Lodore Nursing Home

Updated 5 March 2021

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 Care Act 2014.

This was a focused inspection to check whether the provider had made the improvements required in relation to Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to check on information we received from the local authority in relation to safeguarding concerns.

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 undertaken by one inspector.

Service and service type

Lodore Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We announced this inspection on the morning of our site visit due to the COVID-19 pandemic. To assess the risks to the inspection team and enable the team to wear appropriate Personal Protective Equipment (PPE) during the inspection.

What we did before the inspection

We reviewed the information we held about the service including statutory notifications received about key events that occurred at the service and the provider's action plan following our previous inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people who used the service and three care workers, including the registered manager, a nurse and a care worker. We undertook general observations and reviewed medicines management arrangements. We reviewed a range of records including four people’s care records, one staff recruitment file, audits, policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We liaised with a representative from the local authority’s safeguarding adults’ team and spoke with three relatives.

Updated 5 March 2021

Lodore Nursing Home is a residential care home providing personal and nursing care to 19 people aged 65 and over at the time of the inspection. The service is registered to support up to 37 people in one adapted building. However, due to the COVID-19 pandemic the provider was only using their bedrooms as single occupancy and therefore at the time of inspection they had capacity for 27 people.

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

People felt safe at the service and relatives felt their family members were safe and well cared for by the staff at Lodore Nursing Home. Risks identified at our previous inspection regarding medicines management had been addressed and medicines were stored, managed and administered safely. Individual risk assessments were undertaken and management plans were in place to minimise and mitigate risks to people’s safety and welfare. Staff had received training on infection prevention and control and were adhering to the government guidance in response to the COVID-19 pandemic, including wearing personal protective equipment (PPE), regular testing and participating in the vaccination programme. There was a comprehensive cleaning schedule in place to ensure a clean and hygienic environment was maintained.

Staff were aware of safeguarding adults' procedures and had received regular training on this topic. The management team told us they had liaised with the local public health teams about the blanket restrictions in place during the COVID-19 pandemic and learnt from the safeguarding concerns raised about the risk and impact of social isolation on people. Individual incidents were reviewed.

The registered manager had strengthened their quality assurance processes in response to our last inspection, including implementing a more detailed medicines management audit and a robust infection control audit. There were other processes in place to review key areas of service delivery, however, we found the care records audit was limited and did not include details about the quality of care records or identify if improvements were required, what action was taken and when. We also identified that whilst care plans were regularly reviewed, the number of updates recorded on the original care plan were often difficult to read and there was a risk that any changes to people’s care and support needs may not be easily identifiable. We fed back our concerns about the care record reviews and care records audit to the registered manager and we will follow up on these areas at our next inspection.

People, relatives and staff felt well informed and involved in service delivery. They said there was open communication between themselves and with the registered manager. They felt comfortable expressing their views and felt listened to. The registered manager was clear about their role, including their CQC registration requirements. Statutory notifications about key events that occurred had been submitted, their latest CQC rating was clearly displayed and the registered manager was aware of and adhering to the duty of candour.

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 requires improvement (published 2 January 2020). The service is now rated good.

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

The inspection was prompted in part due to safeguarding concerns received about blanket restrictions regarding people staying in their rooms and being socially isolated. This inspection examined those risks.

The inspection was also prompted in part by notification of a specific incident, following which a person using the service died. The information CQC received about the incident indicated concerns about the management of medical emergencies. This inspection examined those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe section of this full report.

At our last inspection in November 2019 we found a breach of regulation relating to Regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulations 2014). The provider completed an action plan after the last inspection to show what they would do, and by when, to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. As well as to follow up on the other concerns identified through the intelligence we had received. This report only covers our findings in relation to the key questions Safe and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lodore Nursing Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.