CQC report explained · a nursing home
What the CQC found at Chester Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were identified and regularly reviewed. Medicines were stored and recorded safely, staff recruitment checks were in place, and infection prevention arrangements were considered effective.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was carried forward.
- Well-led?
- Good
- Inspectors found that management systems had improved, responsibilities were understood and audits were being used to identify improvements. People, relatives and staff said managers were approachable and able to listen to concerns.
What inspectors found, March 2023
Chester Lodge Care Home was rated Good; inspectors found safe care and improved management after earlier failings.
This was an unannounced follow-up inspection on 26 and 27 January 2023. Two inspectors spoke with people living in the home, relatives and staff. They also reviewed care records, medicine records, staff files and management checks.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found kind staff, safe recruitment, suitable training, accurate medicine records, updated risk assessments and a clean, well-maintained environment.
The previous inspection had rated the home Requires Improvement and found breaches of Regulations 12 and 17. Inspectors found that the required improvements had been made and that the home was no longer in breach.
This was a focused inspection of Safe and Well-led. The ratings for Caring, Effective and Responsive were not assessed during this visit and were carried forward from the previous inspection.
Safe medicines practice
Medicine care plans included relevant information, and administration records were accurate and up to date. The home also used stock checks and audits to reduce errors.
“Medicine administration records (MAR) were accurate and up to date. All medicines, including controlled drugs, were stored safely.” from the report
Individual risk planning
Risk assessments and care plans reflected people's needs and were updated when those needs changed. Emergency evacuation plans were also in place for individuals.
“Risks to people had been identified, mitigated and kept under regular review.” from the report
Kind and attentive staff
Inspectors observed caring staff who knew people well and understood how to support them. People and relatives gave positive feedback about the care.
“Staff were caring and attentive to people's needs. Staff knew people well and understood how to meet people's needs.” from the report
Improved oversight
The management team had improved its monitoring systems since the previous inspection. Managers had shared responsibilities with senior staff and acted on areas needing improvement.
“The improvements needed to keep people safe that had been identified at the last inspection had been made.” from the report
Infection control approach still developing
minorInspectors were assured about the home's infection prevention arrangements, but signposted the provider to resources to develop its approach further.
“We have also signposted the provider to resources to develop their approach.” from the report
Audits planned to develop further
minorThe management checks were in place, but the registered manager said they would be developed further to provide more detailed information about quality.
“The registered manager told us that now these were established they would develop them further to give more qualitative data.” from the report
- 01How will you continue to check that the improvements in risk assessments and care records are being maintained?
- 02What further changes are planned to make the quality audits more detailed, and how will families see the results?
- 03What was the previous rating for Caring, Effective and Responsive, and when will these areas next be fully inspected?
- 04How do you make sure staff continue to follow each person's medicine and 'as required' medicine instructions?
- 05How can relatives raise concerns, and what action will be taken if a concern is not resolved?
This was a focused inspection of Safe and Well-led only; the ratings for Caring, Effective and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 1 March 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, April 2022
Chester Lodge Care Home: Rated Requires Improvement; inspectors found kind care and good support with activities, but risk records, medicines and quality checks were not always reliable.
This was an unannounced focused inspection on 08 March 2022 and 16 March 2022. Inspectors spoke with people using the service, relatives and staff. They also observed care and checked care records, medicines, staff files and management records.
The inspectors found caring interactions, suitable staffing arrangements and good support with consent, healthcare, communication and activities. The home was clean and infection control arrangements gave inspectors assurance. However, some risk assessments and care plans lacked important detail. Medicines records did not always clearly follow prescribers' instructions, including for prescribed creams and thickening agents.
The overall rating was Requires Improvement. Safe and well-led were Requires Improvement, while effective and responsive were Good. The home remained in breach of Regulation 17 because its systems for monitoring risks and the quality of care were not robust. The report says the home has been rated Requires Improvement or Inadequate for the last eight consecutive inspections.
Kind and respectful care
Inspectors observed positive interactions. Staff asked for consent and supported people in the least restrictive way possible.
“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; the policies and systems in the service supported this practice.” from the report
Improved staff training
The home had introduced a new training system. Records of training, induction and staff supervision were better than at the previous inspection.
“Improved records of completed training were now maintained.” from the report
Activities and relationships
People could take part in activities and were supported to keep in touch with family and friends, helping to reduce social isolation.
“People told us they enjoyed these activities.” from the report
Clean environment and infection control
The home was maintained to a high standard. Inspectors were assured about infection prevention, PPE, testing and visiting arrangements.
“Checks were in place to ensure people lived in a clean, safe environment which was maintained to a high standard.” from the report
Risk records were not reliable
seriousSome risk assessments, care plans and monitoring records were unclear or incomplete. Inspectors could not always be assured that risks were being managed safely.
“Systems to assess, monitor and mitigate risks to the health, safety and welfare of people using the service were not robust. This placed people at risk of harm.” from the report
Medicines instructions needed more detail
seriousInstructions for some prescribed creams did not say clearly where they should be applied. Risks linked to storing thickening agents had also not been fully considered.
“A number of instructions lacked detail about which part of the body the cream was to be applied.” from the report
Quality checks were not effective enough
seriousAudits had not found the problems identified during the inspection. The provider remained in breach of Regulation 17.
“Audits and regular checks to review the quality of care being delivered were not always effective or sufficiently robust.” from the report
Frequent management changes
needs fixingThere had been three registered managers since the previous inspection. Inspectors said this affected consistency, and some people had not yet built a trusting relationship with the new manager.
“Since our last inspection there had been three different registered managers. This had impacted on the consistency of the quality within the service.” from the report
- 01How are you checking that every person's risk assessment and care plan contains enough detail and is kept up to date?
- 02What checks now confirm that instructions for prescribed creams clearly state where they must be applied?
- 03How have you assessed and controlled the risks linked to storing thickening agents?
- 04What evidence can you show that the new care planning system and additional quality audits are now working reliably?
- 05How are you improving management stability and helping people and relatives build a relationship with the registered manager?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected, and ratings for key questions not inspected carried over from the previous inspection. This explanation was written from the published report of 21 April 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 Chester Lodge Care Home
11 rated inspections over 8 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2018Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- March 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- October 2016Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2016Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
84 live-in carers within about an hour of Cheshire West and Chester
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. 76 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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.