Derwent Lodge Nursing Home, New Ferry, Wirral.Derwent Lodge Nursing Home in New Ferry, Wirral is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, diagnostic and screening procedures and treatment of disease, disorder or injury. The last inspection date here was 21st November 2019 Contact Details:
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28th March 2019 - During a routine inspection
About the service: Derwent Lodge Nursing Home is a care home registered to provided personal and nursing care to up to 46 people. At the time of our inspection there were 34 people living at the home. People’s experience of using this service: People told us they felt safe living at the home. However, medicines were not administered, stored or recorded safely and in line with the relevant national guidance and best practice. The safety and security of the premises of the home was not maintained. Staff were not always safely recruited by the home and we received consistent feedback from people living at the home and their relatives that there was not enough staff and they sometimes waited long periods of time for assistance. The home did not always act in line with principles of The Mental Capacity Act 2005. This meant there was risk inappropriate decisions could be made on a person’s behalf if they lacked capacity to make the decision for themselves. People were supported to have enough to eat and drink and the feedback about the food and drink at the home was generally positive. The atmosphere and appearance of the home was comfortable, homely and clean but additional environmental adaptations could be made to better support people living with dementia. People and their relatives gave us positive feedback about the staff at the home. Staff respected people’s privacy and treated them with dignity and respect. People’s care plans were informative, regularly reviewed and reflected their needs. People and their relatives told us they felt comfortable raising any concerns if necessary and we saw that complaints were managed appropriately by the manager. There was a positive and caring culture at the home led by the manager and we saw some examples of good leadership and governance. However, the home did not have robust and effective systems in place to monitor, assess and improve the safety and quality of service being provided. This was also the second consecutive time we have rated the service as requires improvement. During this inspection we identified continued breaches of Regulations 11, 12 and 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was also an additional breach of Regulation 19. Rating at last inspection: At the last inspection the service was rated requires improvement (13 February 2018). During the last inspection we found breaches of Regulations 11, 12 and 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Why we inspected: This was a planned inspection based on the previous rating. Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner. For more details, please see the full report which is on the CQC website at www.cqc.org.uk
10th January 2018 - During a routine inspection
The inspection took place on 10 and 15 January 2018 and was unannounced on the first day. At our last inspection of Derwent Lodge on 29 October 2015 we found that the service was good overall, however improvements were needed to the quality auditing systems and to record keeping in general. Derwent Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Derwent Lodge accommodates up to 46 people in a purpose-built building and there were 37 people living there when we visited. The service is required to have a registered manager. 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 2008 and associated Regulations about how the service is run. The home had a registered manager. During our inspection we found breaches of Regulations 11, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people had not always received their medication as prescribed; the requirements of the Mental Capacity Act 2005 were not fully met to ensure that people who lacked capacity to make decisions received the protection they required; the provider had not implemented effective systems to monitor the quality of the service provided. All of the people we spoke with believed the home was safe and said they were happy living at Derwent Lodge. There were enough staff to meet people’s needs. Regular checks of services and equipment were carried out by the home’s maintenance person and utilities and equipment were checked and serviced as required by external contractors. A log of accidents and incidents was maintained and showed that appropriate action had been taken when accidents occurred. Staff received annual training about safeguarding and the manager had reported safeguarding incidents as required. People were generally satisfied with their meals and special dietary needs were identified and catered for. People received the support they needed to eat their meal. The care notes we looked at contained malnutrition risk assessments that were updated monthly. We saw evidence that people at risk were referred to a dietician. Staff received regular training and supervision, however the Care Certificate had not been implemented for new staff. A number of people were being looked after in bed and equipment had been provided to meet their needs. Improvements were needed to some parts of the building, including two shower rooms that were out of use awaiting repair. People who lived at the home told us that staff treated them with respect and respected their choices and independence. Relatives we spoke with were very happy with the care their loved ones received. They could visit at any time and we observed that they were comfortable to speak with the manager and the nurses. We looked at the care files for three people. These showed that people’s care and support needs were assessed before they went to live at the home to ensure that the service would be able to meet the person's individual needs. The care plans contained basic relevant information including nutritional assessments and eating and drinking care plans, falls risk assessments and moving and handling plans, personal hygiene care plans and sleep care plans. These had been updated monthly. There was a weekly programme of varied social activities. People we spoke with said they would be happy to approach the manager with any complaints. The complaints procedure displayed advised people who they could contact with any complaints. We saw that the manager had kept detailed records of complaints that she had received and the records s
29th October 2015 - During a routine inspection
The inspection took place on 29 October 2015 and was unannounced. The home is a purpose-built, two-storey property set in its own grounds in a residential area. There were bedrooms on each floor, some of which had en-suite toilet and wash basin. Communal areas were all on the ground floor.
