Earls Lodge Care Home

Updated 8 May 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.

Inspection team

This inspection was carried out by 4 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience attended the service on the first day of the inspection.

Service and service type

Earls Lodge 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. Earls Lodge is a care home. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We visited the service on 23 November and 24 November 2023. Both visits were unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received feedback from other professionals including the police and representatives of the councils that commission 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 12 people using the service and 6 visitors. We spoke to the registered manager, the deputy manager, the HR Director, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We spoke with the 2 assistant managers, 3 senior care staff, 3 care assistants, the activities coordinator, a cook, a housekeeper, and a laundry assistant. We attended 1 early morning shift handover between night staff and day staff. We received feedback from 2 health care professionals and spoke with the visiting trainer, and the hairdresser. We reviewed care plans for 10 people and a range of records related to the management of the service such as medicines records, safeguarding records, staff recruitment records and the provider’s quality monitoring checks.

After the inspection we continued to seek clarification from the provider to validate the evidence found and reviewed further records in relation to the care provided to people and the running of the service. This included care planning and day to day information for people using the service, safeguarding records, provider quality monitoring information, minutes of meetings, staff rotas and staff training and support records, and feedback from people, relatives, and other professionals. We spoke with 5 staff by telephone and received written feedback from 1 staff member.

Updated 8 May 2024

Earls Lodge Care Home is a residential care home providing accommodation for is a residential care home providing personal care to up to 52 people with care and support needs. The service provides support to older people, people with a physical disability and people living with dementia. At the time of our inspection there were 47 people using the service. The home is registered to provide residential and nursing care. However, the provider has taken the decision not to admit people with nursing care needs at present.

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

The provider’s system did not always effectively monitor the quality of care provided to drive improvements. The provider used a range of checks and audits to monitor the safety and quality of the service. However, there were areas of concern that had not been identified. This included shortfalls in the management of safeguarding concerns, in the assessment and management of risk, and in record keeping.

Some recent safeguarding concerns had not been reported appropriately or investigated robustly by the provider, and it was not clear that lessons had been learned or shared in the wider team.

Although, staff knew people well and were aware of risks associated with their care, there were some people whose care records and risk assessments did not adequately reflect their needs.

The provider operated safe recruitment processes and there were enough staff to meet people’s needs. People were supported to receive their medicines safely. People were protected from the risk of infection. People were able to receive visitors without restrictions in line with best practice guidance.

Overall, people were given sufficient food and drink and most people were provided with appropriate mealtime support. The provider made sure staff had the skills, knowledge, and experience to deliver effective care and support. People were referred to health care professionals to support their wellbeing and help them to live healthy lives. The home was well presented and dementia friendly, using signage and colour to help people to find their way around the building. The provider made sure staff had the skills, knowledge and experience to deliver effective care and support. People were referred to health care professionals to support their wellbeing and help them to live healthy lives. The home was well presented and dementia friendly, using signage and colour to help people to find their way around.

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. Staff worked within the principles of the MCA and sought people's consent before providing personal care and assistance. Staff supported people to make their own decisions about their care.

Staff were kind, caring and respectful of people and offered them choices. They explained things well and gained consent for care. We saw lots of positive interactions between staff and people using the service and people responded well to staff. People were supported to maintain relationships and take part in activities they enjoyed. Staff had good awareness, skills and understanding of people’s communication needs, they knew how to facilitate communication with people. Overall, people were supported as individuals, in line with their needs and preferences. Feedback from health care professionals indicated staff worked well with others when end of life care was needed. People’s complaints were listened to, responded to and used to improve the service.

The management team promoted a culture of care in which staff valued and promoted people’s individuality. The provider sought feedback from people, those close to them, staff and other professionals to help improve the service. People and their visitors told us communication with the service was good and there were newsletters and regular residents’ meetings. Feedback was positive from other professionals who visited the service regularly.

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

Rating at last inspection

The last rating for this service was good (published 1 June 2023).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding people and governance. A decision was made for us to undertake a comprehensive inspection, reviewing the key questions of safe, effective, caring, responsive and well-led.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Earls Lodge Care Home on our 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.

Enforcement

We have found breaches of regulation in relation to safe care and treatment and good governance at this inspection.

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