Princess Lodge Care Centre

Princess Lodge is a purpose-built residential care home providing personal and nursing care to up to 59 people. The service provides support to older people some of whom living with dementia. At the time of our inspection there were 51 people living at the service.

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

People living at Princess Lodge received safe care from skilled and knowledgeable staff. Staff knew and were confident on how to identify and report any concerns.

Risks to people's safety and well-being were managed through a risk management process. Peoples care plans provided staff with the information they needed to manage the identified risks.

Recruitment checks were robust to ensure staff were suitable to work with vulnerable adults and staffing arrangements met people's needs. There were sufficient staff deployed to meet people's needs. The home was using agency staff to ensure continued safety. The provider was continuously recruiting using several staff recruitment and retention initiatives.

Medicines were managed safely, and people received their medicines as prescribed. The provider had an electronic self-auditing system which allowed safe management of all aspects of medicines. Staff had the necessary skills to carry out their roles. Staff had regular training and opportunities for regular supervision and observations of their work performance.

People and relatives told us staff were caring. Staff did all they could to promote people’s independence and we saw examples of this. People had access to other healthcare services, ensuring a holistic level of support was provided.

During this inspection we carried out a separate thematic probe, which asked questions of the provider, people and their relatives, about the quality of oral health care support and access to dentists, for people living in the care home. This was to follow up on the findings and recommendations from our national report on oral healthcare in care homes that was published in 2019 called ‘Smiling Matters’. We will publish a follow up report to the 2019 'Smiling Matters' report, with up to date findings and recommendations about oral health, in due course.

The manager and staff demonstrated a commitment to people and displayed strong person-centred values. 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 service supported this practice. Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied. People were supported to meet their nutritional needs and complimented the food at the home.

The home was well-led by a new manager who was committed to continue improving people’s quality of life. They and the provider had identified areas of improvement which they were already working through to ensure high quality of care. The service had a clear management and staffing structure in place and staff worked well as a team. The provider had effective quality assurance systems in place that they used to monitor the quality and safety of the service. Staff worked well with external social and health care professionals.

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 the service under the previous provider was good, published on 11 December 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ There was a robust visiting policy with arrangements in place to help ensure the safety of visitors. All visitors entering Princess Lodge are screened for symptoms of acute respiratory infection before being allowed to enter the site. Visitors to the designated scheme will be restricted to essential visits which will be assessed for the individual person such as for those receiving end of life care. The area of the service which had been designated for COVID-19 positive people was physically separate from the rest of the service, with its own external entrance.

¿ Each individual bedroom had en-suite facilities, hospital beds and nurse call systems. Consideration has been given to ensure the rooms were furnished with wipe clean seating. Appropriate flooring was in place to ensure enhanced cleaning can be carried out. The designated area of the service was spacious and would allow 2 metre social distancing.

¿ Arrangements are in place to support staff to use personal protective equipment (PPE) safely. Processes were in place for staff to put on their PPE in a designated room which is designed to reduce the risk of cross infection. There were multiple PPE stations inside of the designated area for staff to change their PPE prior to entering individual rooms, clinical waste bins are in place for used PPE. There were facilities for staff to shower and PPE guidance was displayed at PPE stations.

¿ Staff had received training in the appropriate use of PPE, infection prevention and control training had been carried out by all staff. There were sufficient supplies of PPE including face visors to reduce the risk of spread of infection. The registered manager had a system in place to ensure staff have enough supplies of PPE.

¿ Staff will be tested weekly for Covid-19. This meant action could be taken swiftly in the event anyone developed symptoms of the virus or had a positive test result.

¿ Enhanced cleaning schedules including regular cleaning of touch areas such as handrails and door handles were in place. This reduced the risk of cross infection.

¿ The provider was putting in place appropriate signage to mark out separate areas of the COVID-19 positive area to ensure staff and people could reside there safely, which is in line with other practices within the service. The provider had put plans in placed to ensure that laundry from people with COVID-19 would be kept separated from other laundry systems within the service to reduce the risk of cross contamination.

¿ There was a detailed infection prevention and control policy in place. This provided guidance on infection control for staff, people and any visitors. This also included risk assessments of the environment and the tasks being completed. Infection control auditing was regularly carried by the registered manager and the providers infection control lead.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.