Archived: Portland Lodge

Portland 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.

Portland Lodge provides accommodation for up to 19 people and supports older people, some of whom are living with dementia or a mental health need. At the time of our inspection, there were 18 people living in the service.

There was a registered manager at the home. 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, in July 2016, the service was rated as Good. At this inspection, we found the service remained Good overall, however we found evidence that some areas of the service were in need of improvement. You can see more about these findings in the Safe section of the report.

The risk of infection was not always managed safely. Appropriate hand washing facilities were not in place in the laundry room and the condition of the flooring in two communal bathrooms meant they could not be cleaned effectively.

Environmental risks had not always been considered and risk assessments were not always completed to reduce the risk of harm to people.

People felt safe living at Portland Lodge. Staff knew how to keep people safe and how to identify, prevent and report abuse. They engaged appropriately with the local safeguarding authority.

Systems were in place to ensure the safe management of medicines. People were supported to receive their medicines by staff who had been trained appropriately and medicine administration records were completed accurately.

Thorough staff recruitment checks were carried out when a new staff member started working for the service. There were enough staff available to keep people safe and staffing levels were monitored by the registered manager.

Staff received a variety of training and demonstrated knowledge, skill and competence to support people effectively. Staff were supported appropriately by the registered manager and deputy manager.

People had access to health and social care professionals where required and staff worked together co-operatively and efficiently.

Procedures were in place to help ensure that people received consistent support when they moved between services.

People were supported by staff with their nutritional and hydration needs. People were offered choice at mealtimes and menus contained a variety of nutritious and healthy foods. Where people had specific dietary requirements, this was well documented and staff were aware of how to meet these needs.

People were cared for with kindness and compassion. Staff had developed positive relationships with people and knew what mattered most to them.

Staff took action to protect people’s dignity and privacy and encouraged people to be independent with all aspects of their daily routines where possible.

People had a clear, detailed and person-centred care plan in place, which guided staff on the most appropriate way to support them.

People could take part in activities which reflected their interests and provided mental and physical stimulation, as well as opportunities to be part of the local community.

People, their relatives, visitors and staff members commented positively on the leadership of the service and felt that the service was well-led. The provider was engaged with the running of the service and was approachable to people and staff.

Staff were organised, motivated and worked well as a team. They felt supported and valued by the registered manager.

There was an open culture in which people, visitors and staff were encouraged to given feedback about the service.

The last inspection of the home took place in May 2015, which identified that the provider had failed to ensure that people, staff and visitors were protected from the risk of infection and failed to ensure there was an effective system in place to manage medicines effectively. We asked the provider to tell us what action they were taking and they sent us an action plan stating they would be meeting the requirements of the regulations by September 2015.

The inspection was unannounced and was carried out on 24 June 2016. During the inspection we found the provider had completed all the actions they told us they would take in respect of meeting Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

There was 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 2008 and associated Regulations about how the service is run.

People and their families told us they felt the home was safe. The home was clean and appropriately maintained and people were supported by staff who wore appropriate personal protective equipment, such as gloves and aprons in line with the Department of Health Guidance.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

People’s families were involved in discussions about their care planning, which reflected their assessed needs. Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People were supported by staff who were responsive to their communication styles and gave people information and choices in ways that they could understand. They were patient when engaging with people who required more time to respond.

People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people, when necessary in a patient and friendly manner.

There was an opportunity for people, their families and staff to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through an annual questionnaire. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role.

Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

We looked at five care plans and saw they were individualised and included the necessary information to inform staff as to the specific care people required. We saw these were reviewed on a regular basis. We observed care in the communal areas of the home and saw staff interacting with people in a positive way. One member of staff said 'generally, I get time to sit down with people. I do a manicure for the ladies if they want one'.

We saw the home was clean and tidy. However, we found the provider had not taken steps to provide care in an environment which was safe and adequately maintained. Some areas required refurbishment and areas of the ground were untidy, overgrown and filled with rubbish.

We saw there were enough qualified, skilled and experienced staff available to meet people's needs. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We found the provider had an effective quality assurance system and they sought the views of people who used the service and their families through regular surveys.

We found the home to be clean and no unpleasant odours were detected. People told us they liked their rooms and had been able to personalise their own rooms. The home had a recruitment procedure, but attention is needed to ensure this is followed at all times.

People told us they liked the staff and felt they worked hard. We have requested some information from the Isle of Wight Company regarding the finances of the company after concerns were raised.