The Care Quality Commission (CQC) has again rated Stonedale Lodge in Croxteth, Liverpool, inadequate, and taken further action to protect people following an inspection in November.
Stonedale Lodge Care Home, run by Advinia Care Homes Limited, provides personal and nursing care to up to 150 older people, including those living with dementia.
This unannounced inspection was to follow up on the progress of improvements Stonedale Lodge were told to make at their previous inspection as well as to assess further emerging risks from CQC’s regular monitoring, such as the home not having a registered manager which is a legal requirement.
Following the inspection, the home has been rated as inadequate overall again, as well as for how well-led it is. How caring the service is has declined from requires improvement to inadequate. Effective and responsive weren’t inspected so remain rated requires improvement from their previous inspection.
Inspectors identified four breaches of regulation relating to person-centred care, safe care and treatment, safeguarding, and how well the service was being managed.
The service remains in special measures and CQC has begun the process of taking regulatory action to address the concerns if they don’t make rapid and widespread improvements. Advinia Care Homes Limited has the right to appeal.
Karen Knapton, CQC deputy director of operations in the north, said:
“It’s disappointing that despite our previous inspection of Stonedale Lodge highlighting exactly where improvements were needed, leaders had not done this, and in fact we found areas of deterioration. Inconsistent management had left staff directionless and unable to safeguard people from abuse or provide caring, and person-centred support.
“It was extremely worrying that without consistent leadership, staff weren’t always safeguarding people from the potential risk of abuse. Relatives told us about their loved ones belongings going missing. Stonedale’s own processes highlighted concerns around this and people’s finances, but this wasn’t investigated or referred onto other relevant agencies for investigation at the time of the inspection.
“People told us they didn’t always feel safe at the home, and both leaders and staff failed to recognise potential safeguarding concerns exposing people to the risk of neglect and abuse. This was reflected in what relatives told us about them not being informed about incidents that had ended up with people in hospital or sustaining an injury.
“Stonedale’s communication with people, as well as acting on their feedback was also poor. Relatives told us they frequently heard important information about their loved one from outside agencies, such as hospitals or the local authority rather than the home. The home also didn’t always act on feedback such as concerns about people’s finances and unfulfilled equipment needs putting people at risk.
“Staff weren’t managing risks to people’s health and safety well. For example, incorrectly fitted bedrail protectors, and not responding to call bells when people were in pain and distressed.
“Staff weren’t managing or documenting people’s basic care needs properly either. They were putting people at risk of choking by not recording the food consistency of people on modified diets. There were also gaps in documentation for people with other specific dietary needs such as diabetes, so there was no way of knowing whether their conditions were being managed safely.
“We have told leaders where we expect to see immediate and widespread improvements, we’ll be monitoring Stonedale Lodge closely during this time to keep people safe while this happens. CQC has begun the process of taking regulatory action, which Advinia Care Homes Limited has the right to appeal."
Inspectors found:
- Safeguarding records lacked information about the immediate action taken to keep people safe.
- Equipment was not always suitable or used safely.
- Staff didn’t always store, record or administer medicines safely.
- Staff failed to respond to call bells for people who occupied their bedrooms and were experiencing pain and discomfort.
- Garden areas people accessed were unsafe and unclean, with discarded cigarette butts, incontinence pads and used personal protective equipment scattered around.
- Leaders didn’t ensure accident and incident records had enough detail and there was no evidence that incidents were being learned from to prevent them happening again.
- Staff failed to always escalate concerns about people’s health, safety and wellbeing to other partners.
- People’s care wasn’t always dignified, staff routinely used the bedroom of one person unable to consent, to provide hair care to other people and to store communal hairdressing equipment.
However:
- Inspectors saw staff using effective techniques to comfort and reassure people when they were anxious and upset.
- Infection outbreaks were safely managed in line with guidance set out by the community infection, prevention and control team.