CQC report explained · a residential care home
What the CQC found at Abbegale Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines were managed safely, staff were recruited after appropriate checks, and environmental safety checks were being completed. Staffing had increased after the previous inspection, and the home was working to reduce the risk of falls.
- Effective?
- Requires improvement
- Staff had training, supervision and appraisals, and Mental Capacity Act processes had improved. However, there was no specific training for staff supporting people with complex mental health needs, and some areas needed further improvement to their décor.
- Caring?
- Good
- Inspectors saw kind and familiar interactions. Staff knew people well, respected privacy and involved people in their care plans where possible.
- Responsive?
- Good
- Care was based on people's needs, wishes and backgrounds. Complaints were recorded and responded to, and people were supported with healthcare, activities, equality needs and end of life care.
- Well-led?
- Good
- The home had a registered manager and staff said it had improved. Audits, meetings and feedback systems were being used to identify and act on improvements.
What inspectors found, September 2018
Rated Good overall; inspectors found safe, kind and responsive care, but effectiveness Requires Improvement because staff lacked specific training for complex mental health needs.
This was an unannounced inspection on 16 August 2018. Inspectors spoke with people living at the home, a relative, staff and the manager. They reviewed care plans, staff recruitment records, medicines and other documents.
The home was rated Good for safety, caring, responsiveness and leadership. Inspectors found that medicines, staff recruitment, safeguarding and risk checks were managed well. They saw kind interactions and care plans that reflected people's needs, choices and backgrounds.
The Effective rating was Requires Improvement. Staff had general training, but there was no specific training for people with complex mental health needs. Some areas of the building also needed more attention. The previous breach about safety checks had been corrected, and the earlier concerns about leadership systems and capacity records had improved.
Improved safety checks
Checks on the building and equipment were being completed and recorded. The previous safety breach had been corrected.
“Additional environment checks were well recorded and took place when they needed to, such as weekly checks on fire alarms and daily checks on fire exits and door closures.” from the report
Kind staff
Inspectors saw caring interactions and found that staff knew people's preferences and needs. People said staff were kind.
“We observed kind and caring interactions between staff and people who lived at the home.” from the report
Person-centred care
Care plans included people's health needs, life stories, choices and preferred ways of receiving support.
“There were positive examples of person centred information in people's care plans.” from the report
Better leadership systems
The manager and provider had introduced audits and action tracking. Staff said the home had improved and that concerns could be raised.
“Quality assurance systems had improved, and regular checks were being completed by the manager and the provider.” from the report
Some areas needed further improvement
minorThe home had been refurbished in places, but some areas, including the dementia section, needed more attention to décor and orientation.
“The home was in the process of being redecorated, some areas of the home would benefit from further attention with regards to décor.” from the report
More activities were planned
minorPeople had activities and entertainment, but the manager recognised that there were not enough activities and was recruiting an activities co-ordinator.
“The registered manager had identified that not enough activities were taking place for people and was in the process of recruiting a full time activities co-ordinator” from the report
- 01What specific training have staff completed for supporting people with complex mental health needs, and when was it completed?
- 02What further work has been done in the dementia area to help people find their way around?
- 03Has a full-time activities co-ordinator been appointed, and what activities are now available?
- 04How are falls monitored and what changes are made when patterns of falls are identified?
- 05How will you involve my relative and family in reviewing their care plan?
This was an unannounced comprehensive inspection covering all five key questions and checking progress since the May 2017 inspection. This explanation was written from the published report of 22 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2017
Rated Requires Improvement; inspectors found kind, personalised care, but safety checks, capacity records and oversight needed improvement.
This was an unannounced inspection on 15 and 26 May 2017. Inspectors spoke with people living at the home, visitors and staff. They reviewed care plans, recruitment files, medicines information and records about running the home.
The home was rated Good for Caring and Responsive. Inspectors saw kind interactions, staff who knew people well, personalised care plans and a clear complaints process. People said staff were kind and that they felt safe.
The home was rated Requires Improvement for Safe, Effective and Well-led. Some hot water checks and legionella actions were not recorded or dealt with properly. Care records did not always match the findings about people's ability to make decisions. Staffing responses were mixed, and quality checks had missed some of these problems.
The provider was told to improve safe care and treatment. The report says some issues were dealt with during or after the inspection, and CQC would check that the required action was taken.
Kind relationships
Inspectors saw staff treating people kindly and discreetly. People and visitors described staff as caring, and staff showed a good knowledge of individuals.
“We observed kind and familiar interactions between staff and people who lived at the home which confirmed that staff knew people very well.” from the report
Personalised support
Care plans included people's likes, dislikes, routines and preferred names. People could choose aspects of their daily care, including when to bathe or shower.
“Care plans were personalised and encompassed the individual needs of each person living at the home.” from the report
Medicines management
Medicines were stored securely, records were completed correctly and stock checks were carried out.
“We noted that the MAR charts had been completed correctly and in full.” from the report
Safeguarding awareness
Staff knew how to recognise and report abuse. They had safeguarding training and could explain how to raise concerns.
“Staff had received training in the principles of safeguarding but also the practicalities of how to raise an alert with local safeguarding teams.” from the report
Unsafe maintenance checks
seriousSome hot water temperatures were above the recommended level, creating a possible scalding risk. Legionella risk assessment actions had not been properly recorded as complete.
“Some maintenance checks in the home were not being completed accurately.” from the report
Incomplete capacity records
needs fixingSome care plans did not match mental capacity assessments or show that best-interest processes had been followed. Inspectors recommended that the provider improve its approach.
“there was some inconsistent information in people's care plans relating to the MCA and best interests, which needed further clarification.” from the report
Staffing pressure
needs fixingAlthough inspectors observed staff supporting people safely, some staff said they were often short-handed and felt under pressure. The provider was asked to review how staffing levels were decided.
“However, staff told us they were often short and felt pressure to ensure everyone's needs were met.” from the report
Audits missed problems
needs fixingThe home's checks did not identify the water temperature, legionella or mental capacity issues found during the inspection.
“these auditing systems were in place they had failed to highlight some of the issues we found during our inspection” from the report
- 01What evidence can you show that the hot water temperatures in the Lodge are now checked and kept safe?
- 02Has the legionella risk assessment been repeated, and have all actions been recorded as complete?
- 03How do you now make sure mental capacity assessments, care plans and best-interest decisions agree with each other?
- 04How do you decide how many staff are needed at busy times and at night?
- 05What has changed in the quality assurance process so that safety problems are identified promptly?
This was an unannounced inspection covering all five key questions, based on visits on 15 and 26 May 2017 and reviews of care, staffing and management records. This explanation was written from the published report of 12 July 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Abbegale Lodge
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016
Registered with the Care Quality Commission on 5 May 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
38 live-in carers within about an hour of Sefton
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,270 a week. 34 can care for a couple. 11 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.