We carried out a review of the data available to us about Stokeleigh Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Stokeleigh Lodge, you can give feedback on this service.
Stokeleigh Lodge is a residential care home providing accommodation and personal care for up to 15 people. At the time of the inspection there were 15 people living at the home. The home is a converted and extended building with rooms over three floors. There were two communal lounge areas and a dining room in the conservatory. People also have access to a garden area.
People’s experience of using this service and what we found
There had been significant improvements following the inspection of February 2021. We saw positive changes had been made to the home’s infection control procedures. Staffing levels had been reviewed and increased. Quality assurance processes had improved.
People felt safe living in the home, they were protected from abuse and had their risks assessed, planned for and mitigated. There were enough safely recruited staff to meet people's needs. Lessons were learned when things had gone wrong. Medicines were safely managed and stored. Infection control measures were in place to keep people protected. The risks from cross contamination had been reduced due to the effective changes that had been put in place.
Effective quality assurance systems were in place to monitor the quality and safety of care. Audits had improved which helped to identify any shortfalls. There was an open and inclusive culture in the home. The registered manager worked closely with the deputy manager and area manager. The provider had oversight of the home by visiting the home and attending meetings with the area and registered manager.
People and staff felt positive about the registered manager and the management of the home. People and staff were asked for their feedback. The registered manager was aware of their duty of candour. Audits were in place to check people's care and an action plan was in place to continue to improve the home. The home worked in partnership with other organisations.
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 20 March 2021). There were breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an inspection of this service on 15 February 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Stokeleigh Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the home until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Stokeleigh Lodge is a residential care home providing accommodation and personal care for up to 15 people. At the time of the inspection there were 12 people living at the home. The home is a converted and extended building with rooms over three floors. There were two communal lounge areas and a dining room in the conservatory. People also have access to a garden area.
People's experience of using this service and what we found
People were not protected by the homes infection control policy and procedures. Infection control and prevention measures, the cleanliness and repair of the home required improvement. We could not be satisfied staffing levels kept people safe from harm and promoted choice and person-centred care.
Medicines were managed safely, and records were up to date. Processes to safeguard people from abuse were in place and risks, other than infection control and staffing levels, were reviewed and maintained. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people.
Improvements were required to help ensure people were protected from the risk of cross infection. This was because appropriate guidance had not been followed. People were not cared for in a clean, hygienic environment. Monitoring the quality of the service was not always effective.
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. (9 February 2018)
Why we inspected
The inspection was prompted in part due to concerns received about the infection control measures in the home and the lack of domestic hours deployed. A decision was made for us to inspect and examine those areas of risk. 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 coronavirus and other infection outbreaks effectively. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to the service response to infection control measures and ensuring safe levels of staffing. This meant that improvements were required to ensure quality monitoring and management and provider oversight was more effective.
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.
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
People were positive about the care they received, comments included, "the girls are very caring”, “(staff are) nice and kind” and “staff are wonderful, so much attention!”. People reported feeling safe and that staff were always available if they needed them. We observed that people’s needs were met during our inspection and there were enough staff available to keep people safe. We did receive some feedback from staff though that they would prefer more time to be able to carry out activities with people, in particular supporting them to go out from the home.
Staff understood their responsibilities to safeguard people from abuse and had received training to support them to do this. There were risk assessments in place for people to guide staff in provide support in a safe way.
People received support to see healthcare professionals when required. Staff alerted a person’s GP when they were concerned about a person, for example after the person experienced falls. People were mostly positive about the food and meals available and we saw that drinks were available for people in the lounges.
Our observation reflected positive relationships between staff and people. Staff were kind and respectful in their approach and demonstrated concern for people’s wellbeing. People were involved in planning their own care and supported and signed their care plans as evidence of this.
There was a programme of activities in place, although this was flexible according to what people wanted to do. We saw how staff discussed with people what activity they would like. The deputy manager told us about some of the outside organisations they had visiting, such as a specialist organisation providing activities for older people. There was a complaints procedure in place and people told us they felt able to raise issues or concerns if they had them.
The home was well led. There was a manager in place who was going to register with CQC. They were supported by a deputy manager. Staff were mostly positive about the management of the home and felt able to approach them with any issues or concerns.
