CQC report explained · a nursing home
What the CQC found at Astor Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
Rated Requires Improvement; inspectors found risks, staff support and management systems needed improvement, although care was generally appropriate.
This was an unannounced focused inspection on 19 and 22 December 2022. One inspector spoke with people, relatives and staff, and checked care plans, medicines, clinical notes and management records.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe, Effective and Well-led. Risks in care plans were not always fully assessed, records were not always well organised, and staff had not received regular supervision or annual appraisals.
There were also positive findings. Medicines were generally managed safely, people received support with food and drink, staff worked with health professionals, and people were supported to make choices. The home was clean and staff knew how to report safeguarding concerns.
The overall rating fell from Good at the previous inspection, published in February 2019. The provider had started taking immediate action, but CQC requested an action plan and said it would monitor progress.
Safeguarding
Staff knew how to report safeguarding concerns. Incidents had been recorded and reported to the local authority when needed.
“The provider had in place a safeguarding policy and staff were aware how to report any safeguarding concerns.” from the report
Food and health support
Staff understood people's dietary needs and worked with health professionals, including nurses and therapists.
“The staff worked closely with a number of agencies to deliver joined up care.” from the report
Clean environment
The home was clean and tidy, with communal areas and bathrooms well maintained. Staff were using protective equipment.
“The home was maintained in a clean and tidy manner.” from the report
Choice and least restriction
The home supported people to make choices and used best-interests decisions when people could not make particular decisions themselves.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Incomplete risk assessments
seriousSome risks linked to people's care were not fully considered, and actions to reduce those risks were not clearly recorded. CQC made a recommendation for this to be reviewed.
“Risks identified as part of supporting people were not always wholly considered and action to limit or mitigate risk not fully identified.” from the report
Staff supervision and appraisals
seriousStaff did not receive regular general supervision, and only two annual appraisals had been recorded from January 2022. This was a breach of Regulation 18.
“Failure to ensure staff had access to regular supervision meant staff did not always receive appropriate support and oversight.” from the report
Staffing and agency workers
needs fixingPeople said staffing could sometimes be an issue. Agency staff did not always know people well or understand their needs straight away.
“The home used agency staff, and this meant they did not always know people well and were not immediately aware of their needs.” from the report
Record keeping
needs fixingSome care files and daily records contained loose papers, which could be lost and made accurate record keeping harder. CQC recommended that documentation processes be reviewed.
“Some care files, daily care documents and other records contained a number of loose sheets and documents” from the report
Follow-up of audits and incidents
needs fixingAudits identified some problems, but follow-up action was not consistent. Reviews of accidents and incidents did not always clearly consider how to reduce the risk of further falls.
“Audits and checks had identified issues, although follow up action was not consistently undertaken.” from the report
- 01What changes have been made to people's risk assessments, and how are actions to reduce risks checked?
- 02Have all staff started receiving regular supervision and annual appraisals? How is this recorded?
- 03How many agency staff are currently being used, and how are they introduced to each person's needs?
- 04How are care records now stored so that documents cannot be lost or separated from the correct file?
- 05What action has been taken in response to the CQC breach and recommendations, and what evidence can you show of improvement?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and the report does not give ratings for them. This explanation was written from the published report of 9 February 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, January 2022
Astor Lodge was inspected but not rated; inspectors found strong COVID-19 infection control and visiting arrangements.
This was an announced, targeted inspection on 11 January 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements and COVID-19-related staffing pressures.
Inspectors were assured that the home was using PPE safely, arranging testing, managing admissions and visits safely, and keeping its infection control policy up to date. They also found cleaning schedules, hand sanitiser and clear reminders about infection control.
The home was inspected but not rated. This was not a full inspection of all five areas of care, so the report does not provide an overall quality rating.
Infection control planning
The home had detailed procedures for managing COVID-19 risks, including for people who tested positive.
“The home had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic.” from the report
Keeping families in contact
The home supported contact with relatives and arranged window visits when normal visits could not take place.
“People living in the home and their relatives were supported to maintain contact.” from the report
Visitor checks and testing
Visitors and professionals were screened before entry, and regular COVID-19 testing was in place for people living in the home, staff and visitors.
“A programme of regular COVID-19 testing for both people in the home, staff, and visitors to the home had been implemented.” from the report
PPE and cleaning
Inspectors found enough PPE, hand sanitiser, staff training and cleaning arrangements. Staff were observed using PPE correctly.
“There was an ample supply of PPE for staff and any visitors to use.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing staffing pressures linked to COVID-19, and could these affect care?
- 02What testing and screening must visitors and professionals complete before entering the home?
- 03How will you help my relative keep in contact with family if normal visits cannot take place?
- 04How often are staff trained in using PPE, and how do you check that it is being used correctly?
- 05How often are cleaning schedules and touch-point cleaning completed and checked?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it was not a full inspection and the service was not rated. This explanation was written from the published report of 15 January 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.
Every inspection of Astor Lodge
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022Inspected but not ratedSafe: Inspected but not rated
- April 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 14 October 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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23 live-in carers within about an hour of Northumberland
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 £950 to £1,190 a week. 20 can care for a couple. 11 years' experience on average.
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.