Background to this inspection
Updated
20 February 2024
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 Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was undertaken by 2 inspectors.
Service and service type
Monread Lodge is a ‘care home’ with nursing care. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
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. We sought feedback from a health and social care providers. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We visited the service location on 4 January 2024. We spoke with 5 people and received feedback from 4 relatives. We also spoke with 6 staff including the registered manager, regional manager and support workers. We received feedback from health and social care professionals.
We reviewed a range of records. This included 6 people’s care records and a range of medication records. A variety of records relating to the management of the service were also reviewed. These included training records, incident records and quality assurance processes.
Updated
20 February 2024
About the service
Monread Lodge is a residential care home providing accommodation and personal and nursing care to 54 people at the time of the inspection. The service can support up to 62 people.
People's experience of using this service and what we found
There had been a high number of skin tears, both explained and unexplained. Additional training had been provided and these were reported appropriately but we found these numbers had yet to reduce. Pressure care was not always managed safely as mattresses were not always set correctly and repositioning was sometimes missed.
People living with dementia were not always supported swiftly or in a way that reduced the risk of distressed behaviours. Staff had received training and, in most cases observed, were kind and attentive, but this was not consistent.
People’s medicines were managed safely, staff had been trained and audits were in place. We found systems did not always ensure records were accurate, this was addressed on the day of our visit. We also found the morning round was still taking a long time to complete. A plan was put in place to address this.
Management systems did not ensure these issues were identified or managed. There were monitoring and quality processes in place, but these had not ensured consistent safe practice throughout the home.
People told us they were happy and felt safe, and staff were kind. Relatives gave mixed views about the care and support provided. Care plans were in place and staff knew people well. People were supported to eat well, dietary needs were catered for.
Individual risks were assessed. Infection control measures were followed. People told us there were normally enough staff to assist them as needed, relatives gave mixed views. Staff told us there was enough of them to meet people’s needs. Staff received training and regular supervision. They felt well equipped for their roles.
People, relatives, and staff were positive about the registered manager and how the service was run. There were regular meetings to share feedback and obtain views.
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.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
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.
Rating at last inspection
The last rating for this service was good (published 22 February 2023). The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will request an action plan from 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.