This inspection took place on 12 May 2015 and was unannounced. Stokeleigh Lodge provides accommodation for up to 15 people who require nursing or personal care. There were 10 people on the day of our inspection. At our last inspection on 8 July 2014 there were no breaches of the legal requirements identified.
There was no 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 and associated Regulations about how the service is run. There was a manager in post but they had not yet submitted an application to register with the Commission at the time of our inspection.
People told us they felt safe living in Stokeleigh Lodge. Staff were aware of their roles and responsibilities to keep people safe and protect them from abuse .There were procedures to follow if staff had any concerns about the safety of people they supported.
Staff were aware of their responsibilities through appropriate training and were aware of the Mental Capacity Act 2005 (MCA) and how to protect people’s rights.. The service had procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards to safeguard people who lacked mental capacity.
Individual risks had been assessed and identified as part of the care planning process. Control measures were in place to manage any risks in a safe and consistent manner. This meant people were supported to take appropriate risks.
People were involved in planning their care and support. Each person had been fully assessed prior to their admission and the information obtained during the assessment formed the basis for the individualised plan of care. People were supported with nutritious meals and plenty to drink in accordance with their plan of care.
Staff were given sufficient information in each care plan to provide people with the appropriate level of care. All care plans were kept under review in order that changes could be acted upon as soon as they were noted. Procedures in relation to recruitment of staff were robust and ensured only suitable people were employed.
People needs were assessed before they started to use the service. Care records were personalised and identified people’s personal preferences about how they liked their care and support to be delivered. People were supported to use health care services and where people had existing health conditions they were supported to manage these. There were suitable arrangements in place to manage medicines safely.
There were adequate numbers of skilled and experienced staff on duty to provide good levels of care and support. Staff completed training in line with the needs of people living in the home and they were well supported through supervision and appraisal. This ensured staff had the appropriate skills and knowledge to carry out their role effectively.
There were positive interactions between staff and the people they supported. Staff had a good understanding of both people’s care and support needs and their individual preferences. People were listened to and encouraged to express their views about their care and support. People attended regular ‘residents’ meetings and feedback was given about what action had been taken following any suggestions for improvement.
People were given choices about how they wanted to spend their time during the day. A programme of activities was arranged on daily basis. People were encouraged to maintain as much of their independence as much as possible. Complaints were dealt with appropriately and in accordance with the complaints procedure.
Systems were in place to monitor the quality of service. Internal quality audits were carried out to check on the quality of care and record keeping. The management worked with staff to promote personal development and provide training suitable for their job roles.
We visited the home on 8 July 2014 to check evidence of how they have ensured that they were meeting the regulation for these outcomes.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
When we inspected the home on 4 April 2014 we found that people were not protected from the risk of infection because appropriate guidance had not been followed. We observed that the kitchen environment was not clean. This meant that there was a risk of cross contamination of food being prepared for the people who used the service.
At this inspection we observed the kitchen floor was clean with no collection of dust and scum around the skirting boards and between the cupboards in the kitchen. This showed that the risk of cross contamination of food prepared for the people who lived in the home had been eliminated and the environment was now safe and hygienic.
We found that the provider had installed a new bath. This was to ensure that people who used the service were comfortable and safe while supported for personal care. We also saw that a new shower had been installed and the additional one had been refurbished. This provided additional facilities for personal care for people who preferred to have a shower. We asked one person what difference the new shower had made in regards to their personal care and they told us 'I am happier'.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People told us they felt safe with staff. People told us that staff treated them with respect and maintained their privacy. One person told us 'staff are very good, they respect what I say'.
We saw that systems were in place to make sure that the manager and staff learned from events such as accidents and incident. We saw that accidents were recorded and action taken to reduce accidents from happening. We saw that a contingency plan was in place to deal with any foreseeable emergencies. This helped to reduce the risks to people and helped to keep people safe.
We saw some parts of the home were unclean and unhygienic. We found the cleaning schedule was not robust to maintain satisfactory level of cleanliness in the home. We saw two pieces of equipment within the environment were not well maintained. Therefore this was putting people from risk of harm. We have asked the provider to tell us what they are going to do to meet the requirements of law in relation maintaining a clean environment and equipment in order to keep people safe.
We saw that home had an effective recruitment policy to make sure that only the right people were employed. This ensured that people were protected from unsafe care.
People knew how to make a complaint if they were unhappy. One person told us, "I will talk to the manager who if I am concerned about anything". Another person said 'I have no complaints.
