Earlsdon Lodge Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

There were clear governance and management arrangements to support the effective management of the home. Staff felt supported and understood their role and responsibilities. The providers policies and procedures addressed equality and diversity to ensure services were fair and accessible to everyone. The provider’s vision and values had been shared with staff through regular meetings. These meetings addressed risks, learning, and any changes in practice needed to ensure the home ran effectively. The provider had a range of quality monitoring systems and processes to help support ongoing improvements to the service. However, these had not identified some of the issues we had found needing improvement. People, and relatives involved in people’s care told us they were not always aware of meetings to discuss the service. Notifications such as accidents and incidents were consistently submitted to external organisations as required. There were arrangements to ensure the confidentiality of records was maintained.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us the vision and values expected by the provider were shared with them. One staff member said, “We have meetings after 9 months (of start date) with management. If things need to be improved, they are communicated to us. We were told we have to work as a team to improve the home. If improvement is needed in a particular department, we have to approach the manager.” Another staff member said, “[Registered manager] shared visions and values in my interview.” One staff member told us about meetings held with the registered manager. They said, “You can make suggestions. I think there is so much potential here and we can make things even better. [registered manager] writes it all down. She will say, ‘That’s a good idea’, or will explain why we can’t do something.” The registered manager said staff knew about the provider’s values and expectations of them through regular meetings, training and group supervision meetings. They told us, “We check by doing care plan reviews with people and families, meetings to see what we can improve to make a better environment.” And “Policies and procedures explain our values.”

Records showed there were processes to support staff in ensuring they worked in accordance with the providers policies and procedures so that people's human rights and diversity were recognised, and their needs were met. These included staff supervisions, policies and procedures, staff training to ensure the visions and values of the provider were followed. However, there were care records relating to medicines, nutrition and oral care that were not sufficiently detailed to show the care provided was as required. For example, instructions about how a specific medicine should be given, details of what foods were fortified (had added nutrition). Records did not show a specific food item a person needed was provided consistently. This meant it was not always clear the needs of some people were met consistently.

Staff spoke positively of working at the home and the support they received from management. One staff member said, “[registered manager] is very supportive, and we act on any difficulties they come up with. I can approach them (management staff) any time.” A second staff member said, “What I love most about [registered manager] is she is involved with residents and staff. She will ask how your day is going or how it has been. It’s nice to have a manager who is a people person.” The registered manager said a provider representative visited the home every week to provide support. This included the area manager, they said, “[Area manager] will do audits look at work that has been completed. Make sure cleaning schedules are being completed. Last week they did a training session with senior (care staff) to improve documentation on PCS (electronic care planning system) and accidents and incident reports.”

The registered manager was committed to providing an inclusive service. The providers audit processes ensured competencies were checked across the service. Training programmes supported staff in addition to supervision meetings where records were kept to confirm any areas of improvement, successes, or learning required. Meeting notes showed staff involvement, but it was not always clear issues from the previous meeting had been acted upon. Recruitment processes and checks were in place to ensure safe and suitable staff were employed.

Staff were positive about the registered manager and told us they felt able to report any concerns and they would be managed. Staff were aware of the whistleblowing procedures and how to access them if needed. The registered manager confirmed a Whistleblowing and Freedom to Speak up policy was in place, and staff are able to access this online if needed. Daily ‘flash’ meetings took place to enable staff to raise any issues or concerns they may have identified, to management staff for action.

Processes to support staff in speaking up when needed included the provider’s policies and procedures. These included Whistleblowing, Complaints and Freedom to speak up. Records of staff meetings were kept to confirm any discussions and actions agreed.

Staff felt included in decisions about the service. One staff member told us morale was good, and stated, “We have a very lovely environment. We laugh and sing because I enjoy my job.” They went on to explain they did not feel pressured to take on extra shifts if needed because they “Loved their job.”

The training matrix showed equality and diversity training was provided to all staff. A staff member told us each person had a “This is Me” booklet completed which containing individualised information to help staff support people and provide care in ways they preferred. There was a diverse staff team that had been recruited to support people.

Staff were positive about the governance of the service. One staff member told us, “They (management staff) are absolutely fine, never had a crossed word for them, could not say anything better about them.” Staff told us it was their choice to work any additional hours and they did not feel pressured to do this. One staff member told us, “When you love the job you don’t feel pressured.” The registered manager told us the structure of the service meant they always felt supported. Governance of the service was supported by the area manager and nominated individual both of which visited the service weekly. A deputy manager was in the process of being recruited and senior care staff were available to support care staff when needed. The registered manager said all residents personal information was stored in lockable cupboards to support data protection and staff were able to access these as and when required. Information on computers and laptops was password protected and information stored on staff hand held devices was disconnected if the staff member left.

