CQC report explained · a residential care home
What the CQC found at Arthur Lodge Residential Care Home
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 concerns with medicines, including incomplete administration records, medicines without prescriptions and medicines that people could access. They also found that some staff medicine competencies were not always checked.
- Effective?
- Good
- This question was not inspected during this visit. Its previous rating was carried forward to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this visit. The report says staff provided compassionate, person-centred care, but no current rating was given for Caring.
- Responsive?
- Good
- This question was not inspected during this visit. The report says staff knew people's needs and supported their goals, but no current rating was given for Responsive.
- Well-led?
- Requires improvement
- The provider's quality monitoring had not identified or reduced the risks linked to medicines and mental capacity records. The manager was described as responsive and had plans for further improvement.
What inspectors found, May 2023
Arthur Lodge Residential Care Home is rated Requires Improvement; inspectors found caring support but unsafe medicines systems and weak quality checks.
This was an unannounced focused inspection on 17 April 2023. One inspector, a nurse specialist adviser and an Expert by Experience visited the home. They spoke with people, staff, the registered manager and relatives, and reviewed care records, medicines, recruitment and management records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found medicines were not always managed safely. Some medicines were not prescribed, records did not contain enough information, and some medicines were left where people could reach them. Some mental capacity and best interests assessments were also not up to date.
Inspectors found people were treated with kindness and dignity. Staff knew people well, there were enough staff, risks were assessed and the home was clean. The registered manager acted immediately on some issues, including removing medicines from the kitchen and starting a homely remedies policy.
The inspection only assessed Safe and Well-led. The other areas were not inspected and their previous ratings were used. The overall rating fell from Good at the last inspection in 2017 to Requires Improvement.
Kind, person-centred support
Staff knew people well and supported their dignity, choices and individual goals. Inspectors observed respectful and compassionate interactions.
“Care plans were person-centred, which reflected people's individual needs, aspirations, goals and best outcomes.” from the report
Enough experienced staff
Inspectors found suitable staffing levels and continuity because many staff had worked at the home for several years.
“There were suitable numbers of qualified staff to meet people's needs.” from the report
Risk and infection controls
Risks such as falls, nutrition and skin conditions were assessed with guidance for staff. The home also had cleaning, hygiene and infection control systems.
“There were appropriate systems for preventing and controlling the spread of infection.” from the report
Positive management culture
Staff and relatives gave positive feedback about the manager. Staff said they felt supported and able to raise concerns or suggestions.
“The registered manager promoted a positive and transparent culture which supported the delivery of person-centred care.” from the report
Medicines were not always safe
seriousSome medicines were given without prescriptions or a homely remedies policy. Records lacked important information, and medicines were found on a kitchen counter where people could reach them.
“The provider had not always ensured there was a system in place for the safe management of people's medicines” from the report
Mental capacity records were incomplete
needs fixingSome records did not contain up-to-date mental capacity and best interests assessments. The manager took immediate action after the inspection to complete them.
“some lacked up to date mental capacity assessments and best interests assessments in line with guidance.” from the report
Quality checks missed important risks
needs fixingThe provider's monitoring systems were too informal and had not identified the medicines and mental capacity problems before the inspection.
“The providers quality monitoring systems had failed to identify and mitigate risks in relation to the management of medicines and recording of people's mental capacity.” from the report
- 01Have all medicines now been prescribed or covered by an approved homely remedies policy?
- 02Do the medicines records now include each person's photograph, allergies and clear instructions for medicines given when required?
- 03How are medicines kept out of people's reach, and how often are staff checked as competent to administer them?
- 04Have up-to-date mental capacity and best interests assessments been completed for everyone who needs them?
- 05What new quality checks are in place to make sure medicines and mental capacity records remain safe and complete?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward from the last inspection in 2017. This explanation was written from the published report of 18 May 2023 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, November 2019
Arthur Lodge Residential Care Home was rated Good; inspectors found safe, kind and personalised care, but end of life wishes were not yet recorded.
This was an unannounced planned inspection on 22 October 2019. One inspector and an expert by experience spoke with the manager, two support workers and six people living at the home. They reviewed three care records, three staff records and other management documents.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and that staff were kind, respectful and knew them well. Inspectors found enough trained staff, safe medicine systems, detailed care plans and good links with health and social care professionals.
The home supported people with learning disabilities, including people with mental health conditions. Staff promoted choice, independence and community activities. No restrictive intervention practices were used. One gap was that people's end of life wishes had not yet been recorded, although the manager said this would be discussed with people and their families.
Kind and respectful care
People said staff were kind and caring. Inspectors saw relaxed, positive relationships and found that privacy, dignity and independence were respected.
“Respect for privacy and dignity was at the heart of the service's culture and values.” from the report
Consistent staff team
People were supported by a small group of staff who knew them well. Low staff turnover helped provide continuity.
“Most staff had been working in the service for some time, and staff turnover was very low, thus providing a good continuity of care for people using the service.” from the report
Personalised support
Care plans included people's individual needs, preferences, routines and ways of communicating. Staff supported people to make choices and build independence.
“People's care plans contained detailed, clear information about people's specific needs, their personal preferences, routines and how staff should best support them.” from the report
Safe medicines arrangements
Inspectors found that medicines were handled safely. Staff had training and their competence had been checked.
“Medicines were acquired, stored, administered and disposed of safely.” from the report
Positive management
People found the manager approachable, and staff felt supported. The home used audits, surveys and meetings to review its work.
“There were several systems that the registered manager used to monitor and improve the quality of care at the home.” from the report
End of life wishes not recorded
needs fixingThe home had not recorded people's end of life wishes at the time of the inspection. The manager said these discussions would take place with people and their families.
“The service did not currently record peoples end of life wishes, the registered manager told us they would discuss and record these with people and their families in due course.” from the report
- 01How and when will you discuss and record my relative's end of life wishes?
- 02How will you keep my relative's care plan up to date if their needs change?
- 03How will you support my relative to communicate choices and preferences?
- 04What activities and community opportunities would be available for my relative?
- 05How will you involve our family in care planning and reviews?
This was an unannounced planned inspection covering all five CQC questions, including the care provided and the premises; all five ratings remained Good from the previous inspection. This explanation was written from the published report of 20 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.
Every inspection of Arthur Lodge Residential Care Home
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Arthur Lodge Residential Care Home →
- November 2019Goodstayed GoodSafe: GoodWell-led: Good
Read what inspectors found at Arthur Lodge Residential Care Home →
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
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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