People can be assured that complaints were investigated and action taken as necessary. We saw one complaint was investigated and action was taken to redress the issue.
Is the service effective?
People's health and care needs were assessed in relation to dietary, mobility and care plans were in place to ensure that peoples' needs were met. People said that they were involved in planning their care and that the plans reflected their current needs.
Is the service caring?
People told us staff respected their dignity and privacy. We saw staff knocked on each person's door and asked their permission before they entered the room. People we spoke with told us they were able to choose what they wanted to do during the day.
People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People comments included 'the staff are kind and caring. They help me to wash and dress. The girls let me do things for myself because I like to remain independent. I go to bed and wake up when I want to. A relative said, 'I visit my relative every day and the staff are very caring. They look after them so well'.
People using the service, their relatives completed an annual satisfaction survey. This was to make sure that they were satisfied with the service and improvements made were necessary.
Is the service responsive?
People completed a range of activities in and outside the service regularly. The people told us that the activities outside the service helped them to remain connected and involved to the community. They said it helped them to do something different from the usual routine. For example, we saw a group of people visiting the museum.
We saw that people's needs were assessed and care plans were in place to make sure that their needs were met. The care records we looked at contained assessments of any risks that had been identified to the person who received the service. Risk management plans had been put in place so that risk to the people who used the service were reduced.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. This ensured that people who had no capacity to make their own decisions were supported with best interest decision to protect their right. Staff have also received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
People had detailed records in regards to visits from the healthcare professionals. This included GPs, opticians, dentists and district nurses. This demonstrated people were supported to access a range of healthcare professionals.
Is the service well-led?
We saw that the service had quality assurance system to check and monitor if people were satisfied with the care they received. For example, we saw that audits in relation to medication and the care plans were carried out. This was to make sure that if concerns were identified, they were dealt with promptly. Staff were clear of their roles and responsibilities. This helped to ensure that people received a good quality service at all times.
Another comment was: "I like it here, the girls are very respectful' and "I think this place is very good. They (the staff) ask all the time if we are happy. They seem to know what I want them to do without asking and know how to help me. I like my room the sun comes through, I can look out of the window and watch the birds and see what is going on."
We found that staff at Stokeleigh Lodge treated people who used the service with respect and maintained their independence. The standard of care was generally good, and when problems occurred action was taken swiftly to deal with the cause.
We found that people who used the service were protected because the staff were well trained to deal with issues of safeguarding and abuse.
We looked at a recent recruitment process and found that Stokeleigh Lodge had followed all the necessary steps to ensure that competent staff of good character were recruited.
We found that Stokeleigh Lodge had good systems in place to monitor quality and to address any issues that were identified.
For this inspection we did not involve people using the service.
People told us that they experienced good care at the home that staff always asked for their consent before providing them with care or treatment. People told us that staff knocked on door before going in to support them with personal care. People said that they had choice to refuse any treatment or care and that their wishes were respected.
People said they were involved in planning their care and confirmed agreement with their care plan. People told us that they were registered with a General Practitioner (GP) and that the doctor came to see them when they felt unwell.
We observed staff talking to people about their care in a dignified and informal way. We observed staff supporting people who had mobility needs in a sensitive manner allowing them to walk at their own pace
People told us that they had a choice of what to eat, where to eat and when to eat. They said that they had a variety of meals every day. People said that snacks and drinks were available throughout the day and at night.
We observed staff serving a variety of drinks at different times during our visit. We saw that people who used services had a choice of two meals at lunch time and staff were serving people with respect and in a dignified manner.
People said they knew that their information was kept safe and confidential.
People said that staff were good and polite. They told us that they knew who to talk to if they had any concerns. They said they had not experienced any form of abuse.
We observed that the home was clean and there were no unpleasant odours. We saw that hand gel was positioned in different places in the home for people who used services, staff and visitors to reduce risk of infection
People told us that they had confidence that their records were kept safe. They said that they had access to their records whenever they wanted to and that they had no complaints.
One individual represented the view of many people living in the home when the person said "Because the home is small care is very personal. Staff are very kind, loyal and very caring. We call them friends not staff".
We spoke with three relatives during our visit. They told us that they were satisfied with the care their relatives were receiving. The relatives told us that they staff were kind and caring. They said they were treated well whenever they visited. One relative said 'It is like an extended family.