CQC report explained · a residential care home
What the CQC found at Earlfield Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2023
Requires Improvement; inspectors found safer care and kind support, but legal safeguards, the building and management checks still needed work.
This was an unannounced focused inspection on 22 February 2023. Inspectors checked whether the home had acted on problems found at the previous inspection. They spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
The safe and responsive ratings improved to Good. People said they felt safe and were cared for kindly. Medicines, staffing, fire safety, care records, activities and access to health professionals were generally managed well.
The overall rating remained Requires Improvement. Two people were restricted from leaving part of the home without the required capacity assessments, best-interest decisions or DoLS applications. The building still needed substantial decoration and repairs, and management checks had not found all the problems.
Improved staffing
Staffing levels had increased, including three staff at night when three floors were open. Recruitment checks were also completed safely.
“The dependency tool had been updated and now factored in the environment.” from the report
Fire and risk safety
Fire doors and alarms were checked, drills took place, and each person had an evacuation plan. Individual risks were assessed and reviewed.
“Each person's evacuation plan was tested during the homes fire drills.” from the report
Person-centred care
Care records included people's preferences, communication needs and current support needs. People said staff knew them well and supported them in their preferred way.
“People's care records were detailed, reviewed regularly, and were person-centred, containing people's likes, dislikes and preferences.” from the report
Activities and relationships
People could take part in activities and maintain contact with relatives and friends. Visitors were welcomed without restrictions during the inspection.
“People maintained relationships which mattered to them.” from the report
Training improvements
Mandatory training had been completed and the training records had been updated. Staff also received induction and supervision.
“All staff had now completed mandatory training in relation to safeguarding, manual handling, first aid and equality and diversity.” from the report
Restrictions without legal safeguards
seriousTwo people could not leave a secure corridor without staff support. The required capacity assessments, best-interest decisions and DoLS applications were not in place at the inspection.
“The failure to act in accordance with the requirements of the Mental Capacity Act 2005 is a breach of Regulation 13” from the report
Poor condition of parts of the building
needs fixingPart of the home was closed for refurbishment. Inspectors found damaged paint and wallpaper, stained and faded carpets, and strong odours of urine in some areas.
“Some areas around the home had a strong odour of urine.” from the report
Management checks missed problems
seriousAudits had improved but had not identified all the shortfalls found by inspectors. Some actions, including refurbishment, had not been completed promptly.
“The systems in place for monitoring the quality of the service were not always robust.” from the report
Mealtime oversight
minorSome people finished their meals before others had been served, and the hydration station had no cups when inspected. The provider was asked to address these points.
“Some people had received their meals and finished in the time that others on the same table had been served theirs.” from the report
Staff morale and competence
minorSome staff said morale was uneven and that there was a divide in the team. Other staff felt colleagues promoted to senior roles were not yet fully competent.
“It was clear from speaking with the staff that they felt there was a divide within the staff team at times.” from the report
- 01Have capacity assessments, best-interest decisions and DoLS applications now been completed for anyone restricted from leaving?
- 02Which parts of the building still need refurbishment or repair, and what are the completion dates?
- 03How do you now check that audits identify problems with care, restrictions and staff allocation?
- 04How are staffing levels reviewed when the remaining floors reopen or people's needs change?
- 05What action has been taken to improve mealtime supervision and ensure drinks are available at the hydration station?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and its previous rating was used in calculating the overall rating. This explanation was written from the published report of 19 April 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, June 2022
Earlfield Lodge was Rated Requires Improvement; inspectors found kind care but unsafe staffing, risks, premises, training and quality monitoring needed action.
This was an unannounced planned inspection on 12 April 2022. Inspectors spoke with people, relatives, staff and the manager. They observed care and checked care records, medicines, training, recruitment and quality records.
The home was caring. Staff treated people with kindness and respect, understood their needs and supported their privacy, dignity, independence and choices. People also had access to activities, visitors and support to maintain relationships.
