Syston Lodge Residential Home

Updated 27 October 2022

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 carried out by two inspectors and a pharmacy specialist advisor.

Service and service type

Syston Lodge Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Syston Lodge is a care home without nursing care. 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 they and the provider are 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 the local authority and professionals who work with the service. 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 spoke with three people and one relative to get their views about the care provided. We observed care and interactions between people and staff in communal areas. We also spoke with seven staff including the registered manager, deputy manager, three care staff, a housekeeper and a cook. We also met with a visiting health professional. We reviewed care plans and care records for five people, and medicine s records and stocks for eight people. We reviewed four staff recruitment files, staff training records and a variety of other records relating to the day to day management and oversight of the service.

Updated 27 October 2022

About the service

Syston Lodge is a residential care home without nursing providing personal care and accommodation to 22 people at the time of the inspection. The service can support up to 25 people.

People's experience of using this service and what we found

Quality monitoring and oversight was not fully effective at identifying and addressing shortfalls in areas around care planning, care records and risk assessments.

Improvements were needed to care records as these did not always provide the information and guidance staff needed to ensure people received consistent, effective support and intervention. Information in care records was not consistently recorded to fully demonstrate how people's needs were being met. Most staff had worked at the service for a long time and knew people well, which reduced the risk of immediate harm for people.

People felt safe living at Syston Lodge and staff understood their responsibilities in safeguarding people from the risk of abuse. People's medicines were managed safely and staff followed safe working practices to protect people from the risk of infections. There were sufficient numbers of skilled staff deployed to meet people's needs and keep them safe.

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.

People, relatives and staff were able to share their views and feedback was used to make improvements to the service. Staff had a clear understanding of their roles and responsibilities and felt supported by the registered manager. The registered manager was committed to ensuring people achieved positive outcomes as a result of their care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 06 July 2018).

Why we inspected

We received concerns in relation to the management of medicines and a serious injury. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Syston Lodge Residential Home on our website at www.cqc.org.uk

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 continue to monitor information we receive about the service, which will help inform when we next inspect.