This inspection took place on 10 October 2014 and was unannounced. When we last visited the home on the 30 July 2014 we found the service was meeting the regulation we looked at.
Barons Lodge provides accommodation, nursing and personal care for 22 people with mental health needs. Many people were older adults and some also had physical disabilities. On the day of our visit the home was fully occupied.
The home had a registered manager. 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.
We found that people might not have been protected from abuse. This is because procedures to keep people who made repeated allegations safe were not always appropriate. However, staff had a good understanding of how to identify abuse or neglect.
People’s bedrooms were not always clean and tidy. This was because the provider did not ensure that people were supported appropriately to clean their bedrooms. This could put people at risk from the spread of infection. Other parts of the home were clean.
The premises were not always appropriately maintained. For example, a radiator cover had not been replaced which meant people were at risk of getting scalded if they came into prolonged contact with the exposed radiator. However, other parts of the premises were well maintained, such as the electric and fire detecting and fighting systems.
We found gaps in the planning to meet people’s individual needs and to ensure people’s welfare and safety. Planning of care in relation to falls prevention, promoting continence, prevention of pressure ulcers, mental health screening and therapy provision was not always documented or accurate.
The manager had not notified CQC of several incidents including allegations of abuse involving people using the service and incidents involving the police. This meant the CQC could not monitor how these incidents were being dealt with.
There were enough staff employed to meet people’s needs and recruitment procedures were robust, ensuring that only people who were deemed suitable worked in the home. Staff were provided with support and training to help them carry out their roles.
We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure that people are only deprived of their liberties in a safe and correct way, when it is in their best interests and there is no other way to look after them.
Staff had a good understanding of the Mental Capacity Act 2005 and their responsibilities under this. This helped to ensure that people’s rights in relation to this were properly recognised, respected and promoted.
People were provided with a choice of food, and were supported to eat when required. Staff supported people who were at risk of malnutrition and those with specialist needs related to their diet. People were supported effectively with their health needs. Medicines were managed safely.
Staff treated people with kindness and compassion, dignity and respect. They responded to people’s needs promptly. People were involved in decisions about their care, and had access to advocates to help them make some decisions. Staff had a good knowledge and understanding of people’s individual needs and preferences.
People using the service, relatives and staff were encouraged to give feedback on the service. There was an accessible complaints policy which the manager followed when complaints were made to ensure they were investigated and responded to appropriately.
The manager carried out regular audits to monitor the quality and health and safety of the service and to plan improvements, although these audits had not identified the issues we found in relation to care planning and notifications.
At this inspection there were breaches of regulations in relation to safeguarding people from abuse, care and welfare of people, safety and suitability of the premises and notifying CQC of incidents. You can see what action we told the provider to take at the back of the full version of the report.