CQC report explained · a residential care home
What the CQC found at Green Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found up-to-date risk assessments, safe medicines management, enough suitable staff and effective safeguarding systems. They were also assured about infection prevention and control measures.
- Effective?
- Requires improvement
- This key question was not covered by this focused inspection. Its previous rating was carried forward into the overall rating.
- Caring?
- Good
- Staff were kind, patient and respectful. People’s choices were sought, their privacy and dignity were supported, and they were encouraged to remain independent.
- Responsive?
- Good
- This key question was not covered by this focused inspection. Its previous rating was carried forward into the overall rating.
- Well-led?
- Good
- Managers had quality monitoring systems in place and records had improved. Staff felt supported, and the management team understood its responsibilities.
What inspectors found, September 2020
Rated Good; inspectors found safe, kind care and improved medicines, risk records and quality checks.
This was an announced, focused inspection on 15 September 2020. Inspectors spoke with six people, four relatives, five staff and two visiting professionals. They reviewed three care records and records about medicines, quality and management.
The home was rated Good overall. Safe, Caring and Well-led were each rated Good. Inspectors found that medicines were managed safely, risks were recorded clearly, staffing was sufficient and infection control measures were in place.
People were treated kindly and respectfully. Their choices were sought, care plans reflected their needs and preferences, and staff supported people to remain independent. Managers had improved record keeping and used audits to monitor quality.
The previous rating was Requires Improvement, published in June 2019. This inspection found improvements in the areas checked. Effective and Responsive were not looked at during this inspection, so their previous ratings were used in the overall rating.
Safe medicines
Medicines were stored and managed safely. Records showed that people received medicines as prescribed.
“Medicine administration records evidenced that people received their medicines as prescribed.” from the report
Clear risk planning
Care plans contained current risk assessments and detailed emergency information for each person.
“At this inspection care plans contained up to date assessments of risk associated with peoples' care and support needs.” from the report
Kind and respectful care
Inspectors saw a friendly atmosphere. Staff knew people’s preferences and treated them with dignity.
“Staff were kind, patient, respectful and considerate.” from the report
Improved management
Quality checks were being used to monitor standards and improve the service. Record keeping was more accurate and up to date.
“Record keeping had improved. Records were detailed, accurate and up to date.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure medicines records remain complete and medicines are given as prescribed?
- 02How are each person’s risks and emergency arrangements kept up to date?
- 03What staffing levels are in place on the units, including the dementia care units?
- 04How do you use audits, feedback and incident reviews to make further improvements?
- 05How are people and their relatives involved in updating care plans and making decisions about care?
This was a focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 30 September 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.
What inspectors found, June 2019
Rated Requires Improvement; inspectors found good personalised activities and complaints handling, but concerns about dignity, fire drills, risk records and management oversight.
This was an unannounced planned inspection on 14 May 2019. Inspectors spoke with people living at the home, relatives, staff and a healthcare professional. They also reviewed care records, medicines records, staff files and the home's policies and audits.
The home was rated Requires Improvement overall. Safe, Effective, Caring and Well-led were all rated Requires Improvement. Responsive was rated Good.
Medicines management had improved since the previous inspection and was no longer a breach. However, fire drills were not effective, some risk information was incomplete, and people were not always treated with dignity and respect. The home acted on some issues after the inspection, including introducing practical evacuation training and observing staff practice.
Medicines improved
The home had introduced an electronic medicines system. Inspectors found medicines were stored and administered safely, and the previous medicines breach had been resolved.
“We found medicines were stored and administered safely.” from the report
Person-centred care
Care plans included people's preferences, histories and communication needs. They were described as personalised, detailed and regularly updated.
“People received person centred care. Care plans were personalised, detailed and regularly updated.” from the report
Activities and community access
People had regular activities and could use a minibus to visit places in the community. People spoken with were happy with the activities.
“People had regular access to activities.” from the report
Complaints were followed up
People knew how to complain and felt they would be listened to. Complaints had been recorded and reviewed under the provider's policy.
“When complaints were received they had been recorded and reviewed in line with the provider's policy.” from the report
Accidents were reviewed
Accidents and incidents were recorded and analysed each month. The home contacted the falls team when someone had three or more falls.
“Accidents and incidents were recorded and analysed monthly to look for trends and ensure lessons were learnt.” from the report
Fire evacuation practice
needs fixingFire drills did not include practical evacuation training, and the length of drills was not recorded. The manager provided evidence of practical evacuations after the inspection.
“Fire drills were not effective.” from the report
Dignity and privacy
needs fixingInspectors saw people not always being treated with dignity and respect. Personal information was shouted across a lounge, and some staff interactions were task-focused.
“People were not always treated with dignity and respect.” from the report
Incomplete risk information
needs fixingSome risk assessments did not give staff enough information about how to reduce risks. Records for one person's choking risk did not clearly document the required food texture, and a speech and language assessment could not be found on the day.
“Although people had been assessed for risks further information was needed to support staff on how to mitigate the risks.” from the report
Management checks missed problems
needs fixingThe home's audits had not identified all the issues found during the inspection, including fire drill problems and staff practice affecting dignity.
“The quality assurance systems and the registered manager had not identified all the areas of improvement we raised during inspection.” from the report
Limited meal setting choice
minorPeople on the Cedar unit ate in lounge chairs and were not offered the choice of eating at a dining table.
“We did not see people were offered the choice to enjoy their meal at a table.” from the report
- 01What practical fire evacuation training have staff completed since the inspection, and how are drill times now recorded?
- 02How do you check that staff consistently protect people's dignity, privacy and independence?
- 03How are choking risks and speech and language recommendations recorded and shared with staff?
- 04What changes have you made to the Cedar unit so people can choose to eat at a dining table?
- 05How do your current audits identify problems that were missed at the inspection?
This was an unannounced planned inspection covering all five CQC questions and the overall quality and safety of the home. This explanation was written from the published report of 19 June 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 Green Lodge
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- September 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2016
Registered with the Care Quality Commission on 28 April 2016.
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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