Bishopsgate Lodge Care Home

Updated 15 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 22 and 28 January 2019. The first day of the inspection was unannounced. This meant the provider did not know we were coming. The first day of the inspection was carried out by one adult social care inspector, one specialist advisor who was a registered nurse and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The second day of the inspection was carried out by one adult social care inspector.

Before the inspection we reviewed other information, we held about the service and the provider. This included statutory notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send to CQC within required timescales. We also contacted the local Healthwatch, the local authority commissioners for the service, the local authority safeguarding team and the clinical commissioning group (CCG). Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During our inspection we spoke with 12 people who lived at Bishopsgate Lodge. We spoke with the registered manager, area director, clinical lead, one nurse, the wellbeing coordinator, one senior carer, six care workers, ancillary staff and four health care professionals. We also spoke with four relatives of people who used the service.

We looked around the home and viewed a range of records about people’s care and how the home was managed. These included the care records of seven people, medicine administration records of 15 people, recruitment records of two staff, training records and records in relation to the management of the service

Updated 15 February 2019

The inspection took place on 22 and 28 January 2019. The first day of the inspection was unannounced.

We last inspected the service in February 2018 and found the provider had breached two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. These related to the systems and processes used to manage medicines safely and record keeping. We asked the provider to complete an action plan to show what they would do to improve the service.

Bishopsgate Lodge Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates 47 people across three floors. At the time of the inspection 42 people were being supported in the home, 15 requiring nursing care and some were living with dementia.

The service had a registered manager in post. ‘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.’

At this inspection we found the provider had taken action to improve.

The provider had introduced additional documentation to support the administration of medicines. Medicines were managed by staff trained in the administration of medicines. Observations demonstrated people received their medicines safely. The provider had employed a clinical lead to provide additional support to nursing staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Risks to people were assessed and plans put in place to mitigate against them. Risk assessments were reviewed regularly or when there was any change in the person’s needs. Risk assessments for the environment such as slips, trips and falls were in place and reviewed regularly.

Recruitment processes were in place with all necessary checks completed before staff commenced employment. Nurses had their professional identification numbers (PIN) checked on a regular basis.

The provider used a dependency tool to ensure staffing levels met the needs of the people living in Bishopsgate Lodge. Staffing rotas were completed in line with the dependency tool.

The provider had a business continuity plan in place for staff guidance in case of an emergency. People had Personal Emergency Evacuation Plans (PEEPS) in place which were updated regularly.

Staff were aware of safeguarding processes and knew how to raise concerns. Where lessons could be learnt from safeguarding concerns, these were used to improve the service. Accidents and incidents were recorded and monitored as part of the provider’s quality assurance system.

The provider ensured appropriate health and safety checks were completed. We found up to date certificates were in place which reflected gas safety checks and mobility equipment checks.

We found staff received regular supervision and an annual appraisal. Opportunities were available for staff to discuss performance and development. Staff training which the provider had deemed mandatory was up to date.

People’s nutritional needs were assessed and we saw people enjoying a varied diet, with choices offered and alternatives available. People were supported with eating and drinking in a safe, dignified and respectful manner. People had access to healthcare professionals when necessary and were supported with health and well-being appointments.

The provider had systems and processes in place to ensure the principles of the Mental Capacity Act 2005 (MCA) were being met.

People and relatives felt the service was caring and promoted people’s independence where ever possible. We observed how staff provided support in a respectful manner ensuring people’s privacy and dignity was promoted.

Care plans were personalised to meet people’s needs and reviewed on a regular basis.

People enjoyed a range of activities. The service had links with the local community with people accessing the local shops and places of interests.

The provider had a complaints process in place which was accessible to people and relatives.

Staff were extremely positive about the registered manager. We observed the registered manager was visible in the service and found people interacted with them in an open and honest manner. People and relatives felt the management approach in the home was positive.

The premises were well suited to people’s needs, with ample dining and communal spaces. Bedrooms were personalised to people’s individual taste. Bathrooms were designed to incorporate the needs of the people living at the home. A refurbishment plan was in place to address the damaged units in one of the dining rooms.

The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers.