Following a recent inspection of Linda Lodge care home in Sutton, Surrey, the Care Quality Commission (CQC) has rated the service Inadequate overall and has placed it in special measures. It was also rated Inadequate in relation to whether it is safe and well-led and Requires Improvement for its effectiveness and responsiveness.
Linda Lodge is a residential care home providing personal care for up to 26 people aged 65 and over. The service was previously rated Good overall when it was last inspected in December 2018.
The latest inspection was prompted because of concerns received about infection control, staffing and leadership, and people being put at risk of neglect, including malnutrition and dehydration.
At the time of the inspection, which took place on 29 January and 2 February, 15 of the 16 residents at the home had tested positive for COVID-19. The initial focused inspection looked at infection prevention and control measures and whether the service was safe, effective and well-led, as well as some aspects of whether or not it was responsive. This was then widened to look at every aspect of its responsiveness, due to concerns relating to the planning of personalised care.
CQC’s Head of Inspection for Adult Social Care, Neil Cox, said:
“When we inspected Linda Lodge earlier this year, we identified several breaches relating to the safe care and treatment of residents. We also had concerns about the lack of person-centred care, the need to safeguard people from abuse and improper treatment, a lack of good governance, insufficient staffing levels and a lack of appropriate training, as well as the provider’s failure to notify deaths that had taken place.
“As a result, we told the provider that we would take urgent enforcement action unless we received assurance that people were no longer at immediate risk of harm. We will also request an action plan from the provider to understand what they will do to improve the standards of quality and safety.
“The service is now in special measures, which means that it will be kept under review and re-inspected within six months to check for significant improvements.
“For the time being, however, we are satisfied that the local authority is providing the support required to keep people safe. We will continue to monitor the service and work with the provider and the local authority to ensure that improvements are made and fully embedded.”
Inspectors found that the service was not safe for a number of reasons. The most significant of these were:
- There were widespread and serious shortfalls in the prevention and control of infection. Staff did not always use PPE effectively, practice safe social distancing or complete cleaning tasks in line with current guidance. Waste and laundry were not always handled safely. People who tested positive for COVID-19 were not supported to self-isolate effectively
- Systems to access and manage risks in the home and for individuals were not effective. Inspectors had particular concerns about fire safety and pressure ulcers
- Although people's needs were initially assessed, the assessments did not capture enough detail to produce person-centred care plans or ensure the service was able to meet their needs on an ongoing basis
- The provider did not always do enough to ensure people had enough to eat and drink from a choice of varied and nutritious food. Unplanned weight loss was not always followed up promptly
- People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice
- End of life care did not consider all aspects of people's preferences for the support they wished to receive at this time and information about this was not always gathered in good time for staff to be sufficiently prepared to provide personalised end of life care
- The provider did not fully understand their responsibilities and statutory requirements in terms of leadership and governance. They had not told CQC about things they are required to by law, such as deaths of people who used the service
- The provider did not carry out, or had not maintained, a number of important safety and quality checks. They had therefore not identified several of the serious issues found during the inspection or were not aware these were their responsibility
- There were no effective systems in place to follow up and learn from incidents or to safeguard people from abuse and neglect. When things went wrong or problems were identified, the provider did not always follow these up appropriately and there was no evidence of action taken to improve things
Other concerns related to staffing levels, staff training, recruitment systems and record-keeping.
Full details of the inspection are given in the report published online here.
Ends
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