Archived: Doddington Lodge

Updated 13 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. We brought this inspection forward due to concerns that we had received from health professionals and members of the public.

We made an unannounced comprehensive inspection on 6, 7 and 14 September 2017. The inspection team consisted of two Inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had knowledge and experience of care for older people.

We looked at the information we held about the service and the provider. We looked at statutory notifications that the provider had sent us. Statutory notifications are reports that the provider is required to send us by law about important incidents that have happened at the service. This information helped us to focus the inspection.

We asked the local authority if they had any information to share with us about the care provided by the service. We also asked the local Health watch for information relating to people’s experiences at Doddington Lodge. Health watch are the independent national champion for people who use health and social care services.

We used the Short Observational Framework for Inspection (SOFI) because some people were unable to communicate with us verbally so we used different ways to communicate with people. SOFI is a specific way of observing care to help us understand the experience of people living at the home.

We spoke with six people who lived at the home. We spoke with the manager, the provider, and eight members of staff. We also spoke with three health professionals who included two district nurses and a social worker. We looked at the records of six people, which included medicines, mental capacity assessments, nutrition, risk assessments, care plans and assessments of people’s needs. We also looked at the systems for monitoring the safety and quality of the service.

Updated 13 October 2017

This inspection took place on 6, 7 and 14 September 2017 and was unannounced.

At this inspection, we found the registered provider was in breach of seven of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 that we identified during the last inspection. These shortfalls in the service are described throughout all sections of this report.

Doddington Lodge provides accommodation and personal care for up to 41 people, some of whom are living with dementia. At the time of our inspection, there were 30 people living at the home.

There was not a registered manager in post. 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 and associated regulations about how the service is run.

People were exposed to harm, both in terms of their physical environment as well as the care they received. Action had not been taken to address areas that required it which placed people at risk of injury and harm. A fire escape route identified as being obstructed did not get cleared at the time it was identified. People remained without hot water for over two months with no clear plan in place to remedy the situation.

People's risk assessments were not followed, which resulted in unsafe care and treatment. People's skin health was compromised due to guidance not being followed. The provider had not taken action where risks had been identified by staff and brought to their attention.

People’s nutritional dietary needs were not always identified or followed and people were not provided with the support they needed to eat and drink enough. People were at risk of malnutrition and of dehydration with people’s needs and abilities not routinely reviewed.

Complaints were not always appropriately responded to and lessons were not learnt

People were not always treated with dignity and respect. Care did not always centre on people as individuals. People’s care reviews were not completed and people’s preferences were not known by staff.

People were unable to enjoy their individual hobbies and interests. Staff were not always available to support people with the things they enjoyed doing. Professional and medical guidance was not followed, which meant people's health needs were not always met.

There was no effective governance and oversight of the service. The provider and the manager did not have understanding of where they were failing to meet people’s needs. The provider had not identified the concerns we highlighted during the course of our inspection.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.