CQC report explained · a residential care home
What the CQC found at Garden Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, and staff managed risks, safeguarding, medicines, infection control and incidents effectively.
- Effective?
- Good
- Care plans were personalised and staff supported people with decision-making, health care, food, communication and independence.
- Caring?
- Good
- This key question was not inspected during this focused visit, so no new rating was given.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so no new rating was given.
- Well-led?
- Good
- Inspectors found effective governance, visible management and a culture focused on people's needs, rights and wishes.
What inspectors found, December 2022
Garden Lodge is Rated Good; inspectors found safe, effective and well-led care, with improvements since the previous inspection.
This was an unannounced focused inspection on 27 September and 6 October 2022. Inspectors spoke with people, relatives and staff, and reviewed care records, staff files, medicines information and management records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found people were supported to make choices, manage risks, take medicines safely and receive personalised care.
The home had previously been rated Requires Improvement, with breaches of regulations about safe care, consent and governance. Inspectors found enough improvement had been made and the home was no longer in breach.
Choice and independence
Staff supported people to make choices and kept restrictions to a minimum. People were involved in managing risks and decisions about their safety.
“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” from the report
Personalised care
Care plans reflected people's needs, strengths and ambitions. People, relatives and staff reviewed plans together.
“People had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations” from the report
Safe medicines support
Staff followed systems for prescribing, giving, recording and storing medicines. The report also found that medicines were not used to control behaviour inappropriately.
“People were supported by staff who followed systems and processes to prescribe, administer, record and store medicines safely.” from the report
Improved management
The provider had strengthened its audits and governance since the previous inspection. Managers were visible, approachable and focused on improvement.
“Governance processes were effective and helped to hold staff to account, keep people safe, protect people's rights and provide good quality care and support” from the report
Inspectors raised no specific concerns in this report.
- 01How will you show us that Caring and Responsive remain strong, as these areas were not inspected during this visit?
- 02How are people involved in making decisions about risks and their daily lives?
- 03How do you review medicines, including medicines that may affect behaviour?
- 04How often are care plans reviewed with the person and the people important to them?
- 05What checks do managers carry out to monitor the quality and safety of care?
This was an unannounced focused inspection of Safe, Effective and Well-led, including infection control; Caring and Responsive were not inspected and their previous ratings contributed to the overall rating. This explanation was written from the published report of 29 December 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.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found kind and personalised care, but concerns about safety, consent and management checks.
This was an unannounced inspection on 20 January 2020. The inspector spoke with people, relatives and staff, observed care and reviewed care, medicine, recruitment and management records.
The home was caring and responsive. People were treated with kindness and respect, supported to communicate, encouraged to be independent and helped to take part in activities and community outings. Relatives said communication was good.
However, some people were not always kept safe. A restriction on one person was not authorised under the Mental Capacity Act, safety checks were not robust and management audits did not identify important problems. Staff had not received regular supervision and team meetings were irregular.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good.
Kind and patient staff
People and relatives described staff as caring. Staff used reassurance and distraction when people became anxious or distressed.
“Staff were very patient and attempted to provide reassurance and distraction when people started to become anxious and distressed.” from the report
Personalised support
Care plans were detailed and reflected people's needs, communication styles, preferences and routines.
“Plans of support were very person centred and detailed.” from the report
Communication and choice
Staff used signs, gestures, body language and pictures to help people express themselves and make choices.
“Staff knew people very well and were able to understand what people were communicating through their body language and other signs.” from the report
Activities and independence
People took part in outings and activities, used local facilities and were supported to develop independent living skills.
“People were able to take part in a wide range of activities and were supported to access their local community.” from the report
Unauthorised restriction
seriousOne person was restricted in a room at times without clear evidence that this had been properly agreed or legally authorised. This raised concerns about consent, best-interest decisions and least restrictive care.
“We found a restriction on one person's liberty which was not authorised by their DoLS.” from the report
Safety checks were not robust
seriousBuilding safety checks and some risk controls were not strong enough to show that people were protected from harm.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.” from the report
Weak management oversight
seriousAudits did not identify problems found by inspectors, including missing staff supervision, unclear restriction records and maintenance issues.
“The provider and registered manager did not carry out robust audits of the service to assess, monitor and improve the quality and safety of the service.” from the report
Staff support and medicine audits
needs fixingStaff had not received regular supervision, and management medicine audits were not happening regularly. These gaps could allow problems to be missed.
“However, the provider had not ensured staff received support through regular supervision meetings.” from the report
Informal complaints not recorded
minorThe home had a complaints system, but informal complaints were not documented. The manager said this would be put in place.
“We identified informal complaints were not documented.” from the report
- 01What has changed to ensure any restriction on a person's movement is legally authorised, recorded and reviewed?
- 02How do you now record and evidence best-interest decisions under the Mental Capacity Act?
- 03How often are building safety checks, risk assessments and medicine audits completed, and who reviews them?
- 04Are staff now receiving regular supervision and attending regular team meetings?
- 05How do you record and respond to informal complaints and concerns?
This was an unannounced planned inspection covering all five CQC questions, with the inspector reviewing selected care, medicine, staff and management records. This explanation was written from the published report of 13 March 2020 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 Garden Lodge
4 rated inspections over 7 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- August 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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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.”
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