Princess Lodge Care Centre

We assessed 8 quality statements in safe relating to learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risks, safe environments, safe and effective staffing, infection prevention and control (IPC) and medicines optimisation. Staff were able to tell us how to keep people safe from harm and abuse and there was an effective safeguarding process within the service. The service promoted a learning culture following incidents and accidents. People’s risks were managed safely, however, at times, people did not receive care and support at the frequency outlined in their care plan. Some staff told us this was impacted by staffing levels. During our first on-site visit, we identified various health, safety, and IPC concerns, and in some cases, these posed a risk to people living at the service, however, the manager took immediate action to address these. During our second on-site visit, many of these higher risks had been addressed or mitigated, and there were appropriate plans in place to address the remaining risks. People were supported with medicines safely, however we identified some missing documents for some people, such as protocols for ‘as required’ (PRN) medicines. The service was in breach of the legal regulations relating to the premises and equipment.

We assessed 6 quality statements in relation to assessing needs, delivering evidence-based care and treatment, how staff and teams work together, supporting people to live healthier lives, monitoring and improving outcomes and consent to care and treatment. People’s needs were assessed before they moved to the service and people and their relatives were involved in this. There were processes to ensure staff were up to date with people changing needs. We found evidence-based tools were used to assess people’s care needs and staff were aware of these. Relatives gave examples of where people achieved good outcomes, and felt staff monitored people’s needs well. There were processes in place to ensure people were checked regularly, however this did not always take place hourly in line with what the manager told us should happen. Staff, teams and services worked together, however some people felt staff did not always have time to support people with outlined guidance from other health professionals, such as supporting people with exercises suggested from a physiotherapist. Staff asked for people’s consent before supporting them, however, we saw many people had their bedroom doors open which meant that people could see into their rooms. It had not been assessed or recorded whether this was people’s choice or whether this decision was made in people’s best interest, however, people we spoke with did not express this as a concern.

We assessed 2 quality statements in relation to kindness, compassion and dignity, and responding to people’s immediate needs. Staff treated people and their relatives with kindness and compassion. People told us staff promoted their dignity. Staff were responsive to people’s needs, but some people told us they had to wait for support at busy times.

We assessed 3 quality statements relating to freedom to speak up, governance, management and sustainability, and partnerships and communities. There were processes in place to allow people, relatives, and staff to speak up and have their voices heard. There was evidence of the provider liaising with various health professionals to ensure safe care and treatment for people living in the service. Staff provided consistently positive feedback about the management of the service, and people and their relatives described the manager as approachable and communicative. There were governance systems in place to monitor the quality of the service, however, we found that at times these were not always effective and at times this posed a risk to people living at the service. Therefore, the service was in breach of the legal regulations relating to governance.