The service is registered to provide accommodation and nursing or personal care for up to 46 people and 41 people were living there when we visited. The people accommodated were older people who required 24 hour support from staff.
The home had a manager who was registered with the Care Quality Commission. 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 2008 and associated Regulations about how the service is run.
People we spoke with said they felt safe living at Derwent Lodge. All staff had received training about safeguarding and this was updated every year. There were enough qualified and experienced staff to meet people’s needs and keep them safe. The required checks had been carried out when new staff were recruited.
The members of staff we spoke with had good knowledge of the support needs of the people who lived at the home and had attended relevant training. The staff we met had a cheerful and caring manner and they treated people with respect. Visitors who we spoke with expressed their satisfaction with the care provided.
We found that the home was adequately maintained and records we looked at showed that the required health and safety checks were carried out. We found that medicines were generally managed safely and records confirmed that people always received the medication prescribed by their doctor.
People we spoke with confirmed that they had choices in all aspects of daily living. They were happy with the standard of their meals and the social activities provided.
People were registered with local GP practices and had visits from health practitioners as needed. The care plans we looked at gave details of people’s care needs and how their needs were met, however a new care plan format was being introduced which was designed to improve the recording of information about the person’s life and their preferences.
There was a friendly, open and inclusive culture in the home and people we met during our visits spoke highly of the home manager. Quality audits were not completed consistently and we found other areas where the standard of record keeping required improvement.
31st December 2014 - During an inspection to make sure that the improvements required had been made
We carried out this visit to check whether safe recruitment practices were followed and whether staff were suitably trained and supported to meet the needs of the people who used the service. During our visit we did not speak with people who lived at the home. We spoke with the registered manager and checked staff records. Below is a summary of what we found. Is the service safe? Records we looked at showed that the correct procedures had been followed to ensure that new staff were safe and suitable to work with vulnerable older people. Is the service effective? Records we looked at showed that people were cared for by staff who were trained and supported to deliver care and treatment safely and to an appropriate standard.
28th July 2014 - During a routine inspection
One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. Is the service safe? The premises had been adequately maintained to provide a suitable home for people to live in. Effective recruitment procedures had not always been followed when employing new staff to check that they were of good character. Records showed that staff received regular training, supervision and appraisal to ensure that they knew how to work safely. Is the service effective? People told us that they were happy with the care and their needs were met. Staff had a good understanding of people's care and support needs. A person who lived at the home said: “I’m fine. They look after you well, they are all very good.” And another person told us: “The help here is very good.” Is the service caring? Staff were kind and patient to the people who lived at the home and we observed positive interaction between staff, visitors and people who lived at the home. A relative told us: “They are angels. They could not look after my mother any better if she was their own mother.” Is the service responsive? People's needs were assessed before they moved into the home. Care plans recorded people's personal preferences and interests, and care was provided in accordance with people's wishes. People were asked to give their views of the service. Is the service well led? The manager was an experienced registered nurse and was registered with CQC. A deputy manager had recently been appointed and there were four senior care staff. An operations manager provided support in all areas of the service.
