CQC report explained · a residential care home
What the CQC found at Alsley Lodge
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, July 2020
Rated Requires Improvement; inspectors found risks, care planning and management oversight were not reliable enough.
This was an unannounced scheduled inspection on 7 and 14 November 2019. Inspectors spoke with people living at the home, relatives and staff. They observed care and checked care plans, medicines records, staff files and management records.
The home was not always safe. Risk assessments were too limited, a personal emergency evacuation plan contained inaccurate information, and a potentially serious incident had not been dealt with properly. Medicines records and checks of staff competence also needed improvement.
People were not always given enough choice about daily routines, personal care or decisions about their support. Care plans varied in quality, and the home's checks had not identified important problems. There were positive findings too, including enough staff, training, activities, healthcare access and positive comments about staff and managers.
All five areas were rated Requires Improvement. The overall rating had fallen from Good at the previous inspection. Well-led remained Requires Improvement, as promised improvements to auditing were still not evident.
Staff training and support
New staff had detailed inductions, and staff received training, supervision and practice observations. People and staff said the team was well trained.
“The provider ensured the staff team received a good level of support in relation to induction, training and supervision.” from the report
Activities and social contact
The home offered group and individual activities, outings and opportunities to maintain interests and relationships.
“A range of activities were provided, which included visiting musicians and outings during the warmer weather.” from the report
Healthcare links
Community health and social care professionals were involved, and people could access services such as GPs, dentists, opticians and mental health services.
“People had access to community health care services, such as GP's, dentists, opticians and mental health services.” from the report
Clean environment and infection control
The home was clean during the visit. Staff had infection control training and were observed using suitable protective clothing.
“The premises were clean and hygienic throughout at the time of our inspection.” from the report
Risk management
seriousRisk assessments did not contain enough detail. A personal emergency evacuation plan was inaccurate, and a potentially serious incident was not properly responded to.
“The provider did not have effective systems in place to properly assess and manage risks.” from the report
Medicines safety
seriousAs-needed medicines lacked clear protocols at the time of inspection. Some end of life medicines were not recorded correctly, and the home had not shown that relevant staff were competent to administer medicines.
“The management of medicines could have been better.” from the report
Choice and person-centred care
seriousSome daily routines did not give people enough choice about when they got up or had a bath or shower. Care plans did not always reflect current needs or preferences.
“Some of the daily routines were task orientated and therefore did not allow freedom of choice.” from the report
Mental capacity records
needs fixingMental capacity assessments had not been completed for people living with dementia on the first day. Work to improve this had started by the second day.
“The provider did not have effective systems in place to establish if people living with dementia had the capacity to make decisions.” from the report
Dietary information
needs fixingTwo of the three care records checked did not give enough detail about dietary needs and contained conflicting information. One person's diabetes was not recorded in enough detail.
“The provider had not always ensured people's dietary needs were recorded in enough detail.” from the report
Management oversight
seriousInternal checks had not found several of the problems identified by inspectors. This meant the home's systems for monitoring and improving quality were not reliable enough.
“Therefore, oversight and overall governance of the service was not always effective.” from the report
- 01What changes have been made to risk assessments and personal emergency evacuation plans since this inspection?
- 02How do you check that every staff member giving medicines has been assessed as competent?
- 03How are people now supported to choose when they get up, bathe or shower, rather than following fixed routines?
- 04How do you make sure care plans contain clear, current information about dietary needs, diabetes and other risks?
- 05What checks are now used to identify problems before they affect people's safety or choice?
This was an unannounced scheduled inspection covering all five key questions and the overall quality and safety of the care home; the previous ratings were also considered. This explanation was written from the published report of 11 July 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, May 2017
Rated Good overall; inspectors found safe, kind and personalised care, but the home’s leadership and quality checks still Require Improvement.
This was an unannounced inspection on 21 February 2017. Inspectors spoke with people living in the home, relatives and staff. They observed care and activities, checked bedrooms and shared areas, and examined care plans, medicine records, staffing, training and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. People said they felt safe and well cared for. Inspectors found enough staff, improved medicine arrangements, suitable training, good support with food and drinks, kind staff and personalised care plans. Activities were varied and tailored to people’s interests.
The Well-led rating was Requires Improvement. Some quality checks had been completed, but checks in areas such as infection control, night care and health and safety had not been done since 2015. One incident reported to the police had not been notified to the CQC.
The previous overall rating was Requires Improvement. The provider had made the improvements required after the 2014 inspection, including improvements to medicine management and protection from unsafe care and treatment. The overall rating was now Good, but the leadership concerns remained.
Improved medicines safety
Medicine storage, ordering, disposal and administration records had improved since the previous inspection. Inspectors found the home compliant in this area.
“This included improvements to the ordering, storage, disposal and recording of how medicines were administered.” from the report
Kind and respectful care
People and relatives praised the staff. Inspectors saw staff explain care, protect privacy and support people with patience and encouragement.
“We saw staff interacted well with people in a pleasant and kind manner and approached them with respect.” from the report
Personalised care and activities
Care plans recorded people’s needs, preferences and routines. The activities coordinator offered a good range of activities, including individual support for people who did not join group activities.
“People's support plans were person centred.” from the report
Enough staff and good training
Inspectors found staffing levels were sufficient and training was mostly up to date. Staff also received regular supervision and appraisals.
“On the day of inspection we found there were sufficient numbers of staff.” from the report
Quality checks were not consistent
needs fixingThe home had some audits, but its system was not robust enough. Audits covering infection control, night care and health and safety had not been completed since 2015.
“However a number of other audits such as Infection control, night time care and health and safety had not been carried out since 2015.” from the report
Some CQC notifications were missed
needs fixingThe report identified one police-reported incident that should also have been reported to the CQC. The home had investigated the incident, but the required notification had not been made.
“We did however see one example of when a matter had been reported to the police and a call log number was given to the home.” from the report
Consent records were limited
needs fixingThe home recorded consent for photography, but inspectors could not find consent records for some areas of care and for other professionals to access care records.
“We found that documentation around gaining people's consent was limited.” from the report
Some medicines checks needed strengthening
minorThe medicines policy was out of date, and the report did not find recent competency checks for senior carers who administered medicines.
“We did still see a few more improvements that needed to be made including updating the medication policy that was in place.” from the report
- 01What quality audits are now completed, especially for infection control, night-time care and health and safety?
- 02How do you make sure every incident that should be reported to the CQC is notified promptly?
- 03How do you record people’s consent for care, treatment, CCTV and access to care records?
- 04Has the medicines policy been updated, and how are staff competency checks for medicines administration recorded?
- 05What changes have been made since this inspection to address the Requires Improvement rating for Well-led?
This was an unannounced inspection covering all five CQC questions, including care observations, six people’s care and medicine records, staffing and quality monitoring. This explanation was written from the published report of 10 May 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 Alsley Lodge
3 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- July 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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85 live-in carers within about an hour of Lancashire
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 £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.