However, inspectors found important safety and management problems. Staffing levels were not always safe, fire safety checks and drills were inconsistent, many staff training records were not up to date, and the building and equipment needed repair and replacement. Care information was spread across three systems, making it harder for staff to follow people's plans.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard. The ratings were Requires Improvement for Safe, Effective, Responsive and Well-led, and Good for Caring. This was the first inspection since the service changed provider and registered in 2021.
Kind and respectful staff
People and relatives described staff as kind, friendly and caring. Inspectors saw positive and respectful interactions.
“The atmosphere in the home was calm and friendly. We observed that staff members interacted with people in a positive and respectful manner.” from the report
Privacy and independence
Staff respected people's privacy and encouraged them to remain as independent as possible.
“Staff respected people's dignity and their need for privacy.” from the report
Personalised knowledge
Staff knew people's preferences and communication needs. Personal information in the care records helped staff understand people's lives and routines.
“The 'This is me' document provided staff with a detailed account about people's lives to help form positive relationships with staff and aid meaningful conversations, care and support.” from the report
Medicines and infection control
Inspectors found improvements in medicines management, including suitable storage, records and audits. Infection control arrangements were also considered reassuring.
“Medicines were audited regularly and were stored in a locked room and medicines trolley.” from the report
Supportive manager
Staff consistently said the manager supported them. Inspectors also noted that the manager understood many of the improvements needed.
“We received consistent feedback from staff who felt the manager was supportive of them.” from the report
Staffing levels
seriousInspectors could not be satisfied that there were enough suitably qualified and experienced staff. Night staffing was a particular concern because many people needed help from two staff.
“This meant people were not always protected from risk because the provider failed to deploy enough suitably qualified, competent and experienced staff.” from the report
Fire safety checks
seriousFire door checks were not evidenced, staff had not attended drills often enough and evacuation plans had not been tested. This increased uncertainty about how people would be kept safe in a fire.
“We could not be satisfied these were effective because they had not been tested during fire drill/evacuation procedures.” from the report
Staff training
seriousMany staff were not up to date with important training, including manual handling, first aid and safeguarding. Competence checks also needed improvement.
“There were a number of staff who had not completed training in some areas.” from the report
Building and equipment
seriousThe home needed redecoration and refurbishment. Inspectors found some furniture and equipment in poor repair, including rusty commode legs, damaged beds and stained soft furnishings.
“Although areas of the home were clean and fresh, the interior fixtures, fittings and furnishings were not in good physical repair.” from the report
Weak quality checks
seriousThe provider visited weekly but did not keep formal monitoring records or carry out formal quality surveys. These systems had not identified the problems found by inspectors.
“This meant systems for monitoring the quality of the service and ensuring people and staff were kept safe were not always robust and had not identified obvious short falls in practice.” from the report
Three care record systems
needs fixingStaff were using paper and computer records across three systems while moving to a new system. Inspectors said this made people's care plans difficult to navigate and follow.
“It was therefore difficult to navigate through people's records and for the staff to follow each person's plan.” from the report
- 01How many care staff are now on duty during the day and night, and how is the number matched to residents' needs and the building layout?
- 02Have all staff completed and passed competency checks for manual handling, first aid and safeguarding?
- 03When was the most recent fire drill, who attended, and have every resident's evacuation plan been tested?
- 04What repairs and refurbishment have been completed since the inspection, including replacement of damaged beds, commodes, carpets and furniture?
- 05Have care records been moved into one system, and how do you check that staff are following each person's current care plan?
This was an unannounced planned inspection covering all five key questions, including infection prevention and control under Safe; it was the first inspection after the service changed provider and registered in 2021. This explanation was written from the published report of 10 June 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 Earlfield Lodge
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- April 2023Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2021Inspected but not ratedSafe: Inspected but not rated
- April 2021
Registered with the Care Quality Commission on 30 April 2021.
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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23 live-in carers within about an hour of North Somerset
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 £1,050 to £1,320 a week. 19 can care for a couple. 12 years' experience on average.
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