Archived: Virginia Lodge Care Home

Virginia Lodge is a residential care home for up to 32 older people, some of whom may be living with dementia. The home is located approximately a mile and a half from the small border town of Longtown and is in a rural setting. Accommodation for people using this service is all at ground floor level. At the time of our inspection visit there were 20 people living in the home.

There was a registered manager in place who was also the registered provider. 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.

At our last inspection on 3 December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. This service remains good.

People who used this service were safe. The staff knew how to identify if a person was at risk of abuse and the action to take to protect people from harm. Risks to people's safety had been assessed and measures put in place to manage any hazards identified. Staff had completed training in the protection of vulnerable people.

Staffing levels were good. The records we looked at showed that staffing levels were planned around the needs of people who lived in the home. We saw that staffing levels were increased at certain times during the day when the work load was at the highest level. People were recruited safely which ensured only suitable people were employed at Virginia Lodge.

We found that peoples' medicines were managed well with staff having a good working relationship with the local pharmacist. Healthcare needs were met through advice from the mental health team, peoples' doctors and consultants where necessary. Dental, optical, chiropody and dietician services were accessed when required.

The building was warm, safe, suitably decorated and well furnished. Equipment was maintained and replaced as necessary. Some areas were in the process of being upgraded and the maintenance person was working on this. The provider had plans to continue re-decoration until the work throughout was completed.

The home was clean and good infection control practices were in place.

The registered manager understood her responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Restraint was not used nor was it needed at the time of our visit and we had evidence that people were asked for consent for all interventions.

Nutritional plans were in place and people told us they enjoyed their meals. Dieticians were consulted if people were at risk of losing weight.

Health care professionals visited the home regularly. Staff supported and cared for people during times of ill health and at the end of life.

We observed caring and sensitive interactions between staff and people they supported. We saw that people were respected and treated with dignity and patience. Matters of equality and diversity were taken into account by the team.

Care plans were easy to follow and provided staff with the guidance required to meet peoples’ assessed needs.

There was an activities programme and people could join in if they wished. External entertainers visited the home.

The provider had a suitable quality monitoring system in place. The results of the regular audits were used to identify how well the service was running. Any changes and/or improvements that were required as a result of the audits were dealt with as soon as possible. Good recording systems were in place.

Virginia Lodge is a residential care home for up to 32 older people, some of whom may also have dementia. It is managed by Mrs Julie Walsh. She and her husband own the service.

The home is located approximately a mile and a half from the small border town of Longtown and is in a rural setting. Accommodation for people using this service is all at ground floor level and accommodation is in single rooms.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We spoke to people who lived Virginia Lodge and they spoke positively about what it was like to live in the home. People living there told us that care staff respected their privacy and treated them with respect. People said, “I feel very safe here and the staff are wonderful”. Relatives told us they were more than happy with the care and support provided to their family members.

We spent time in all the areas of the home and saw there was sufficient staff on duty to meet the needs of people who lived in the home. We saw there was catering and domestic staff available to support the care staff in providing appropriate levels of care and support.

The registered provider had systems in place to make sure people living there were protected from abuse and avoidable harm. Staff were trained and knew the action to take if they were concerned about the safety or welfare of anyone.

We saw that people had nutritional assessment and plans in place. This ensured people received a balanced diet and were not at risk of becoming malnourished or dehydrated.

Medicines were being safely administered and stored and we saw that accurate records were kept of medicines received and disposed of so they could be accounted for.

Some activities were provided if people wanted to join in. People could follow their own interests and maintain relationships with friends and relatives.

The environment of the home was well maintained and the communal areas were decorated and arranged to make them homely and relaxing. There was sufficient communal space to allow people to sit in quiet spaces if they wished. We found that the home was clean and being kept tidy and fresh because the provider employed ancillary staff to undertake housekeeping duties.

Staff were recruited in a way which ensured only suitable people were employed to care for and support older people with a variety of physical and emotional needs.

People knew how they could complain about the service they received and information on this was displayed in the home. People and their relatives told us they were confident and complaint or concern they had would be listened to and dealt with as soon as possible.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

We had evidence to show that the staff who worked in this home were aware of the need to protect vulnerable older adults. They understood the different types of abuse and were aware of how to report any potential bad practice.

We saw evidence from staff records that the recruitment of staff was appropriate with all legal checks and references obtained before people started work.

Risk assessments were in place to ensure all risks were monitored and minimised.

Is the service effective?

We saw that care planning in the service was being reviewed by the manager and that this meant that people had the most suitable care delivered to them. We asked the provider to continue the review in order for the staff to have as much information as possible and so continue to provide effective care and support.

People in the home told us that they had some choice of activities, they were happy in their environment and staff looked after them well.

Is the service caring?

We saw that staff treated people with respect but also spent time enjoying a joke with them. Some staff had worked in Virginia Lodge for some time and knew people well whilst the newly appointed staff were getting to know people. They all told us, 'We only want what is best for people who live here and we go out of our way to treat them as we would our own family'.

Daily notes and care records were written in a respectful and positive way and the care plans that had been recently reviewed were up to date and reflected the care needs.

Is the service responsive?

We spoke to the local health professionals and they told us they visited the home on a regular basis in response to health care needs. They also said, 'If we get a request for an extra visit we know that it is necessary'. We saw in care planning that any issues were dealt with appropriately and a doctor's visit was requested in a timely manner.

Is the service well led?

This is a family run service with the provider also being the registered manager. She was very much 'hands on' and worked long hours, together with the assistant manager to ensure a good quality of care. Recently there had been a considerable change in the staff personnel and new staff had been appointed.

We spoke to members of the staff team and they confirmed that manager had 'very high standards' and was currently working long hours to maintain the standards of care. Staff told us, 'The manager does her very best to make sure the home is well run and in the best interest of the people that live here'

'I love it here. I was so lonely at home on my own and I could not mange by myself. I could not be happier'.

'I am very well looked after. I decided to stay in my room today and the staff brought me my lunch'.

We saw, throughout our visit, that people were treated with respect and their dignity was preserved. Staff were constantly chatting to people whilst they were providing support.

Each person had an up to date care plan which evidenced that every person was fully assessed prior to moving in to the home. This ensured that the service was able to provide an appropriate level of care and support.

Medicines were managed well and safely. All staff who administered medicines had been appropriately trained.

Risk assessments were in place and reviewed each month with the care plans.

The home had a full set of policies and procedures in place and records were up to date and securely stored in lockable facilities.

We found good standards of care and support were delivered in a warm and caring manner and that people were relaxed in their surroundings.

People spoken with felt that their privacy, dignity and independence were promoted. These values were underpinned by the essential training that staff had received. People spoke very positively of the staff team describing them as, 'Helpful and kind.'