CQC report explained · a nursing home
What the CQC found at Carmel Lodge Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2021
Carmel Lodge Care Home was rated Requires Improvement; inspectors found caring support but risks in care records and management oversight.
This was an unannounced focused inspection on 26 February and 4 March 2021. Inspectors looked at Safe, Responsive and Well-led, following concerns about staffing and pressure care during a COVID-19 outbreak. They spoke with relatives and staff and reviewed care, medicines, recruitment and management records.
The home was rated Requires Improvement overall. Safe and Well-led were rated Requires Improvement. Responsive was rated Good. Inspectors found incomplete records for repositioning, hydration and some pressure care. They could not always be sure that risks to people's health were being monitored safely.
Inspectors also found positive, caring interactions. People had person-centred care plans, access to healthcare and support to keep in touch with relatives. Infection control measures were judged effective, and staff recruitment checks were appropriate.
The home had previously been rated Good in 2018. This focused inspection did not reassess Effective or Caring, so earlier ratings for those questions were carried forward. The provider was asked for an action plan and CQC said it would monitor progress and return to inspect.
Kind interactions
Inspectors saw staff offering choices and respecting people's preferences and consent during care.
“Throughout our inspection we observed positive, caring interactions.” from the report
Communication support
Care plans recorded communication needs, and staff used equipment and video calls to help people stay in contact with families.
“Staff were aware of people's communication needs and had sourced additional equipment such as headphones to facilitate effective communication with families through video calls.” from the report
Infection control
Inspectors were assured that the home had measures to prevent and manage infection during the COVID-19 outbreak.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Safe recruitment
The home completed appropriate checks for permanent and temporary staff, and agency workers received an induction.
“Staff were safely recruited. Appropriate checks had been made before being offered employment.” from the report
Incomplete care records
seriousRecords did not always show that people had been repositioned or supported with hydration. This meant inspectors could not be sure that pressure care and other risks were being safely monitored.
“Some monitoring documentation was incomplete. There was a lack of review or oversight by senior staff.” from the report
Staffing pressure
needs fixingThe COVID-19 outbreak led to staff absences, agency use and changes in the staff team. Staff described periods when staffing was not always sufficient and morale was poor.
“On the dates we completed our unannounced visits to the home, staffing levels were appropriate, however staff told us of, and rotas confirmed, some dates when this had not always been the case.” from the report
Family communication
needs fixingSome relatives said calls were not returned and they did not receive regular or accurate updates about falls, medicines and their relative's health.
“It has been overall very difficult, no regular updates and calls are not returned. It is impossible to get through.” from the report
- 01How are you now checking that repositioning and pressure care records are completed for every person who needs them?
- 02How do you monitor people's fluid intake and identify gaps in hydration records?
- 03What changes have you made to staffing levels and agency use since the COVID-19 outbreak?
- 04How will families receive regular updates, and who should we contact if a call is not returned?
- 05What evidence can you show that the action plan for Regulation 17 has been completed and checked?
This was an unannounced focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 22 April 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.
What inspectors found, March 2018
Carmel Lodge Care Home was rated Good; inspectors found safe, kind and personalised care, with a few small improvements needed.
Inspectors visited on 5 and 6 February 2018 without warning. They spoke with residents, relatives, staff and health professionals. They observed care and checked care plans, medicines, staff records, complaints, safety checks and other documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Residents and relatives were positive about the care and staff. Inspectors found safe medicines management, enough staff, personalised care plans and good links with health professionals.
A few issues were identified for the manager to address. These included less frequent fire drills for night staff, small and difficult-to-read menus, and a small and difficult-to-read activities display. The home still met all relevant fundamental standards.
The home had also been rated Good at its previous inspection. This inspection used a shorter report because the overall rating had not changed.
Safe care
Inspectors found effective safeguarding, risk management, staffing and medicines systems. People and relatives said they felt safe.
“The arrangements for how medicines were managed were safe.” from the report
Kind staff
Staff understood people's needs and treated them with patience, dignity and respect. Inspectors saw relaxed and caring interactions.
“All our observations were that the staff engaged with people in a caring and relaxed way.” from the report
Personalised support
Care plans included people's histories, preferences and wishes. They were maintained and reviewed regularly.
“Care plans were personalised and reflected the needs of the individual.” from the report
Strong management checks
The manager and provider used audits, meetings and action plans to monitor the service and resolve issues.
“Quality assurance systems were robust and considered a wide range of service provision.” from the report
Menus were hard to read
minorThe menus were described as small and difficult to read. This was raised with the manager.
“We did note the menus were quite small and not easy to read which we raised with the manager to address.” from the report
Activities information was hard to read
minorThe display showing activities was small and difficult to read. Inspectors asked the manager to address this.
“We noted that the display of activities was small and not easy to read.” from the report
- 01What has been done to make sure night staff take part in fire drills as regularly as day staff?
- 02Have the menus been made larger and easier for residents to read?
- 03Has the activities display been changed so residents can read it easily?
- 04How are residents' care plans and risk assessments kept up to date?
- 05How can residents and relatives raise a complaint, and how will the home respond?
This was an unannounced inspection of the whole care home and all five rating areas; the report used a shorter format because the overall Good rating had not changed. This explanation was written from the published report of 13 March 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 Carmel Lodge Care Home
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- April 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- February 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 11 November 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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