CQC report explained · a residential care home
What the CQC found at Davigdor Lodge Rest Home
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- People were not always protected from avoidable harm because risk assessments were incomplete, out of date or not detailed enough. Medicines, staffing, recruitment and infection control were found to be safe.
- Effective?
- Good
- This question was not inspected during this focused visit, so no new rating was given.
- Caring?
- Good
- This question was not inspected during this focused visit, so no new rating was given. Inspectors did observe warm interactions and found staff caring in their approach.
- Responsive?
- Good
- This question was not inspected during this focused visit, so no new rating was given.
- Well-led?
- Requires improvement
- The manager was approachable and people, relatives and staff spoke positively about the culture. However, management systems did not reliably identify risks or make sure improvements were completed.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found unsafe risk management and weak quality checks, although medicines, staffing and day-to-day care were generally good.
This was an unannounced focused inspection on 07 March 2023. Inspectors looked mainly at Safe and Well-led because of concerns about risk management, staffing and information sharing. They spoke with 5 people, 5 relatives and 7 staff, and checked care, medicines, recruitment and management records.
The home did not always assess or manage risks properly. Fire risks were not fully assessed, some emergency evacuation plans were out of date or missing, and some risk records were unclear after incidents. Management checks also failed to identify problems with accidents, safeguarding records and environmental safety.
Inspectors found enough trained staff, safe recruitment, safe medicines management and caring relationships. People were supported in line with the Mental Capacity Act. The overall rating fell from Good at the previous inspection in 2019 to Requires Improvement because this inspection found breaches of regulations 12 and 17.
Safe medicines
Medicines were given as prescribed. Records and storage were safe, and staff competency was checked.
“People's medicines were managed safely, and they received them as prescribed.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks were in place to help ensure staff were suitable.
“There were enough staff to safely support people.” from the report
Safeguarding knowledge
Staff knew how to recognise and report abuse, including to outside organisations. The home was working within the Mental Capacity Act.
“Staff were trained in safeguarding and knew how to report any concerns both within the service and to outside organisations such as the local authority safeguarding team.” from the report
Caring relationships
People appeared comfortable with staff, and inspectors saw warm interactions. People and relatives said they felt safe and able to raise concerns.
“People were comfortable with staff and we observed warm interactions throughout the inspection.” from the report
Involvement
People and relatives were asked for their views through meetings, calls and surveys. Staff also said they could suggest improvements.
“People and their relatives were engaged and involved in shaping their care in the way they wanted.” from the report
Risk assessments
seriousKnown risks were not always assessed or reduced effectively. Some records were contradictory or had not been updated after incidents.
“Risks were not always effectively assessed or mitigated. This meant people were exposed to unnecessary harm.” from the report
Fire safety and evacuation
seriousA smoking-related fire risk did not initially have a robust assessment. Some personal emergency evacuation plans were out of date or missing from the emergency bag.
“People had personal emergency evacuation plans (PEEPs) however not all of these were up to date or available in the 'grab and go' emergency bag.” from the report
Learning from incidents
needs fixingFalls and other incidents were not consistently reviewed and analysed for patterns. This could mean missed opportunities to prevent repeat incidents.
“There was a lack or review and analysis of other incidents, such as falls, to look for patterns and trends.” from the report
Management checks
seriousQuality checks did not identify the problems found by inspectors. Reviews of accidents and safeguarding concerns were not up to date, and completed environmental actions were not always checked.
“Governance processes were not always operating effectively to identify where improvements were required.” from the report
- 01What has been done to complete and regularly review fire risk assessments, especially for people who smoke in their rooms?
- 02Are every person's personal emergency evacuation plans now up to date and kept in the emergency grab-and-go bag?
- 03How are falls, safeguarding concerns and other incidents now reviewed for patterns and recorded?
- 04How does the manager check that environmental safety actions, including portable appliance testing, have been completed?
- 05What progress has been made on the action plan required after the Regulation 12 and Regulation 17 breaches?
This was a focused inspection of Safe and Well-led, including infection control under Safe; the other key-question ratings were not inspected and the overall rating used previous inspection ratings where needed. This explanation was written from the published report of 31 May 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, March 2019
Rated Good in all five areas; inspectors found safe, kind and personalised care, with improvements since the last inspection.
This was an unannounced, planned comprehensive inspection on 11 February 2019. One inspector spoke with people, staff and managers, observed medicines being given, and checked care records, staff files, rotas, incidents, complaints and quality checks.
The home was supporting 25 people with mental health conditions. Inspectors found that people felt safe, had enough staff, received medicines safely and were supported to access health care. Staff knew people's needs and treated them with kindness, dignity and respect.
Care was personalised. People were supported to make choices, maintain relationships, take part in activities and work towards greater independence. The home had systems for handling complaints and monitoring quality.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. The Effective rating had improved from Requires Improvement in June 2016 because nutrition, hydration and staff understanding of the Mental Capacity Act had improved.
Safe staffing
Inspectors found enough suitable staff on duty and saw that staffing levels were maintained. Recruitment checks were also completed.
“There were enough suitable staff on duty to care for people safely.” from the report
Kind relationships
People had positive relationships with staff. Staff knew people well and offered emotional support when they were anxious or upset.
“Our observations were that people appeared comfortable and relaxed with staff.” from the report
Personalised support
Care plans focused on people's strengths, preferences, interests and independence goals. Staff supported people to make choices and work towards moving to more independent living.
“Support plans placed a clear emphasis upon the individual's strengths, abilities, independence and their overall quality of life.” from the report
Improved effectiveness
The home had improved its approach to nutrition, hydration and the Mental Capacity Act since the previous inspection.
“At this inspection improvements had been made, people were supported with eating and drinking and staff demonstrated an understanding of MCA.” from the report
Open management
Inspectors found approachable leadership, clear governance and regular audits. Staff and people said they could share ideas and concerns.
“There was visible leadership.” from the report
No lift
minorThe building has no lift, and one person found the stairs difficult. The manager offered a ground-floor room to meet that person's mobility needs.
“There was no lift within the property and one person told us that they had found the number of stairs within the home difficult.” from the report
- 01How would you support someone who finds the stairs difficult, given that there is no lift?
- 02How do you monitor and support people who are at risk of poor nutrition or who do not accept prescribed food supplements?
- 03How do you support people when their mental health changes, including when they refuse medicines or stop eating?
- 04What individual activities and independence goals would you plan for my relative?
- 05How would you support my relative to manage some or all of their own medicines safely?
This was an unannounced comprehensive inspection covering all five key questions, and the CQC looked at both the premises and the care provided. This explanation was written from the published report of 27 March 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 Davigdor Lodge Rest Home
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- May 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodstayed GoodSafe: GoodWell-led: Good
- August 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- April 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 17 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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