13 May 2015
During a routine inspection
The inspection took place on 13 May 2015 and was unannounced.
Argentum Lodge is a care home providing accommodation for up to 56 people who require nursing and personal care. During our inspection there were 47 people living at the home. The home is set out over three floors and provides support to older people living with dementia.
There was a registered manager in post at the service. 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.
People and their relatives told us they were happy with the care they or their relative received at Argentum Lodge. One person told us “I trust staff, I am very comfortable and safe” and a relative told us “I am more than happy with the care, as far as safety goes”.
People’s medicines were administered safely. The service had appropriate systems in place to ensure medicines were stored correctly and securely. One person told us “The nurse gives me my tablets, I trust them, I don’t think about it I just take them”. Systems were in place to protect people from harm and abuse and staff knew how to follow them. The environment was safe, clean and well maintained.
There were recruitment procedures in place to ensure only staff with suitable character were employed by the organisation. We found the recruitment procedure was not always followed robustly. There were sufficient numbers of staff available to meet people’s needs.
We found people’s rights were not fully protected as the registered manager had not followed correct procedures where people lacked capacity to make decisions for themselves. We observed where decisions were made for people the principles of the Mental Capacity Act 2005 were not always followed. Mental capacity assessments were not completed and where decisions had been made there was no evidence it was in the person’s best interest.
Staff received appropriate training to understand their role and they completed training to ensure the care and support provided to people was safe. New members of staff received an induction which included shadowing experienced staff before working independently. Most of the staff felt well supported, but one staff member told us they had not been given the option to discuss their work or role in the home.
People and their relatives told us they were happy with the care they or their relative received at Argentum Lodge. One person told us “The staff are very kind” and a relative told us “ Staff are very caring, they know and treat my relative as an individual ”.
People’s needs were set out in individual care plans. The care plans were regularly reviewed and updated by staff; however people were not involved in these reviews. People’s relatives told us they were involved in the care planning process for their family member and they thought the care plan reflected their relative’s needs. People told us they were able to make everyday decisions about their care and how they liked to spend their time and live their lives. The home offered a range of activities to ensure people received social and mental stimulation.
The provider had a complaints policy in place and people and their relatives were confident they could raise concerns or complaints and they would be listened to. The provider did not have a system in place to collate and review feedback from people and their relatives to guage their satisfaction and make improvements to the service.
The registered manager had systems in place to monitor the quality of the service provided. Audits covered a number of different areas such as incidents, infection control and health and safety. The audits did not always identify where there were shortfalls in the service.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.