CQC report explained · a nursing home
What the CQC found at Allerton Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found poor infection control, dirty equipment, weak environmental checks and gaps in monitoring people's care needs. Medicines and safeguarding arrangements were reported to be safe.
- Effective?
- Good
- This key question was not assessed during the focused inspection. Previous ratings were used when calculating the overall rating.
- Caring?
- Good
- This key question was not assessed during the focused inspection. Relatives nevertheless described staff as kind and caring.
- Responsive?
- Good
- This key question was not assessed during the focused inspection. Previous ratings were used when calculating the overall rating.
- Well-led?
- Inadequate
- Inspectors found widespread weaknesses in leadership, accountability, quality checks, care records and engagement with people, relatives and staff.
What inspectors found, June 2022
Kingswood Mount was rated Requires Improvement, with unsafe infection control and inadequate management despite kind care and safe medicines.
This was a focused inspection on 28 April and 3 May 2022. Inspectors looked mainly at Safe and Well-led because of concerns about safe care and treatment. They spoke with one person, 12 relatives and nine staff, and checked care, medicine, recruitment, staffing and quality records.
Inspectors found the environment was unclean and unsafe. Equipment was stained or dirty, infection control was not reliable, fire and moving-handling training levels were low, and some care records were incomplete or out of date. They also found that checks and management systems had not identified or fixed these problems.
There were positive findings. Medicines were administered safely, staff knew people well, safeguarding procedures were understood, and people could access healthcare when needed. Relatives also described staff as kind and caring, although some felt staff were overstretched.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe was rated Requires Improvement and Well-led was rated Inadequate. The other three key questions were not reassessed during this focused inspection, so their previous ratings were used in the overall rating.
Medicines
Inspectors found that medicines were managed safely and records showed people received them as prescribed.
“Medicines were safely managed.” from the report
Healthcare support
Staff recognised changes in people's health and sought professional advice when needed.
“People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.” from the report
Safeguarding
Staff knew how to recognise and report suspected abuse, and accident and incident procedures were followed.
“Staff were aware of how to raise concerns.” from the report
Kind approach
Relatives said staff treated their family members with kindness, although they also described staff as under pressure.
“Relatives told us that staff members had a kind and caring approach towards their family members” from the report
Infection control
seriousThe home did not consistently prevent infection risks. Shared areas and equipment were not always cleaned properly, and some equipment was visibly dirty.
“Infection prevention and control practices were inadequate and did not protect people from the risk of infections.” from the report
Unsafe environment
seriousBedrooms and equipment were poorly maintained. Fire safety and moving-handling training compliance was also low.
“The provider had not ensured people lived in a safe environment.” from the report
Incomplete care records
needs fixingSome daily notes and care plans did not accurately reflect people's needs or changes in their condition.
“Records used to monitor, and review people's care were not fully completed and kept up to date.” from the report
Weak management oversight
seriousQuality checks and audits were not effective, and leaders had not identified or dealt with important risks and shortfalls.
“The systems for assessing, monitoring and improving the quality and safety of the service were ineffective as they failed to identify and bring about improvements to the service people received.” from the report
Staffing and recruitment
needs fixingSome people and relatives felt staffing levels were too low. Recruitment files also had missing references or induction records.
“People had mixed views on staffing numbers at the home.” from the report
- 01What cleaning has been completed for wheelchairs, walking aids, pressure-relieving cushions and shared areas?
- 02What changes have been made to fire safety and moving-handling training, and what are the current completion rates?
- 03How are care plans and daily records now checked and updated when people's needs change?
- 04Who is currently responsible for managing the home, and how often are quality and safety audits completed?
- 05What has been done to improve staffing levels, staff morale and recruitment checks?
This was a focused inspection of Safe and Well-led, with infection control also reviewed; the Effective, Caring and Responsive ratings were not reassessed and previous ratings carried over. This explanation was written from the published report of 9 June 2022 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, February 2019
Allerton Lodge is rated Good; inspectors found safe, kind and personalised care, with improvements in management since the last inspection.
This was an unannounced, comprehensive inspection on 20 November 2018. Inspectors reviewed care records, medicines, staff files, safeguarding information, complaints, audits and safety records. They also looked around the home and observed care and activities.
The home was rated Good overall and received Good ratings for Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable training, kind care and personalised support. People were supported with activities, healthcare and end-of-life wishes.
The Well-led rating had improved from Requires Improvement at the previous inspection in February 2016. Inspectors found stronger quality checks and no serious risks or concerns from this inspection or ongoing monitoring.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicines were stored, administered and recorded correctly, with regular checks by management.
“Medication was correctly administered, stored and recorded at the home.” from the report
Kind and respectful care
People were treated as individuals and supported with dignity, privacy, choice and independence. Inspectors saw caring interactions between staff and residents.
“We observed caring interactions between staff and people living at the home throughout our inspection.” from the report
Personalised support
Care plans described people's individual needs and how staff should support them. Residents, relatives and health professionals were involved in reviews where possible.
“People living at the home had person centred care plans and risk assessments.” from the report
Activities and community links
The home offered a range of activities, trips and entertainment. It also had links with schools, churches and other community organisations.
“There was a range of activities on offer provided by a full-time activities coordinator, two activities team leaders and two well-being officers” from the report
Improved management systems
The Well-led rating improved from Requires Improvement to Good. Inspectors found more reliable audits and stronger oversight of care quality and safety.
“The home’s quality assurance processes were now more robust and reliable.” from the report
Documentation being revised
minorThe home was revising some documents, including the hospital passport used to summarise care needs, medicines and allergies.
“The registered manager explained that they were in the process of revising some of the documentation” from the report
- 01How many staff are on duty for the number and needs of residents, and how is this checked when people's needs change?
- 02Are all staff now up to date with their annual appraisals and individual supervision?
- 03How are residents and relatives currently involved in care plan reviews and service feedback?
- 04Has the revised hospital passport documentation been completed, and how is it kept up to date?
- 05What activities are available for someone with my relative's interests, communication needs or health condition?
This was an unannounced comprehensive inspection covering all five key questions; the overall rating stayed Good and Well-led improved from Requires Improvement at the February 2016 inspection. This explanation was written from the published report of 8 February 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.
Every inspection of Allerton Lodge
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- February 2019Goodstayed GoodSafe: GoodWell-led: Good
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015
Registered with the Care Quality Commission on 31 March 2015.
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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