CQC report explained · a residential care home
What the CQC found at Boughton Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rated Requires Improvement; inspectors found kind, personalised care but serious safety, medicines, staffing and management problems.
Inspectors made an unannounced visit over four days in September 2023. They spoke with people, staff and representatives, observed care, and checked care, medicines, accident and incident records, audits and recruitment files.
The home was caring and responsive. People were treated with kindness and dignity, involved in their care plans, supported with food and drink, and helped to access healthcare, activities and their cultural faiths.
However, inspectors found increased risks to people's safety. Medicines were missed or given late, safeguarding concerns were not always reported, night staffing was not always enough, recruitment checks were incomplete, and fire, water, equipment, infection control and other safety checks were not reliable. The home was rated Requires Improvement overall, with the same rating for Safe, Effective and Well-led. Caring and Responsive were rated Good.
Kind and respectful care
People received care from staff who knew them. Inspectors saw staff speaking positively to people and respecting their privacy, dignity and independence.
“People received care from staff that knew them well.” from the report
Personalised support
People and families helped create care plans. These recorded individual preferences, communication needs, routines and goals.
“People and their families were involved in creating their care plans.” from the report
Food and healthcare
Food and drinks matched people's needs and preferences, including modified meals where needed. Staff identified illness and referred people to healthcare professionals promptly.
“People received food and drink that met their needs and preferences.” from the report
Activities and relationships
People were supported to take part in activities, maintain relationships and continue practising their cultural faiths.
“People were encouraged to socialise and maintain those relationships important to them.” from the report
Medicines
seriousPeople did not always receive medicines as prescribed. Time-critical medicines were late, and records and audits did not reliably identify missed or unsafe administration.
“People did not always receive their medicines as prescribed.” from the report
Building and environmental safety
seriousInspectors found gaps in fire, water, electrical, gas, equipment and boiler checks. They also found hazards including unprotected stairs, unsafe radiator access, unlocked cleaning products and blocked emergency access.
“People were at risk of harm from the lack of protection from environmental hazards.” from the report
Safeguarding and incident reporting
seriousStaff did not always recognise or report possible abuse. Three unexplained injuries had not been reported as safeguarding concerns, and accident and incident records were incomplete.
“People were not always protected from harm and abuse as staff did not always understand how to recognise and report any concerns.” from the report
Night staffing
seriousThere was only one staff member in the home at some points during night tasks and breaks. This meant staffing might not meet people's needs or maintain safety and cleanliness.
“There were not enough staff deployed at night to ensure people's needs were met.” from the report
Infection control
needs fixingStaff did not always handle used protective equipment or dirty laundry safely. There was no reliable system for deep cleaning rooms and communal areas after an infection episode.
“Staff did not always follow infection prevention measures when disposing of used PPE or separating dirty and clean laundry.” from the report
- 01What changes have been made to ensure time-critical and as-needed medicines are given safely and recorded correctly?
- 02How many staff are now present overnight, including when staff take breaks or complete laundry tasks?
- 03Which fire, water, electrical, gas, equipment and boiler safety checks have been completed, and when will the remaining work be finished?
- 04How are safeguarding concerns, unexplained injuries, accidents and incidents now recorded, reported and reviewed?
- 05What recruitment and competency checks have been completed for current staff, especially for safeguarding and medicines?
This was an unannounced inspection covering all five key questions and infection prevention and control; the previous overall rating was Good, published on 12 January 2018. This explanation was written from the published report of 22 November 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 2018
Rated Good overall, but Safe Requires Improvement because maintenance and cleanliness needed prompt improvement.
This was an unannounced inspection on 21 November 2017. The inspector and an expert by experience spoke with people, a relative, staff and managers. They observed care and checked care plans, staff records, medicines, maintenance, complaints and quality checks.
The home had improved since its previous inspection in October 2016. People were supported by kind staff, received suitable care and had their choices respected. Care plans were personalised, activities were available and healthcare needs were followed up.
The Safe rating remained Requires Improvement. Inspectors found damage in the main bathroom had not been repaired quickly enough, and some areas were not clean. Food and drink records were not always complete, and the home was advised to improve its quality audits.
The overall rating was Good. Effective, Caring, Responsive and Well-led were all rated Good, while Safe was rated Requires Improvement.
Kind and respectful care
People were treated with kindness and compassion. Staff listened to people's wishes, offered choices and respected independence.
“People were treated with dignity and respect and they were able to make their own choices about how they spent their time.” from the report
Personalised care
Care plans reflected people's individual needs and preferences. Staff knew people well and adapted support as their needs changed.
“Each person had an individualised care plan which reflected the care they required.” from the report
Healthcare support
Staff monitored people's health and contacted healthcare professionals when needed. They followed up actions and shared accurate information.
“People's healthcare needs were carefully monitored and staff worked proactively to support people to have access to healthcare professionals.” from the report
Open management
The manager and provider involved people, relatives and staff in improvements. Feedback was collected and acted on.
“There was an open and transparent culture within the home, with the home's CQC rating gained at the last inspection, on display.” from the report
Delayed maintenance
needs fixingThe damaged casing around the bath in the main bathroom had been known about since the previous inspection. Repairs had not been completed promptly, although a replacement bath had been ordered.
“The approach within the home to anticipate and manage risks was not proactive and this had led to people being exposed to unnecessary risks.” from the report
Cleaning standards
needs fixingInspectors found dirt and dust in bathroom areas, including a toilet frame that needed a deep clean or replacement. The home had started a deep clean, but its usual cleaning was not thorough enough.
“The daily cleaning was not sufficient to ensure all areas of the home were cleaned regularly and thoroughly.” from the report
Incomplete food and drink records
minorRecords did not always show everything people had eaten and drunk, or receive a full review. Inspectors recommended getting advice about managing nutrition records.
“We found that the records of what people ate and drank required attention as not all food and drinks that had been consumed had been recorded or reviewed” from the report
Quality checks needed strengthening
minorThe home had audits, but they had not identified cleanliness problems early enough. Inspectors recommended that audits become more thorough and proactive.
“We recommend the provider seek advice and guidance from a reputable source about auditing procedures” from the report
- 01Has the damaged bath in the main bathroom now been replaced, and how are maintenance risks checked before they affect residents?
- 02What regular cleaning checks are now carried out in bathrooms and other shared areas?
- 03How do you record and review what each resident eats and drinks, especially if they are at nutritional risk?
- 04How do your audits now identify cleanliness and maintenance problems early?
- 05What improvements have been made since the previous inspection, and how are families told about any remaining issues?
This was an unannounced inspection covering all five CQC questions, including observations, discussions with people and staff, care records, medicines, maintenance and quality systems. This explanation was written from the published report of 12 January 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 Boughton Lodge Care Home
4 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 10 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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