CQC report explained · a residential care home
What the CQC found at Autumn Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were administered safely, infection controls were in place and there were enough staff. Recruitment checks had also been completed.
- Effective?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found clear management roles, regular quality checks, an open culture and good working relationships with health and social care professionals.
What inspectors found, November 2022
Rated Good; inspectors found safe care, accurate medicines records and strong management, with improvements since the last inspection.
The inspection was unannounced and took place on 13 October 2022. One inspector reviewed records, observed care and spoke with people, relatives, staff and health professionals. Most people were living with advanced dementia, so observations were also used to understand their experience.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe medicines systems, suitable infection control and well-managed risks. Care plans and risk assessments had been updated, and an electronic system gave staff quick access to care information.
This was a focused inspection. The other key questions were not inspected during this visit, so their ratings carried over from the previous inspection. The overall rating improved from Requires Improvement at the last inspection, published on 4 June 2021, to Good.
Updated care information
Care plans and risk assessments had been reviewed and transferred to an electronic system. Staff could access information about people's needs quickly.
“The provider had implemented an electronic care system that allowed staff to have immediate access to information about people's care and support.” from the report
Enough staff
Inspectors found enough staff to support people safely, including people who needed extra help with moving or eating. The home used agency staff when needed.
“There were enough staff in place to ensure people remained safe and met their needs.” from the report
Safe medicines
Staff were trained and checked for competence. Medicines were stored and given safely, and records showed they were given as prescribed.
“Medication Administration Records (MAR) showed people received their medicines as prescribed and these records were completed accurately.” from the report
Open management
The registered manager was approachable and encouraged feedback from people, relatives, staff and professionals. Inspectors also found effective quality checks and partnership working.
“The registered manager was visible in the service, approachable and took a genuine interest in the feedback from people, staff, family and other professionals.” from the report
Further environmental work underway
minorThe home had already improved some flooring and lighting, but inspectors said more environmental improvements were still in progress.
“The provider was in the process of making further improvements around the home.” from the report
- 01What environmental improvements were still outstanding after this inspection, and have they now been completed?
- 02How do you keep the electronic care plans and risk assessments up to date when a person's needs change?
- 03How do you maintain safe staffing levels when permanent staff are off sick or unavailable?
- 04What support is available for people living with dementia, and how do you work with specialist health professionals?
- 05What were the ratings and findings for Effective, Caring and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their ratings carried over from the previous inspection. This explanation was written from the published report of 17 November 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.
What inspectors found, June 2021
Rated Requires Improvement; inspectors found kind, person-centred care but weaknesses in risk records and oversight.
Inspectors visited on 3 March and 25 March 2021. They spoke with staff, relatives and a healthcare professional, observed care, and reviewed care plans, risk assessments and management records. The inspection was prompted partly by a reported fall, but it did not examine the circumstances of that incident.
The home provided care for 34 older people, many living with advanced dementia. Staff were caring, had time for people and supported choice, activities, food and healthcare well. Infection prevention arrangements were also found to be effective.
The main problem was safety information. Some risk assessments and short support plans were incomplete or contradicted other records. This meant staff might not have had the right instructions. The registered manager had not identified these issues through the home's checks. The provider said records had since been updated and monitoring introduced, but inspectors said time was needed to make sure the changes worked in practice.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. This was the first inspection since the service registered in 2019.
Kind and respectful care
Staff spent time with people, spoke kindly and supported their dignity, choices and independence.
“People were treated well and supported by staff that cared about them.” from the report
Good dementia support
The home used dementia-focused training and adapted its environment with memory areas, activity areas, lighting and contrasting toilet seats.
“The provider had created 'memory' and 'activity' areas throughout the home to both add interest for people and to help to orientate people.” from the report
Personalised choices
Care plans included people's likes, dislikes, communication and mobility needs. Staff adapted meals and supported people to choose how they spent their time.
“People had personalised care at the home.” from the report
Infection prevention
Inspectors were assured about the home's COVID-19 arrangements, including PPE, testing, cleanliness, visiting and outbreak planning.
“We were assured that the provider was using PPE effectively and safely.” from the report
Open communication
Relatives received updates and could raise concerns with the registered manager. The home also worked with GPs and other healthcare professionals.
“Relatives told us the registered manager was always available if they had concerns and they thought the service was very open and achieved good outcomes for people.” from the report
Conflicting risk information
seriousSome records did not clearly explain how staff should reduce risks. Paper and electronic records sometimes gave different instructions, including about using the stairs. This could have led to the wrong support.
“Contradictions within care records meant that people might have received the wrong support from staff.” from the report
Monitoring people on stairs
seriousThe layout made it difficult to constantly know where everyone was. People who needed help on the stairs might not always have received it.
“This meant that people that needed help on the stairs may not always get it.” from the report
Management checks
needs fixingThe registered manager had not found the gaps and contradictions in care records through the home's own monitoring. Records were updated after the inspection, but the changes still needed to become established in practice.
“The registered manager had not identified discrepancies between care plans and risk assessments on paper and electronic systems.” from the report
- 01How are risk assessments and short support plans now checked against each other?
- 02What clear instructions are now in place for people who use the stairs or need mobility support?
- 03How do staff know they are using the current care plan while the electronic system is being introduced?
- 04How do you monitor whether people who need help on the stairs are seen promptly?
- 05What evidence can you show that the changes made after this inspection are working in practice?
This was a first inspection covering all five key questions, including infection prevention and risk management; it did not examine the circumstances of the fall that prompted part of the inspection. This explanation was written from the published report of 4 June 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.
Every inspection of Autumn Lodge
4 rated inspections over 8 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2019
Registered with the Care Quality Commission on 9 April 2019.
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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Most charge £1,020 to £1,280 a week. 37 can care for a couple. 10 years' experience on average.
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