CQC report explained · a residential care home
What the CQC found at Adelaide Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, there were enough staff, and medicines, risks, equipment and the premises were managed safely. The Safe rating improved from Requires Improvement at the previous inspection.
- Effective?
- Good
- Staff assessed people's needs, received training and support, and helped people maintain a balanced diet. The home worked well with health professionals, although inspectors noted that some dementia-friendly signage was still lacking.
- Caring?
- Good
- Staff were kind, patient and respectful. People were involved in decisions, and personal care was provided in a way that protected privacy and dignity.
- Responsive?
- Good
- Care plans were personalised and reviewed regularly with people and relatives. People had a wide range of activities and support to maintain relationships, although the computerised care system did not allow staff to record emotional and psychological wellbeing.
- Well-led?
- Good
- The home had established checks, audits and meetings to monitor quality and safety. Inspectors found a positive, open culture, but some information on electronic devices had been accessible to others and was addressed immediately.
What inspectors found, January 2020
Rated Good; inspectors found safe, kind and personalised care, with only minor improvements still needed.
Inspectors visited without warning on 29 November and 3 December 2019. They spoke with people living in the home, relatives, staff and visiting health professionals. They also reviewed care, medicine and staff records, quality checks and training information.
People said they felt safe and relatives were confident in the staff team. Inspectors found enough staff, safe medicines arrangements, good infection control and suitable checks on the building and equipment. Staff were trained, knew people well and worked effectively with health professionals.
Inspectors found people were treated kindly and with dignity. Care was personalised, families were involved in reviews, and there were regular activities and trips. The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led.
The overall rating remained Good, the same as at the previous inspection in April 2017. The Safe rating improved from Requires Improvement to Good. Inspectors noted some minor issues, including limited dementia-friendly signage, a care recording limitation and a short-lived confidentiality problem with electronic devices.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and saw that medicines were stored, given and checked safely.
“People said staff responded quickly when they used their call bells.” from the report
Kind and dignified care
Staff treated people with patience, kindness and respect. They protected privacy during personal care and supported independence.
“Care and support was provided in a way that respected people's privacy and dignity.” from the report
Personalised support
Care plans reflected people's needs, preferences and communication requirements. People and relatives were involved in regular reviews.
“People continued to receive personalised care from staff that knew them well.” from the report
Activities and relationships
People could choose from activities such as music, baking, quizzes, trips and visits from community groups. Staff also supported people who preferred activities in their rooms.
“People had opportunities to take part in activities which they enjoyed, and which met their abilities and interests.” from the report
Good teamwork and oversight
Staff worked well with health professionals, and managers used audits, meetings and feedback to monitor the service and act on issues.
“A range of audits and checks were carried out to monitor the quality and safety of the service.” from the report
Limited dementia-friendly signage
needs fixingSome parts of the building had signs, but inspectors said there was not enough clear signage to fully support people's independence. The manager said this would continue to be worked on.
“There was a lack of clear signage to fully assist people with their independence.” from the report
Emotional wellbeing records
needs fixingStaff understood and responded to people's emotional and psychological wellbeing, but the computerised care system did not provide a way to record this.
“The computerised system did not give staff the opportunity to record people's emotional and psychological wellbeing.” from the report
Confidentiality of electronic records
needs fixingSome information on electronic devices used by staff could be accessed by others. The manager took immediate action to address this during the inspection.
“Electronic devices used by staff to review and record care delivered, contained some information which was accessible by others.” from the report
Odour in two bedrooms
minorTwo bedrooms had an unpleasant odour at the start of the inspection. Domestic staff reduced this significantly by the end of the inspection.
“Two bedrooms did have an unpleasant odour at the beginning of the inspection.” from the report
- 01What changes have been made to the signage to help people living with dementia find their way around independently?
- 02How do staff now record and review people's emotional and psychological wellbeing?
- 03What safeguards are now in place to prevent confidential information on electronic devices being seen by unauthorised people?
- 04How are bedroom cleanliness and odours checked and followed up?
- 05How have staffing levels and response times to call bells been monitored since the inspection?
This was an unannounced inspection covering all five CQC questions; Safe improved from Requires Improvement to Good and the other four ratings remained Good. This explanation was written from the published report of 18 January 2020 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, April 2017
Rated Good overall, but Safe required improvement because recruitment checks and staff presence in communal areas were not always reliable.
Inspectors visited on 16 and 17 February 2017. The first day was unannounced. They spoke with people living in the home, relatives, staff and health and social care professionals. They also observed care and checked care records, medicines records, staff files and management records.
Overall, inspectors found kind, personalised care. People were supported with their health, meals, activities and medicines. Staff understood people's needs and treated them with respect. The home was also judged effective, caring, responsive and well-led.
Safe was rated Requires Improvement. One recruitment file did not initially contain all the required checks, and staff were not always present in communal areas. There were also delays with one lunchtime meal. The registered manager acted during and after the inspection on some of these issues.
The home had improved since the previous inspection in December 2015, when it was rated Requires Improvement overall and had three breaches. Inspectors found those earlier improvements had been made. A recommendation remained about obtaining all recruitment information before agency staff started work.
People felt safe
People, relatives and professionals said they felt safe. Staff knew how to recognise and report abuse, and risks such as falls and pressure damage were assessed.
“People were protected from potential abuse and harm.” from the report
Good training and health support
Staff had a wide range of training, regular supervision and support. People could see GPs and other health professionals, and the home acted on professional advice.
“Staff were trained and supported to help them to meet people's needs effectively.” from the report
Kind and respectful care
Inspectors observed warm relationships between staff and people. Staff supported privacy, independence and comfort, including for someone receiving end-of-life care.
“People were supported by staff that were kind and respectful.” from the report
Personalised support
Care plans included people's health needs, preferences and routines. The home offered activities, outings and one-to-one support for people who did not join group activities.
“People received personalised care that met their needs and took account of their preferences.” from the report
Visible management
The registered manager and deputy were accessible and worked with staff on the floor when needed. Systems were used to monitor quality and safety.
“There were systems in place to assess and monitor the quality and safety of the service.” from the report
Agency recruitment checks
needs fixingOne staff file did not initially contain proof of satisfactory previous employment or a DBS check. The manager requested the missing information after inspectors raised it.
“Their personnel file did not contain proof of satisfactory previous employment or a DBS check.” from the report
Staff not always visible
needs fixingThere were two periods of 10 and 15 minutes when no staff were in a communal lounge area. One person needed help to use the toilet and another was calling for attention.
“Staff were not always deployed in a way that ensured their presence in communal areas at all times.” from the report
Activities cover
minorThere were no organised activities or one-to-one time on the first day because the activities staff were away. Some people were left disengaged and dozing.
“This meant there were no organised activities or one to one time.” from the report
- 01What checks are now completed before agency staff start work, including references and DBS checks?
- 02How do you make sure staff are always available in communal areas, especially during sickness or other short-notice absence?
- 03What changes were made after the delays and poor organisation at lunchtime found during the inspection?
- 04How are activities and one-to-one support provided when the activities co-ordinator or social well-being staff are away?
- 05How do your quality audits now record and act on feedback from people living in the home?
This was an overall inspection covering all five questions and included observation, discussions with people and professionals, and checks of care, medicines, recruitment and management records. This explanation was written from the published report of 22 April 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 Adelaide Lodge Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
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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