CQC report explained · a residential care home
What the CQC found at Abbey Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff understood safeguarding and people's risks. Inspectors found medicines were handled safely, accidents were reviewed and there were enough staff.
- Effective?
- Good
- Staff had improved training and supervision and understood consent and legal safeguards. People received suitable food, drink and access to health professionals.
- Caring?
- Good
- People described staff as kind and caring. Staff respected privacy and dignity and supported relationships, independence and personal choices.
- Responsive?
- Good
- Care was personalised and staff knew people's needs well. Activities were tailored to individual interests, and complaints were responded to appropriately.
- Well-led?
- Requires improvement
- Management and quality checks had improved, but some records were inaccurate or out of date. The service had not clearly set out how it would meet the needs of people with a learning disability.
What inspectors found, March 2019
Rated Good overall; inspectors found safe, kind and personalised care, but the well-led rating Requires Improvement because some records were not reliable.
Inspectors visited on 17 and 22 January 2019. The first visit was unannounced. They spoke with people, relatives, staff and health professionals, observed care and meals, and checked care records, medicines, staff files and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safer medicines practice, improved staff training, respectful care and activities suited to people's interests and needs.
The well-led rating was Requires Improvement. Some care and medicines records were not accurate or up to date. The home also had not clearly explained how it would meet the needs of people with a learning disability.
The previous three inspections had rated the home Requires Improvement. Inspectors said earlier breaches had been addressed at this inspection, but further work was needed to make record keeping consistent.
Safe medicines
Staff were trained and checked as competent before giving medicines. There was guidance for medicines given only when needed.
“People received their prescribed medicines safely.” from the report
Improved staff skills
The home had established a regular training programme and supervision. Training included dementia and practical care skills.
“Staff training had been developed and improved and now ensured staff received a varied programme to provide them with the skills required to support people safely and effectively.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Staff respected privacy, dignity, relationships and people's independence.
“Staff were kind and treated people with respect, promoted their individuality and independence whenever possible.” from the report
Personalised activities
Activities were based on people's interests, past lives and goals. The home also supported trips, friendships and contact with animals.
“The activities co-ordinator worked closely with people and staff to tailor specific activity and entertainment that met people's individual need.” from the report
Care records were not always accurate
needs fixingSome records did not reflect current risks, care needs or medicines. Inspectors said this had not affected care during the inspection, but asked for records to be kept consistently up to date.
“Some records were not accurate or up to date.” from the report
Learning disability guidance
needs fixingThe manager was not familiar with the guidance called Registering the Right Support. The home's statement of purpose did not explain clearly how the needs of people with learning disabilities would be met.
“The registered manager was not familiar with the guidance and the Statement of purpose (SOP) did not address how the provider would ensure the service embraced the values that underpin Registering the Right Support.” from the report
- 01How do you make sure care plans are updated when a person's risks or care needs change?
- 02How are medicine records checked after medicines are changed, including records for creams?
- 03What changes have been made to the statement of purpose about supporting people with learning disabilities?
- 04How do you make sure people's choices, independence and inclusion are reflected in their care?
- 05What progress has been made with the planned electronic care planning system?
This was a comprehensive inspection covering all five key questions, with the first visit unannounced; the report also considered improvements since the previous inspection in November 2017. This explanation was written from the published report of 12 March 2019 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, January 2018
Abbey Lodge is rated Requires Improvement; inspectors found kind care but serious gaps in safeguarding, staff skills, care records and management.
Inspectors visited on 23 and 29 November 2017. The first visit was unannounced. They spoke with people, staff, relatives and health and social care professionals. They observed care and checked care plans, medicines, staff records, complaints, accidents and quality checks.
People generally felt safe and were happy with the care. Staff were kind, friendly and respectful. There were enough staff, medicines were usually handled safely, and people were supported with food, health appointments, relationships and activities.
However, possible abuse and some falls or other incidents were not always reported properly. Accident records were incomplete, and some as-required medicines did not have clear instructions. Staff training and supervision were not strong enough, and care records did not always explain people's individual needs.
The home was rated Requires Improvement in four areas: Safe, Effective, Responsive and Well-led. Caring was rated Good. This was the third time the home had received an overall Requires Improvement rating.
Kind relationships
People and relatives spoke positively about staff. Inspectors saw staff being affectionate, friendly and attentive while respecting people's dignity.
“People were supported by staff who were pleasant and caring in their approach.” from the report
Enough staff
Inspectors found staffing arrangements allowed people's needs to be answered in a timely way. Recruitment checks were completed before staff worked unsupervised.
“There were enough staff to meet people's care and support needs.” from the report
Health and nutrition
Staff worked with healthcare professionals and monitored people's food and drink. Special diets and support with eating and swallowing were provided.
“Staff monitored people's nutritional needs and people had access to food and drink that met their needs and preferences.” from the report
Relationships and activities
People could maintain friendships and have visitors freely. New activity staff and a minibus were being used to widen individual activities.
“People were supported to maintain their own friendships and relationships with whoever they wanted to.” from the report
Safeguarding and incident reporting
seriousStaff did not consistently recognise or report possible abuse. Falls, assaults and other incidents were not always reported to the right authorities or properly reviewed, leaving risks insufficiently reduced.
“This placed people at risk of potential abuse.” from the report
As-required medicines
seriousSome people did not have clear, individual instructions for medicines taken only when needed. This meant the home could not be sure they were given safely and consistently.
“Individual protocols and guidelines were not always in place to guide staff on the safe and consistent administration of these medicines.” from the report
Staff training and supervision
needs fixingTraining records were limited and many new staff had not had supervision. Inspectors found staff might not have the practical skills needed, including for moving people safely.
“Staff training records to confirm the training undertaken by staff were limited.” from the report
Incomplete care plans
seriousSome care records did not explain how to meet important health, safety or emotional needs. They also did not always record people's choices in a person-centred way.
“The care documentation did not provide staff with the information and guidelines to provide individual and person centred care.” from the report
- 01What changes have been made to ensure all safeguarding concerns, falls and accidents are reported to the right authorities and reviewed?
- 02How are as-required medicines now covered by individual instructions, and how is safe administration checked?
- 03How do you record and monitor training, practical competency and regular supervision for all staff, including new and agency staff?
- 04Have care plans been updated for catheter care, blood glucose changes, choking risks and behaviour that could challenge?
- 05What quality checks are now used to make sure previous inspection concerns and new problems are identified and fixed?
This was a comprehensive, unannounced inspection covering all five CQC questions, with visits on two dates; the report also compares the findings with the previous inspection in August 2016. This explanation was written from the published report of 27 January 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.
Every inspection of Abbey Lodge
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- June 2014
Registered with the Care Quality Commission on 30 June 2014.
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.
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Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
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