CQC report explained · a residential care home
What the CQC found at Broughton Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were mostly protected from abuse and medicines and infection control were managed safely. However, safety protocols could restrict everyday relationships, and incident information was not always gathered and reviewed fully enough to identify learning.
- Effective?
- Requires improvement
- Staff training, food support and access to healthcare were effective. However, the design of the home did not meet everyone’s needs, and some day-to-day opinions and choices were not always sought.
- Caring?
- Good
- Staff were warm, caring and respectful. People were supported to communicate, make choices, build independence and maintain dignity.
- Responsive?
- Requires improvement
- Care plans were detailed, but some focused more on routines, risks and triggers than on choice, control and understanding what people were communicating. Some people had limited opportunities to form relationships or take part in community life.
- Well-led?
- Requires improvement
- Managers had systems for safety checks and engaged with families, advocates and other professionals. However, governance did not properly assess people’s experience, the culture of the home or lessons from incidents.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found kind care and safe medicines, but concerns about the home’s institutional setting, person-centred support and oversight.
Inspectors visited on 16, 20 and 24 May 2022. They spoke with and observed eight people, contacted eight relatives, spoke with 13 staff and reviewed care, medicine and management records. The inspection considered the care home and personal care provided in people’s own homes.
Staff were warm, caring and respectful. People had individual care plans, support with healthcare and generally safe medicines. Families said people were treated well, and some people had gained independence or moved into their own homes.
However, the home was institutional in style and did not always support ordinary living, choice or relationships. Strict safety arrangements could limit people’s everyday interactions. Care plans relied too much on routines and risk reduction, and incidents were not always reviewed well enough to learn lessons.
The overall rating changed from Good to Requires Improvement. Safe, Effective, Responsive and Well-led were all Requires Improvement. Caring remained Good. The provider breached Regulations 9 and 17 and must send an action plan. CQC said it would monitor progress and return for another inspection.
Kind and respectful staff
Inspectors saw staff treat people warmly and with dignity. Families also described the care as caring and supportive.
“Staff in their interactions showed a warm, caring and respectful approach towards people.” from the report
Safe medicines
People’s medicines were managed safely. The home used medicine reviews and checks, including reviews aimed at avoiding excessive use of some medicines.
“People's medications were managed safely.” from the report
Healthcare support
Staff worked with health professionals and adapted support to people’s needs. Families said staff helped them get the most from medical appointments.
“People received effective and creative support when accessing community healthcare services.” from the report
Support for independence
Some people learned skills such as planning and cooking meals. Some had moved into their own homes, while others were preparing to do so.
“Some people had recently moved from Broughton Lodge into their own homes and other people were ready to do this and were planning this move.” from the report
Family communication
Families said they felt involved and could contact staff easily. The home used key workers, agreed communication arrangements and a newsletter.
“Staff are very good at keeping in touch… If we have a query, we call them, or email and they are always quick to respond.” from the report
Institutional environment
seriousThe home was large and institutional rather than domestic. Some features, including frosted windows, observation windows and limited communal space, did not always reflect people’s experience or preferences.
“Broughton Lodge was institutional in style; it was large and not domestic.” from the report
Choice and ordinary living
seriousStrict protocols helped reduce risks between people but could prevent natural interaction and relationships. Day-to-day views and opinions were not always sought.
“The service was not consistently meeting the principles of Right support, right care, right culture.” from the report
Care plans and routines
needs fixingSome care plans relied too much on routines and reducing risks. They did not always focus on increasing choice and control or understanding what a person was communicating through their actions.
“Care plans did not always focus on listening to people, increasing their choice and control or trying to work out what a person was trying to communicate by their actions.” from the report
Learning from incidents
needs fixingIncident reviews did not always look for patterns or gather staff and people’s perspectives. This meant opportunities to improve support were missed.
“This system was fragmented and was not effective in gathering, recording and assessing information to enable senior staff to be effective in their roles.” from the report
Limited relationships and community opportunities
needs fixingSome people had not developed relationships at the home or in the community. Activities did not often focus on helping people build relationships with others.
“A number of people had not developed any relationships within the community or with other people living at the home.” from the report
- 01How would you assess whether this home is the right accommodation for my relative’s needs, preferences and desired level of independence?
