’s care planning documentation. Individual risk assessments identified potential risks and provided information for staff to help them avoid or reduce the risk of harm to people. However, further improvements were required to the electronic care planning documentation. For some people some of their risk assessments required additional detail to provide clearer guidance to staff. People’s care planning documentation was in the process of being updated at the time of the inspection.

Right Care: People’s needs were reviewed regularly to ensure staffing levels were safe. The provider had adjusted staffing levels when people’s needs had changed. People confirmed staff were trained and knew how to support them. We observed people being supported by staff who knew them well and staff demonstrated their knowledge of people and their likes and dislikes. Staff spent time getting to know people and were able to recognise any signs that may indicate a decline in their mental health. They understood how best to respond when people were upset or anxious.

People were kept safe from avoidable harm. People told us they felt safe and were happy living at the home. People confirmed they knew who they could talk to if they had any concerns.

Since the previous inspection the provider had made changes to their medicines systems and processes. We found further improvements were required as these were not always effective. We have made a recommendation about medicines quality assurance. Staff files mostly contained all the information required to aid safe recruitment decisions. We have made a recommendation in relation to ensuring recruitment processes are compliant with legislation.

We observed people received person-centred care and support. People were not rushed; staff were ensured they listened to people and supported people at their preferred pace. Staff worked collaboratively with health and social care professionals to ensure people received good quality of care which suited their needs.

Right Culture: People were provided with opportunities to feedback about their care and the service. People told us they could give their views on what they wanted and confirmed they felt listened to. People were happy with the service.

At the last inspection we had identified there were areas of the home which had been poorly maintained. We found some improvements had been made. The provider had a programme of planned environmental improvements which when complete would enhance the environment.

Since the previous inspection the provider had implemented more robust quality assurance processes and systems. We found these were mostly more robust and effective with actions taken to drive improvements. This was a work in progress and time was needed for these to become fully embedded within the service. The registered manager had oversight of accidents, incidents, complaints and safeguarding concerns within the home. These were monitored regularly to identify any patterns, trends or areas for development. The registered manager was open and transparent during the inspection process. They told us of the lessons they had learned, staffing changes they had made and the improvements in progress as well as the challenges they were working on.

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 5 August 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Recommendations

We have made recommendations in relation to medicines, recruitment and mental capacity assessments, best interest decisions and deprivation of liberties and safeguards.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.