Background to this inspection
Updated
1 October 2019
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.
Inspection team
This inspection was completed by a team of three inspectors, each visit to the home was made by two inspectors.
Service and service type
Bidston Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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. They are referred to in this report as the registered manger.
The day to day running of the home had been delegated to a home manager. They are referred to in this report as the home manager; to distinguish them from the registered manager.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and we sought feedback from the local authority. We used the information in the initial report from the local authority’s food hygiene visit.
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 four people who used the service and two people’s relatives about their experience of the care provided. We spoke with five members of staff including the registered manager and home manager. We also spoke with the provider.
We reviewed a range of records. This included four people’s care plans, 10 people’s daily care records and multiple medication records. We looked at four staff files and information for four bank members of staff. We looked at a variety of records relating to the management of the service including audits and policies.
After the inspection
We continued to seek clarification from the provider to validate evidence found. This related to information concerning bank staff, staff meetings and health and safety checks.
Updated
1 October 2019
About the service
Bidston Lodge is a residential care home providing accommodation and personal care to 10 people aged 65 and over at the time of the inspection. The service can support up to 16 people in one adapted building.
People’s experience of using this service and what we found
The service was not well-led. The systems at the home were not used by the home manager and registered manager to assess the quality and safety of the service effectively. They were at times not able to use their systems to provide us with basic information about the service provided for people. When concerns had been raised they were in some areas slow to react or reacted in a way that was not effective; this meant that at times things went wrong again in a short timeframe.
The provider had not put a system in place to ensure that recruitment process followed the regulations and was safe.
The provider and registered manager had not ensured that the culture of the home was always respectful and empowered people to have maximum control and choice over their lives. Staff did not always support people in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Consulting with people in a meaningful way was not embedded into the culture of the service.
We recommended that the provider consulted with people about their preferences with their care and support; and arranged people’s care to meet these preferences as much as possible.
People’s medication was administered safely at the home. We have made a recommendation that the provider ensures that there was a system in place for recording all medication stocks on hand.
People told us that they felt safe living at Bidston Lodge. People and their relatives told us that they thought they were treated with respect. One person told us, “The staff are fantastic.”
The home was well decorated in a homely style. One person told us, “I like it here, it’s lovely.” The provider had made improvements to the design of the home to meet people’s needs. For example, they had recently arranged for new accessible bathroom facilities to be fitted on the ground floor.
Care staff told us that they felt supported in their roles. They spoke positively about the new provider and told us that the atmosphere at the home had improved since they took over.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 28/04/2019 and this is the first inspection.
The last rating for this service was inadequate (published 9 April 2019). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection.
Why we inspected
The inspection was prompted in part due to concerns received about the safe management of the home. A decision was made for us to inspect and examine those risks.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We have identified breaches in relation to person-centred care, safe care and treatment, fit and proper persons employed and good governance at this inspection.
During the inspection the provider took action to mitigate some of the risks that had been identified. You can see the action we have told the provider to take at the end of this report. This included issuing the provider with a warning notice. If the provider fails to achieve compliance within the timescale on the warning notice, we may take further action.
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.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.