About the service Ernehale Lodge Care Home is a residential care home providing personal and nursing care to 17 people aged 65 and over at the time of the inspection. The service can support up to 30 people.
People’s experience of using this service and what we found
There were widespread and significant shortfalls in the way the service was led. There were three breaches of the Health and Social Care Act 2008 (Regulations) 2014. The delivery of high-quality care was not assured by the leadership, governance or culture in in the home
Staff felt unable to raise concerns with the provider. Staff did not feel listened to or that their views mattered. Overall governance of the home was ineffective. Limited or no action was taken to address known risks. The environment in which people lived and staff worked was unsafe in places. The provider had not acted to address this.
People’s care records did not always reflect their current care needs and increased the risk to their health and safety. People who needed continuous supervision were provided with the staff to keep them safe; however, staff were not provided with the guidance needed to support them in a way that reduced the risk of them presenting behaviours that may challenge. This resulted in increases in agitation and anxiety for these people. It was noted that the provider had ensured staff supported one person with this care whilst an application for funding from the Local Authority was being made. This helped to reduce the immediate risk to the person's safety.
People’s medicine records were not always correctly completed. The clinical room where medicines were stored had damaged and/or broken furniture. Robust infection control procedures were not always followed. This increased the risk of the spread of infection. People did not always receive the support they needed to maintain good nutritional health.
Accidents and incidents were reported to the relevant agencies; although little action was taken to support staff with learning from mistakes made. Staff supervision was not consistently provided. Staff felt unsupported by the management.
Safe recruitment processes were followed; however, when agency staff came to work at the home, no formal induction was provided. Staff responded quickly to call bells and other requests for assistance. People were not left alone and unsupervised. People told us when they asked for help from staff, they always responded quickly.
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; the policies and systems in the home supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 3 January 2020).
Why we inspected
The inspection was prompted in part due to concerns received about the management of the home, infection control and people’s safety. A decision was made for us to inspect and examine those risks.
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.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full 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 Ernehale Lodge Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, premises and equipment and governance at this inspection.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.