23 November 2023
During a routine inspection
People's experience of using this service and what we found
The provider’s system did not always effectively monitor the quality of care provided to drive improvements. The provider used a range of checks and audits to monitor the safety and quality of the service. However, there were areas of concern that had not been identified. This included shortfalls in the management of safeguarding concerns, in the assessment and management of risk, and in record keeping.
Some recent safeguarding concerns had not been reported appropriately or investigated robustly by the provider, and it was not clear that lessons had been learned or shared in the wider team.
Although, staff knew people well and were aware of risks associated with their care, there were some people whose care records and risk assessments did not adequately reflect their needs.
The provider operated safe recruitment processes and there were enough staff to meet people’s needs. People were supported to receive their medicines safely. People were protected from the risk of infection. People were able to receive visitors without restrictions in line with best practice guidance.
Overall, people were given sufficient food and drink and most people were provided with appropriate mealtime support. The provider made sure staff had the skills, knowledge, and experience to deliver effective care and support. People were referred to health care professionals to support their wellbeing and help them to live healthy lives. The home was well presented and dementia friendly, using signage and colour to help people to find their way around the building. The provider made sure staff had the skills, knowledge and experience to deliver effective care and support. People were referred to health care professionals to support their wellbeing and help them to live healthy lives. The home was well presented and dementia friendly, using signage and colour to help people to find their way around.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. Staff worked within the principles of the MCA and sought people's consent before providing personal care and assistance. Staff supported people to make their own decisions about their care.
Staff were kind, caring and respectful of people and offered them choices. They explained things well and gained consent for care. We saw lots of positive interactions between staff and people using the service and people responded well to staff. People were supported to maintain relationships and take part in activities they enjoyed. Staff had good awareness, skills and understanding of people’s communication needs, they knew how to facilitate communication with people. Overall, people were supported as individuals, in line with their needs and preferences. Feedback from health care professionals indicated staff worked well with others when end of life care was needed. People’s complaints were listened to, responded to and used to improve the service.
The management team promoted a culture of care in which staff valued and promoted people’s individuality. The provider sought feedback from people, those close to them, staff and other professionals to help improve the service. People and their visitors told us communication with the service was good and there were newsletters and regular residents’ meetings. Feedback was positive from other professionals who visited the service regularly.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 1 June 2023).
Why we inspected
The inspection was prompted in part due to concerns received about safeguarding people and governance. A decision was made for us to undertake a comprehensive inspection, reviewing the key questions of safe, effective, caring, responsive and well-led.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Earls 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.
Enforcement
We have found breaches of regulation in relation to safe care and treatment and good governance at this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.