- 02What has changed in the building and communal areas to make the home feel less institutional and more suitable for ordinary living?
- 03How will staff support my relative to make day-to-day choices rather than following routines automatically?
- 04How do you review incidents, including patterns involving particular people, staff, times or activities, and how is the person’s own perspective included?
- 05What opportunities would my relative have to build relationships and take part in activities in the community?
This inspection assessed the principles of Right support, right care, right culture and included all five key questions; infection prevention and control was also checked, while the supported living premises were not regulated as part of this inspection. This explanation was written from the published report of 15 October 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, January 2019
Rated Good overall, but inspectors found supervision and staff training were not always effective.
Inspectors visited without notice on 14 and 17 December 2018. They spoke with people living in the home, relatives, staff and professionals. They observed care and reviewed care plans, staff records, medicines, complaints, safeguarding records and audits.
The home was rated Good for Safe, Caring, Responsive and Well-led. Inspectors found kind and respectful care, personalised activities, good care planning, safe medicines systems and management oversight.
Effective was rated Requires Improvement. On three occasions, a person did not receive the expected one-to-one supervision because staff were not close enough. Some newer staff had also not completed all relevant training. The manager took action during and after the inspection.
Kind and respectful care
Inspectors saw staff respond sensitively to people's needs. People were encouraged to follow their own routines and were treated with dignity.
“Overall, we observed that staff were sensitive and responsive in their approach to people's needs and that people were encouraged to follow their preferred daily routines and treated with dignity and respect.” from the report
Personalised activities
People had individual timetables and were supported with activities at home and in the community, including trips, college and exercise.
“People had been supported to access local leisure, recreational and social facilities and to participate in their preferred trips to various destinations such as Knowsley Safari Park, Flip Out (a trampolining activity in Manchester) and Rudyard Lake.” from the report
Detailed care planning
Care records included information about people's histories, needs, communication and risks. Records were reviewed so they could be updated when needs changed.
“Files viewed contained an index form, were generally well organised and contained comprehensive person-centred information about people's biography, needs, support requirements and how to keep people safe.” from the report
Access to advocacy
An independent advocate visited weekly and helped people express their views, raise concerns and attend meetings.
“The registered provider continued to employ an independent advocate to engage with people using the service on a weekly basis.” from the report
Supervision was not always provided
needs fixingInspectors saw three occasions when a person did not receive appropriate supervision because support staff were not nearby. They said there was no direct impact on wellbeing, but the service was not consistently meeting people's needs.
“During the two days of our inspection, we observed three occasions when a person using the service was not receiving appropriate supervision as support staff were not within proximity of the person.” from the report
Some staff training was incomplete
needs fixingSeveral newer staff had not completed all training relevant to their roles. The home had booked priority training and was monitoring progress.
“Consequently, some staff had not completed all training relevant to their roles and responsibilities.” from the report
Staff vacancies and agency use
needs fixingThe home had several vacant support worker posts and was covering many hours through overtime and agency staff. The provider was recruiting and aiming to reduce agency use.
“The manager told us that the service was covering on average 429 hours per week via overtime and the use of agency staff that were known to the care home.” from the report
No registered manager at the visit
minorThere was no registered manager when inspectors visited. A new manager was in post and was applying to become registered.
“At the time of our inspection, the care home did not have a registered manager in post.” from the report
- 01How do you make sure each person receives their planned one-to-one supervision whenever it is needed?
- 02Have all staff now completed the training relevant to the people they support?
- 03How many support worker vacancies remain, and how often are agency staff currently used?
- 04Has the manager now become registered with CQC?
- 05What changes have been made to daily walk-round records, fire drill records and staff rotas?
This was an unannounced inspection of the whole service and considered all five CQC questions, including the care provided and the care home premises. This explanation was written from the published report of 9 January 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 Broughton Lodge
4 rated inspections over 5 years: the service has improved, from Inadequate to Requires improvement.
- October 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2019Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- July 2015
Registered with the Care Quality Commission on 23 July 2015.
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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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 £980 to £1,260 a week. 88 can care for a couple. 10 years' experience on average.
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