CQC systems showed statutory notifications had been forwarded by the provider when there had been accidents or incidents. This included reporting the passenger lift when a problem had arisen needing a repair. This showed actions were taken by the provider to keep people safe. A training matrix showed staff had accessed the training they needed to complete their role safely. Meeting notes showed staff attended meetings where some learning was provided to support staff competency and needs. The registered manager told us people had the opportunity to attend ‘resident’ meetings to discuss issues related to the home. Records showed topics of conversation varied at each meeting. For example, notes of one meeting showed food preferences was discussed. The registered manager completed monthly governance reports which showed they were required to monitor various aspects of the service through audits and report the findings to the provider. This was so any potential risks could be identified and acted upon. A report seen included information in relation to complaints, staffing and competencies, Deprivation of Liberty Safeguards, safeguarding, accidents and incidents, supervisions matrix, medication, training, fire audits and service improvements. However, we found audits had not always been fully effective because they had not identified areas we had found. For example, equipment checks had missed a walking frame was not safe to use due to a worn ferrule. Medicine records were not clear regarding crushing medicines, oral healthcare records had not been completed consistently for people. Staff meeting notes did not show issues at the previous meeting had been effectively addressed. Staffing arrangements were not always safe because sometimes the lounge was unattended. Cleanliness of the home needed attention in some areas. Recruitment records did not show all the required checks were in place.

People specific needs were identified during their initial assessment, and they were supported to see health professionals when needed. This was confirmed by relatives. Relatives said they were not involved in ongoing reviews of people's care and were not aware of meetings they could attend to share information about their experiences of the service to support improvement. One relative said, “No I am not aware of any relatives meetings and have not been invited or attended any.” Another said, “No I have never been invited or attended any relatives meetings.”

Staff told us arrangements were in place to support people in the community where this was possible. One staff member told us how some people had been supported to go to the local library and how they had been involved in building links with local schools. They told us how some people enjoyed going for local walks. However, staff also recognised some people didn’t want to go out or were not able to. Staff explained how they shared any concerns about people with the registered manager so they could refer people to health professionals such as a district nurse or GP as required. One staff member said, “We work with the doctor and district nurse. Someone from the GP surgery comes to do a ward round. It keeps everyone updated and they tell us what we need to do if someone isn’t well.”

A paramedic told us they visited the service weekly to undertake health checks. Local Authority commissioning visited the home to provide support to enable improvements within the service. Areas needing improvement included infection prevention and control. An action plan had been completed which the service was working through. The provider had signed up to the Gold Accreditation Award in relation to ‘Say no to Infection’. Staff had completed hand hygiene training and other training was being arranged. Two staff members had attended oral health training and had shared their learning with other staff although we found this was an area needing improvement.

Accident and incident reports showed relatives were informed of any accidents or incidents involving their family member so they could be involved in any decisions as appropriate.

Staff completed ongoing training to support them in their role and ensure a consistent approach to care and support. Staff had supervision meetings to discuss any learning needs, and daily handover meetings helped to ensure any important information about people was shared and acted upon as required. One staff member told us, “I’ve had supervision, and it was good to hear good feedback. We talked about what training I had done, how I was getting on and help I needed. Everything. It was good.” Another staff member told us, “We have daily handovers, and we have staff meetings every 4-6 weeks, so you are kept up to date. When my training is due the manager reminds me but I can see my training online so I can monitor it.” Staff told us there was an ‘on call’ rota that showed who they could call during the evenings and weekends if they needed help and management staff were not available. The registered manager shared areas of learning they had identified which included learning from safeguarding incidents. These had resulted in changes in practice, for example changes to the management of continence care. It had also been recognised that information sharing with health professionals at an early stage was important when things went wrong.

The registered manager completed a monthly governance report for the provider after having completed audits across the service to check policies and procedures were followed. However, these audits had not picked up issues we had found. For example, the improvements needed in relation to medicine audits, supplementary records checks (such as food intake records), maintenance checks (equipment and furniture), and infection, prevention and control. Recruitment procedures were in place but had not been followed consistently to ensure all checks had been fully completed for new staff. However, staff were subject to regular supervision to ensure they worked safely, and any learning needs were identified and addressed. Reviews of accidents and incidents and safeguarding incidents took place to check for any themes and patterns and any learning required from these. For example, unwitnessed falls which could suggest a review of staffing arrangements was needed. The Nominated Individual had meetings with the Local Authority commissioners to help drive improvement at the home. An action plan was in place to support these improvements. Relative meetings were arranged to help identify any changes in practice needed although a number of relatives were not aware of them. This had not been identified through any quality monitoring process.