CQC report explained · a residential care home
What the CQC found at Apasen Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, safeguarding procedures and safe medicines systems. Some protective radiator covers were not secure and still presented a risk of injury.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff received training and supervision, people had choices about food and drink, and the home worked with health professionals.
- Caring?
- Good
- People said staff were kind and caring. Inspectors saw respectful support that promoted privacy, dignity, independence and choice.
- Responsive?
- Good
- Care plans were personalised and reviewed. People had access to activities, communication support and family contact, but the complaints procedure contained inaccurate information and one end of life plan needed updating.
- Well-led?
- Good
- Quality checks and lines of accountability had improved since the previous inspection. The home was still working on staff discontent and poor communication.
What inspectors found, November 2019
Rated Good; inspectors found safe, kind and personalised care, with a few records and building issues to address.
This was a planned, unannounced inspection on 22 October 2019. One inspector spoke with two people living in the home, four staff members and reviewed care, medicines, recruitment and management records.
The home supported five people with a learning disability or who were autistic, although it could support up to ten. Inspectors found all five areas were Good: Safe, Effective, Caring, Responsive and Well-led.
People were protected from abuse, medicines were managed safely and there were enough staff. People were treated with kindness and respect, involved in their care, supported to make choices and helped to take part in activities and maintain relationships.
The home had improved from Requires Improvement at the previous inspection. The earlier breaches had been addressed, although inspectors noted some radiator covers were not secure and recommended better care planning around sexuality.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks included criminal record checks, references and employment history.
“There were enough staff working at the service to meet people's needs.” from the report
Safe medicines
Medicines were stored securely and administration records were signed after medicines were given. Audits were carried out by the manager and pharmacist.
“Systems were in place for the safe management of medicines. Medicines were stored securely in locked cabinets in each person's bedrooms.” from the report
Kind and respectful care
People said they were treated well. Inspectors observed staff supporting people in a caring and respectful way.
“We observed staff interacted with people in a caring and respectful manner during the course of the inspection.” from the report
Personalised support and choice
Care plans reflected people's needs and preferences. People were involved in decisions about their care, food, activities and bedrooms.
“Care plans were in place for people which set out their assessed needs and how to meet them.” from the report
Activities and relationships
People took part in day centres, puzzles, beauty treatments, trips, cinema visits and meals out. Family and friends were able to visit and people used electronic devices to stay in touch.
“People were supported to take part in a variety of social and leisure activities.” from the report
Insecure radiator covers
seriousSome protective covers were not secure, leaving a remaining risk that people could be hurt. The manager said work was being arranged to fix them securely.
“However, some of these were not secure which meant there was still a risk of people being hurt.” from the report
Care plans did not cover sexuality
needs fixingThe home considered several equality and diversity needs, but care plans did not include people's sexuality. Inspectors recommended following best practice and the manager planned a new care plan system.
“However, care plans did not cover people's sexuality.” from the report
Complaints information
needs fixingThe complaints procedure gave timescales but did not accurately explain who people could complain to if they were unhappy with the provider's response.
“However, it did not provide accurate information about who people could complain to if they were not satisfied with the response from the provider.” from the report
Staff communication
needs fixingThe manager reported some staff discontent and poor communication. An outside facilitator was helping, but this work was still continuing at the inspection.
“The registered manager told us there had been some discontent within the staff team in recent months and at times poor communication.” from the report
One end of life plan
minorOne person's end of life care plan did not explain that their family wanted to take responsibility for this. The manager said the plan would be updated.
“However, one person did not.” from the report
- 01Have all the protective radiator covers now been securely fixed, and how do you check that they remain safe?
- 02How do current care plans record each person's equality, diversity and sexuality needs?
- 03How can a resident or relative complain if they are unhappy with the provider's response?
- 04What changes were made to improve communication and resolve the reported staff discontent?
- 05How are end of life wishes recorded where a family wants to take responsibility for planning?
This was a planned, unannounced inspection covering all five CQC questions, following a previous Requires Improvement rating and earlier regulatory breaches. This explanation was written from the published report of 19 November 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, December 2018
Rated Requires Improvement; inspectors found good care and support, but safety, money controls and quality checks were not reliable enough.
This was an unannounced inspection on 8 November 2018. The inspector reviewed care plans, medicines, staff records, policies, meetings and health and safety records. They spoke with one person, four staff and managers, and observed how staff supported people.
The home was rated Good for Effective, Caring and Responsive. Inspectors found enough staff, suitable training, respectful care, personalised care plans, activities and support to access health professionals.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found problems with some parts of the building, medicine records, food temperature checks, first aid supplies, fire door records and the handling of people's money. There were three breaches of regulations.
The overall rating changed from Good at the previous inspection in April 2016 to Requires Improvement at this inspection. The provider was asked to send CQC a report explaining what action it would take.
Enough staff
Inspectors saw enough staff to support people safely and promptly. Recruitment checks, including criminal record checks and references, were in place.
“There were enough staff working at the service to meet people's needs in a safe way.” from the report
Respectful care
People said staff treated them with respect. Care plans supported privacy, dignity, choice and independence.
“People told us they were treated with respect and that staff were caring.” from the report
Personalised support
Care plans covered health, personal care, mobility, finances, food, emotional wellbeing, daily living and religious needs. They were reviewed regularly.
“Care plans were in place which set out the support people required in a personalised way.” from the report
Training and health support
Staff received induction, ongoing training and supervision. People had health plans and were supported to see relevant health professionals.
“Records showed people were supported to access health care professionals, including GP's, opticians, dentists, psychiatrists and occupational therapists.” from the report
Safety checks and equipment
seriousInspectors found several safety problems, including a bathroom lock that could delay emergency access, uncovered radiators, incomplete first aid supplies and missing records of fire door checks.
“The service was not always safe. We found safety concerns with the physical environment, medicine recording, fire door safety checks, food storage and first aid supplies.” from the report
Medicine records
seriousOne person's medicine chart was not signed for two medicines. Daily records showed one had been given, but it was unclear whether the other had been administered.
“This meant it was not clear if the person had received their prescribed medicine which potentially put their health and wellbeing at risk.” from the report
People's money
seriousRecords of money held for people did not match the cash available. Money was not routinely counted at every staff handover, increasing the risk of financial abuse.
“Poor record keeping and lack of regular checks with regard to people's money increased the risk of financial abuse occurring and was a breach of Regulation 13” from the report
Quality monitoring
seriousThe home's audits and monitoring visits did not identify the safety and financial recording problems found during the inspection. This was a breach of the good governance regulation.
“Although systems were in place for monitoring the quality of safety at the service, these were not always effective.” from the report
Condition of the building
needs fixingInspectors found worn and stained carpets, scuffed paintwork and damaged plaster. Managers said improvements were planned by the end of January 2019.
“However, we noted that much of the décor within the service was in a poor state.” from the report
- 01What changes have been made to ensure every medicine is recorded immediately after it is given?
- 02How are people's cash balances now counted, checked at handover and matched to receipts?
- 03Have the bathroom lock, uncovered radiators, food temperature checks and first aid supplies all been put right?
- 04How are fire door checks and other safety checks recorded and reviewed by managers?
- 05Has the planned work to improve the carpets, paintwork and plaster been completed?
This was an unannounced inspection covering all five questions and both the accommodation and care; the previous inspection in April 2016 had rated the service Good, and only one person could be spoken with because of communication needs. This explanation was written from the published report of 12 December 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 Apasen Lodge
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 6 September 2012.
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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