About the service:

Godden Lodge Care Home provides accommodation, personal care and nursing care for up to 133 older people. Some people have dementia related needs and some people require palliative and end of life care. The service consists of four houses: Victoria House, Cephas House, Boyce House and Murrelle House.

People’s experience of using this service:

Not all people felt well cared for or treated with dignity and respect. Staff routines and preferences took priority over consistent care and meeting people’s preferences and wishes.

People were not routinely supported to take part in social activities, relevant to their interests, preferences or needs. There were insufficient activity coordinators available to facilitate activities.

People’s comments about staffing levels were variable. The service did not always ensure there were enough staff with the right skills and experience to support people. This was because there was high agency usage across the service. Staff did not always have the time to give people the care and support they needed. Staff regularly felt stretched, and the focus was on completing tasks rather than on providing person-centred care and support.

Information about risks to people’s safety was not consistently identified and recorded. Some staff practices placed people at potential risk of harm. Medicine practices did not ensure the service followed relevant national guidelines. People did not always receive their medicines as prescribed.

People were not always protected by the service’s prevention and control of infection procedures as the premises were not as clean and hygienic as they should be.

Staff training was not designed around the care and support needs of people who use the service. Training was not embedded in staff’s everyday practice. Staff supervision and support was not consistent, and improvements were required.

• Care records were not always accurate, up-to-date or followed by staff. People were not always involved in decisions about their care and support. People’s end of life care needs were not clearly documented.

People stated they were safe and supported to eat and drink enough. People’s healthcare needs were monitored, and they received access to healthcare services. Consent to care was always sought and people’s capacity to make decisions assessed.

People, relatives and staff did not feel the service was always well-led. Governance and performance management arrangements were not always reliable or effective.

Rating at last inspection:

Following the last inspection, the rating of the service was ‘Good’ (Last report published October 2017).

Why we inspected:

This was a planned inspection based on the rating at the last inspection of ‘Good’.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as outlined in our inspection programme and schedule. 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

Although the service was newly registered on 31 January 2017 the service provider remained the same and there were no changes to the overall management of the service. Therefore we have made reference to our previous inspection to the service in June 2016. The last inspection was undertaken on 7, 8 and 9 June 2016. Though the overall rating of the service at that time was judged to be ‘Requires Improvement’ no regulatory breaches were identified. This inspection was completed on 24, 25 and 26 July 2017 and we found the improvements made at the last inspection had been sustained. Further advances had been made to improve the quality of the service.

Godden Lodge Care Home provides accommodation, personal care and nursing care for up to 133 older people. Some people have dementia related needs and some people require palliative and end of life care. The service consists of four houses: Victoria House, Cephas House, Boyce House and Murrelle House. At the time of this inspection there were 98 people living at the service and across the site.

A registered manager was 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 2008 and associated Regulations about how the service is run.

People told us the service was a safe place to live. Although people’s comments about staffing levels were variable, the deployment of staff was generally seen to be appropriate. However, improvements were needed to ensure that staffing levels were reviewed and staffs practice was person-centred rather than service-led.

Systems were in place which safeguarded people from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to. Staff followed safe procedures when giving people their medicines. Appropriate arrangements were in place to recruit staff safely so as to ensure they were the right people.

Care records for people centred on the individual and provided sufficient information relating to their care and support needs and how these were to be delivered by staff. Relatives confirmed they were given the opportunity to be involved in the assessment and planning of their family member’s care. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Staff demonstrated a good understanding and knowledge of people’s specific support needs, so as to ensure theirs’ and others’ safety.

Staff understood and had a good knowledge of the Deprivation of Liberty Safeguards [DoLS] and the key requirements of the Mental Capacity Act [2005]. Arrangements had been made to ensure that people’s rights and freedoms were not restricted. People were routinely asked to give their consent to their care, treatment and support. People’s capacity to make day-to-day decisions had been considered, assessed and respected?

The dining experience for people was positive. Consideration by staff had been given to ensure that eating and drinking was an important part of people’s daily life and treated as a social occasion. People’s healthcare needs were managed well and relatives confirmed they were kept up to date with interventions and outcomes for their member of family. People received care and support that was kind and caring. People were mostly treated with respect and dignity.

Quality assurance checks and audits carried out by the registered provider and the management team of the service were in place and had been completed at regular intervals in line with the provider’s schedule of completion. The registered provider and management team of the service were able to demonstrate an understanding and awareness of the importance of having good quality assurance processes in place. Feedback from people using the service, those acting on their behalf and staff were