CQC report explained · a residential care home
What the CQC found at Conifer Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2018
Conifer Lodge was rated Good; inspectors found safe, kind and responsive care, with one recommendation about accessible information.
Inspectors visited the home without notice on 14 December 2017. They observed care, spoke with people, relatives and staff, and checked care plans, staff records, medicines records and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines systems, clean surroundings and suitable risk checks.
People were treated kindly and involved in choices about their care, food and daily activities. Their health, nutrition, communication needs, relationships and end of life wishes were supported.
The home had improved its medicines management and quality monitoring since the previous inspection. Inspectors made one recommendation that the home should improve its understanding and use of the Accessible Information Standard.
Medicines
Medicines were stored, given, checked and recorded safely. The home had improved its systems since the previous inspection.
“Medicines were managed safely and in accordance with current regulations and guidance.” from the report
Kind, respectful care
Staff knew people well and supported their choices, dignity and independence. Inspectors saw friendly and caring interactions.
“People were supported with kindness and compassion.” from the report
Improved oversight
The home had introduced regular audits and action plans to monitor care and identify improvements. This addressed concerns found at the previous inspection.
“Improvements had been made and the provider was now meeting the legal requirements of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Accessible information
minorMost staff did not know about the Accessible Information Standard. Inspectors recommended training and written procedures so people's communication needs are consistently identified and met.
“We recommend that the provider obtains information, sources training and implements policies and procedure in relation to compliance with the AIS.” from the report
- 01What training and written procedures have you introduced about the Accessible Information Standard?
- 02How will you record and meet my relative's communication needs, including if they cannot easily speak or understand information?
- 03How are medicines, including as-required medicines, checked and audited now?
- 04How will you involve my relative and our family in creating and reviewing the care plan?
- 05What activities and one-to-one support would be available if my relative preferred to spend time in their room?
This was an unannounced inspection covering all five key questions, including care, premises, records, staff and quality systems; it also checked whether concerns from the 2016 inspection had been addressed. This explanation was written from the published report of 8 February 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.
What inspectors found, November 2016
Rated Requires Improvement; inspectors found kind and effective care, but medicines management and quality checks were not reliable.
This was an unannounced, comprehensive inspection on 29 September 2016. Two inspectors and an expert by experience observed care, meals and medicines. They spoke with people, relatives, staff and managers, and checked care plans, medicine records, staffing information, complaints and audits.
People were treated with kindness and respect. Staff supported people's independence, health needs, food and drink choices, and access to activities. Staff understood consent and safeguarding. Recruitment checks and arrangements for reducing risks were also found to be suitable.
There were important shortfalls. Some medicines records were inaccurate, medicine stocks did not always match the records, and checks on storage temperatures were incomplete. Quality audits were not completed consistently or were not effective. Some care plans had gaps, some people felt bored, and staffing levels had not been reviewed in line with the provider's own process.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good, while Safe and Well-led were rated Requires Improvement. The report says two legal requirements were not met.
Kind and respectful care
Inspectors saw warm and patient interactions. People were treated with dignity and were supported to make their own choices.
“People were treated with dignity and respect by kind and caring staff.” from the report
Support for independence
People were encouraged to live their lives with as much choice and independence as possible. Their freedom was not unnecessarily restricted.
“People were supported to live the life they chose and their freedom was not restricted.” from the report
Health and nutrition
The home helped people access healthcare and catered for different diets and preferences. Drinks and snacks were available throughout the day.
“People's nutritional needs were met and people could choose what to eat and drink on a daily basis.” from the report
Staff training and consent
Staff received induction, training and supervision. Inspectors found that staff understood consent and the Mental Capacity Act.
“There were systems in place to ensure that staff received the induction, training and support they needed to meet people's needs effectively.” from the report
Medicine records and storage
seriousSome medicine stocks did not match the records. Instructions for 'as and when needed' medicines were missing in some cases, and staff did not always record administration accurately.
“The stocks of some medicines did not balance with the records, and medication administration records had not always been completed accurately.” from the report
Weak quality checks
seriousCare plan and medicine audits were not completed as required and did not reliably identify problems. This meant the provider could not be sure that care plans reflected people's needs.
“The provider had not ensured the processes they had in place to monitor quality and identify areas for improvement were effectively implemented.” from the report
Staffing reviews
needs fixingThe home had not completed dependency assessments as often as its own protocol required. It had also not shown that staffing levels were reviewed when dependency scores increased.
“The provider could not be assured that the staffing levels were still sufficient to provide people with care that was responsive to their needs.” from the report
Activities and care plan gaps
minorAn activity timetable had been introduced, but some people still felt they did not have enough to do or did not go out often enough. Some care plans also needed more information.
“A range of daily activities were available however, some people felt bored and records did not always reflect how people spent their time.” from the report
- 01What has been changed to make sure 'as and when needed' medicines have clear instructions and are recorded correctly?
- 02How do you now check that medicine stocks, administration records and storage temperatures are accurate?
- 03When was the last dependency and staffing review completed, and what did it show?
- 04How have you made sure care plans are complete, current and checked effectively?
- 05What activities and outings are now available for people who cannot go out independently?
This was an unannounced comprehensive inspection covering all five CQC questions and checking progress against issues found at the July 2015 inspection. This explanation was written from the published report of 4 November 2016 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 Conifer Lodge
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- February 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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.
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46 live-in carers within about an hour of Brighton and Hove
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 £1,020 to £1,280 a week. 37 can care for a couple. 10 years' experience on average.
“Lottie showed incredible patience and empathy, adapting her routine to fit in with Mum's moods. Most importantly, Lottie's cheerful manner helped Mum to get some enjoyment out of life.”
“He was infinitely patient with them and got on very well with us to the extent that we now regard him as a personal friend.”
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.