Archived: Washington Lodge Nursing Home

Updated 12 January 2017

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 13 December 2016 and was unannounced. This meant the provider did not know we were coming.

The inspection was carried out by one adult social care inspector. A member of the Commissions health and safety team attended the inspection to observe how the adult social care inspector completed an inspection.

Before the inspection we reviewed other information we held about the service and the provider. This included previous inspection reports and statutory notifications we had received from the provider. Notifications are changes, event 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 three people who lived at Washington Lodge Nursing Home. We spoke with the area manager, the manager, one nurse, three care workers, the activities coordinator and catering staff who were all on duty during the inspection. We spoke with one care professional who was visiting the home. We also spoke with two relatives of people who used the service.

We carried out some observations using the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

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 three people, the recruitment records of three staff, training records, and records in relation to the management of the service.

Updated 12 January 2017

Washington Lodge Nursing Home provides nursing care for older people, some of who are living with dementia. The service is registered to provide care for 65 people. At the time of our inspection 30 people were receiving a service.

Washington Lodge Nursing Home was inspected on 30 and 31 July 2015 where we identified breaches in regulation 9, 11 and 17. A further inspection was carried out on 31 May 2016 which confirmed all improvements had been made. This inspection took place on 13 December 2016 and was unannounced. This meant the provider did not know we were coming.

Washington Lodge Nursing Home is in the process of being sold. The application for registration with the new provider has been submitted to the Commission.

The service did not have a registered manager. ‘The deputy manager was in a managerial role with support from the area manager. They will be referred to as the manager throughout the report.’

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.

Staff had been safely recruited with relevant checks completed prior to them starting work. Staff were provided with training to enable them to care effectively for the people they supported. Staff told us they felt supported by the manager and found them to be open and approachable.

The manager kept a log of all accidents, incidents and safeguarding concerns and audited these for patterns and themes.

Staff had an understanding of how to recognise and report any concerns or allegations of abuse and described what action they would take. Staff felt confident the manager would respond to any concerns.

Risks to people had been managed safely. Records demonstrated when risk had been identified, and what action had been taken to reduce them wherever possible.

We found policies and procedures were in place to manage people's medicines safely. Medicines were administered by trained staff who had their competency to do so checked regularly.

The manager and staff understood their role in relation to the Mental Capacity Act 2005 (MCA) and how the Deprivation of Liberty Safeguards (DoLS) should be put into practice. These safeguards protect the rights of people by ensuring, if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect them from harm.

There were staff on duty with the necessary skills and experience to support the people using the service. The provider was actively trying to recruit nurses and was using agency staff to ensure safe staffing levels. Training was up to date with staff completing some training electronically. Staff received regular supervision and some had received an annual appraisal. Where appraisals were out of date steps had been taken to address this.

Relatives and people felt staff were caring. Staff treated people with respect and dignity and promoted people's independence wherever possible, offering choices and options.

People were provided with a varied and nutritious menu. Staff supported people to eat and drink if required and encouraged independence were ever possible. They ensured people at potential risk of undernutrition received adequate nutrition and hydration.

The provider had information about advocacy services available for people and their relatives.

Care plans were personalised enabling people to receive care and support that was responsive to their individual needs. People were provided with access to health care appropriate to their needs.

The registered provider had a process in place to obtain the views of people and their families by using a survey. Where people had communication needs a pictorial survey was available.

People had access to activities within the service such as taking part in crafts or board games. We saw people accessing the community to visit the local day centre with staff. Previous trips included a local attraction to see the illuminations.

The registered provider had a system in place to monitor the quality and effectiveness of the service provided to people and their families in order to drive improvement. The provider had a policy and procedure in place to manage complaints and kept electronic records of all complaints and concerns. Relatives and people knew how to make a complaint. One relative told us, “I know how to complain but never had to.”

The manager submitted statutory notifications to CQC when necessary. People's personal information was kept safely and securely in line with Data Protection Act.

The provider had a business continuity plan in place to ensure staff had guidance and contact numbers in case of an emergency. People had an up to date personal emergency evacuation plan (PEEPs) on their file.