13th November 2013 - During a routine inspection
We spoke to three people who lived at the home and one relative about the care provided. People and the relative we spoke with said the care was good and they were well looked after. People said consent was always sought prior to any care being given and that they were given a choice in how they lived their lives at the home. We saw people’s needs were assessed and regularly reviewed. Care records were personalised, contained information about a person’s individual needs and preferences and promoted the person’s independence where possible. We reviewed the safeguarding arrangements at the home. We saw staff had received appropriate training in safeguarding and were knowledgeable about types of abuse and who to report concerns to. We found staff treated people kindly and supported them at their own pace. We saw during lunchtime however that the number of staff on duty was insufficient to meet people’s needs. People and staff said at times there were not enough staff on duty. We saw staff had received appropriate training to care for people but they had not had an appraisal or received adequate supervision. This meant staff had not received appropriate support in respect of their job role. People/relatives we spoke with said they had no complaints but they would know how to make a complaint if they needed to do so. We saw the provider had the complaints policy displayed in the home and that the manager had responded appropriately to any complaints made.
12th September 2012 - During an inspection to make sure that the improvements required had been made
When we last visited Derwent Lodge in May 2012, we had some concerns about how medicines were handled, recorded and administered. The manager sent us an action plan as to how the home was going to become compliant with the regulations. We carried out this inspection on the 12 September 2012 to check the compliance actions had been met. We found significant improvements in the systems for the storage, ordering, administering, safekeeping, reviewing and disposing of medicines. However we still had some minor concerns as not all the nurses were following the correct procedures.
10th August 2012 - During an inspection in response to concerns
We carried out this inspection in response to concerns we had received about people being woken up too early. We arrived early in the morning and found these concerns to be unsubstantiated. We spoke with three people who use the service and two relatives. Three people who used the service told us they were given choices in what they wanted to do and this included what time they liked to be woken up in the morning. The relatives we spoke with said they had never had any concerns or issues about the care provided and we saw evidence to show people were included in their care planning process. One person told us they “couldn’t fault anything about the home” another said, “The care my mother receives is fantastic.” All the people we spoke with said they felt safe at the home and we witnessed call bells being answered promptly throughout the duration of our visit. We saw evidence to show there were robust recruitment processes in place and staff received induction training to provide them with the necessary skills to care for people. The manager had only been in post for six weeks but all staff we spoke with felt supported by her and told us that they could go to her if they had any concerns. We saw evidence that quality assurance processes were being developed to maintain the quality of care people received.
24th May 2012 - During an inspection in response to concerns
Although we talked with some people living in Derwent Lodge, they did not know what medicines they were prescribed which meant it was difficult for us to gain people’s views on the care they received.
5th January 2012 - During a routine inspection
As part of the planning and site visit we spoke to a range of people about the service. Those we spoke to included, the manager, people who live at the home, staff and visiting relatives. We also had responses from external agencies such as social services in order to gain a balanced overview of what people experience living at Derwent Lodge Nursing Home. The staff had a good awareness of individual care needs and the importance of treating people with respect and dignity. We observed this during our visit with the care and attention staff were giving residents due to their nursing needs. One staff member said, “It is important when people need a lot of care and nursing it is done in a dignified way.” A relative spoken to said, “They are so aware of what mum requires it is really comforting.” Comments from people living at the home about the care, experiences and support they receive were all positive, they included, "The staff are all caring, fantastic people." Also, "Definitely no complaints I feel well cared for.” The staff we spoke to said to us this is a good care home to work for and staff felt supported in carrying out their roles. One staff member said, "Since the changes things have got a lot better in relation to the environment, attitudes towards residents and management support.” We received information from Liverpool council's contracts monitoring team who told us they currently had no issues with the service in relation to care practices. The manager told us of the improvements made to the building in terms of redecoration and new furnishings. We confirmed this through a tour of the premises. One relative spoken to about the building said, “It has come on leaps and bounds the place looks really nice now.” The manager said, “We still have a continued plan of refurbishment which will be completed.”
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