CQC report explained · a residential care home
What the CQC found at Alphington Lodge Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The service was described as safe. Inspectors found risk assessments, safeguarding systems, safe recruitment and infection control measures, but medicines cream records needed further improvement.
- Effective?
- Good
- This question was not assessed in this targeted inspection.
- Caring?
- Good
- This question was not assessed in this targeted inspection. Relatives did say staff were kind and that their family members were safe.
- Responsive?
- Good
- This question was not assessed in this targeted inspection. The report noted activities, family contact and support during visiting restrictions.
- Well-led?
- Good
- The service was described as well-led. Inspectors found open management, clearer roles, staff training and a comprehensive quality assurance process, but they did not review the whole question.
What inspectors found, January 2021
Overall rating remained Good after a targeted inspection; inspectors found safe care and improving management, but medicines cream records still needed improvement.
This was a targeted inspection on 20 November 2020. Inspectors checked specific concerns about risk management, safety, staffing and recruitment, medicines, and management. They also checked infection prevention and control during the COVID-19 pandemic.
Inspectors found no evidence that people were at risk of harm from the concerns checked. They found suitable staffing, safe recruitment, risk assessments, safeguarding systems and generally safe medicines processes. They also found the home was meeting infection control expectations.
The management team was described as open about earlier failings and the improvements still needed. A new staff team, training, supervision and quality checks were in place. However, recording when creams were given still needed improvement, and some staff said staffing levels depended on overtime.
The home was inspected but not rated in this visit. Its overall rating remained Good from the previous comprehensive inspection, published on 14 March 2019. The Safe and Well-led questions were also not re-rated because this inspection only covered specific concerns.
Risk management
People had regularly reviewed risk assessments and clear guidance for staff. Concerns about changing risks were passed to health and social care professionals promptly.
“A comprehensive assessment of risks was completed when people moved to Alphington Lodge and reviewed regularly to ensure the information was up to date.” from the report
Staff training
The home had recruited a largely new team and provided induction, training, supervision and competency checks.
“The provider and management team ensured staff had the knowledge and skills they needed to provide safe and effective care.” from the report
Open management
Managers were open about previous failings and the work still needed. Relatives, staff and professionals spoke positively about the improvements.
“There was an open and transparent culture at the service.” from the report
Quality checks
The home had a quality assurance programme involving feedback from people, relatives and staff. Actions were recorded with timescales and named responsibility.
“There was a comprehensive quality assurance process, developed in line with the CQC rating system.” from the report
Infection control
Inspectors were assured about the home's arrangements for preventing and managing infection, including PPE, testing, visitors and possible outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Reliance on overtime
needs fixingSome staff were concerned that the level of support for people could only be maintained with overtime. The report did not say this had put people at risk during the inspection.
“However, some staff were concerned this was only achievable with overtime.” from the report
- 01How are you now checking and recording every prescribed cream that is given?
- 02Can you maintain safe staffing levels without relying on staff overtime?
- 03How has the virtually new staff team settled, and have any further recruitment or retention problems arisen?
- 04Has the manager completed registration with the CQC?
- 05How are relatives and residents currently involved in quality checks and service improvement?
This was a targeted inspection of specific parts of Safe and Well-led, including infection control; the other questions were not assessed and the previous Good ratings carried over from the comprehensive inspection published in March 2019. This explanation was written from the published report of 13 January 2021 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, March 2019
Alphington Lodge Residential Home is rated Good; inspectors found safe, kind care and better management, with some waiting times and limited activities.
This was an unannounced inspection on 31 January and 4 February 2019. One inspector and an expert by experience reviewed records, medicines, staffing, care plans, complaints, building safety and quality checks. They also spoke with people living there, relatives, staff and managers.
The home had improved since its previous inspection, when it was rated Requires Improvement. Medicines were stored and administered more safely. Care records, staff training, confidentiality and management checks had also improved. Staff were described as patient, kind and respectful, and they knew people's needs.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. The report says legal requirements were met at this inspection. Inspectors still found some areas needing attention, including delays when staff were busy, limited activities for some people and inconsistent consent records.
Clear improvement
The provider had made good improvements since the previous inspection. The overall rating rose from Requires Improvement to Good.
“The provider had made good improvements to the service since our last inspection on 26 January 2018.” from the report
Safer medicines
Medicines were stored securely, temperatures were checked and staff had training and competency checks. Audits had also been strengthened.
“There were safe systems in place for the storage and administration of medicines.” from the report
Kind and respectful staff
Inspectors observed staff treating people with dignity and respect. People were supported with patience and were involved in choices about their care.
“People were supported by staff who treated them with patience, kindness and understanding.” from the report
Personalised care
Care plans contained detailed information about people's needs, risks and preferences. Staff were observed following these plans.
“The care plans were person-centred and held detailed information about how people's risks and needs and how they wanted those needs to be met.” from the report
Stronger management checks
The provider, manager and deputy manager carried out regular checks covering care and the environment. Results were analysed and actions were taken.
“There was a comprehensive programme of audits in place which looked at all aspects of the support provided and the environment.” from the report
Waiting for staff
needs fixingPeople said staff could be busy and were sometimes unable to respond quickly. An extra floating staff member had been added to the morning shift.
“People told us that although there were enough staff on duty to meet their needs they were busy at times and unable to respond quickly.” from the report
Limited activities
needs fixingSome people were positive about activities, but others said the programme was limited and they felt bored. A new activities co-ordinator had been recruited to develop it.
“Some people were positive about the activities, but others told us the activities programme was limited and they felt bored.” from the report
Staff supervision
minorIndividual supervision meetings had been put on hold while staff completed the new training programme. They were due to restart after the inspection.
“Individual supervision sessions had been put on hold while they focussed on completing the new training programme.” from the report
Short-stay medicines process
needs fixingInspectors found confusion about how medicines brought by a person on a short stay fitted into the home's usual process. Management investigated immediately and planned training and audit changes.
“during the inspection there was confusion about the administration of medicines for a person on a short stay.” from the report
- 01How quickly can staff usually respond when someone needs help, particularly during busy periods?
- 02What activities are now available, and how are people who previously felt bored involved in planning them?
- 03How do you record consent when it is given verbally or by a third party?
- 04Has the new permanent manager started and registered with CQC?
- 05Have individual staff supervision meetings restarted, and how often do they now take place?
This was an unannounced inspection covering all five CQC questions, including the care provided and the home's premises, records, staffing, medicines and management systems. This explanation was written from the published report of 14 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.
Every inspection of Alphington Lodge Residential Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- January 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
Read what inspectors found at Alphington Lodge Residential Home →
- March 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Alphington Lodge Residential Home →
- April 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2017
Registered with the Care Quality Commission on 11 December 2017.
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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