CQC report explained · a residential care home
What the CQC found at Cosin Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Rated Requires Improvement; inspectors found safe staffing and caring support, but concerns about restrictive practice and management oversight.
The inspection took place on 12 and 13 April 2023. One inspector visited the home, spoke with people, relatives, staff and a professional, and reviewed care records, medicine records, recruitment files, policies, audits and training records.
The home was generally clean, well maintained and safely staffed. Medicines were managed safely. Staff understood people's communication needs and care plans gave clear guidance. However, inspectors found that one restrictive practice was not properly documented, reviewed or included in the person's legal authorisation.
The overall rating changed from Good at the last inspection in 2017 to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The report says the provider must improve its systems and has asked for an action plan.
Enough skilled staff
Inspectors found that staffing levels and staff skills matched people's needs and kept them safe.
“The service had enough staff to safely support people. The numbers and skills of staff matched the needs of people using the service.” from the report
Safe medicines
People received medicines as prescribed. Records were clear, and staff recorded why and whether as-needed medicines worked.
“Medicines were managed safely, and people received their medicines as prescribed.” from the report
Good understanding of people
Staff knew people well, followed their support plans and understood their communication needs. Care plans reflected people's health and support needs.
“People had individual support plans in place which contained good information about people's health conditions and the impact on them.” from the report
Supportive culture
Staff said they felt respected, supported and valued. The home sought feedback and used it to make changes.
“There was a positive culture within the service. The registered manager and deputy manager set a culture that valued reflection, learning and improvement” from the report
Restrictive practice
seriousOne practice used to monitor a person could be restrictive and intrusive. The records did not show that less restrictive options had been considered or that regular reviews took place.
“Documentation did not demonstrate less restrictive and intrusive options had been considered.” from the report
Management checks missed the problem
needs fixingThe home's audits and oversight did not identify the issue with the restrictive practice. CQC recommended getting advice about oversight and compliance with the Mental Capacity Act.
“However, governance processes were not robust enough around the use of a restrictive practice for a person who lacked capacity to consent to this practice, and this had not been identified.” from the report
- 01What was the restrictive practice identified by CQC, and exactly what has changed since the inspection?
- 02How do you now record, review and legally authorise any restrictive practice?
- 03How do you check that less restrictive options have been considered before using a restrictive practice?
- 04What action plan did you send to CQC, and what progress has been made?
- 05How do your audits now identify problems with restrictive practices and Mental Capacity Act requirements?
This was a focused inspection of Safe and Well-led; the other key question ratings were not inspected and were carried forward from the previous inspection in 2017. This explanation was written from the published report of 9 June 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, September 2017
Rated Good; inspectors found safe, kind and person-centred care, with minor actions around aprons and supervision records.
The announced inspection took place on 15 August 2017, with relatives contacted by telephone on 22 August. The inspector spoke with people, relatives, the manager and care staff. They observed care and checked care records, staff files, medicines and quality records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found safe staffing, suitable medicines systems, trained staff, regular care plan reviews and kind interactions. People were supported with their health, food, activities, choices and relationships.
The home had remained Good since the previous inspection in November 2014. Inspectors found that it met all the fundamental standards they checked. Quality audits had identified some actions, including staff not always wearing aprons during food preparation and not all staff having a supervision agreement.
People felt safe
People and relatives told inspectors they felt safe and well cared for. Staff understood safeguarding procedures and how to report concerns.
“People and relatives we spoke with told us they felt safe at Cosin Lodge.” from the report
Kind and respectful care
Inspectors saw warm, positive interactions. Staff respected people's privacy, dignity and choices.
“We observed staff treating people kindly and with respect.” from the report
Strong quality checks
The home used audits, feedback and action plans to review its care, environment and safety. Accidents and incidents were monitored for patterns.
“The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Cosin Lodge” from the report
Some routine actions remained
needs fixingThe home's audits identified that staff did not always wear aprons during food preparation and that some supervision agreements were not yet in place. Ask what action was taken and whether this is now complete.
“For example there was an action about staff not always wearing aprons with food preparation and that not all staff had a supervision agreement in place.” from the report
- 01What action has been taken about staff not always wearing aprons during food preparation?
- 02Do all staff now have a supervision agreement, and how often are they supervised?
- 03How would you assess and review my relative's individual needs, wishes and preferences?
- 04What activities and community outings would be available for my relative?
- 05How would you involve my relative and our family in decisions, complaints and changes in care?
This was an announced inspection covering all five key questions, including observations, care records, staff files, medicines, quality records and telephone discussions with relatives. This explanation was written from the published report of 30 September 2017 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 Cosin Lodge
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodWell-led: Good
- January 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 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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47 live-in carers within about an hour of County Durham
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 £960 to £1,210 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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.