CQC report explained · a residential care home
What the CQC found at Grove Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found kind care and enough staff, but consent records and checks on care quality were not reliable.
This was an unannounced focused inspection. Inspectors visited on 20 and 21 February 2023, observed care, spoke with relatives and staff, and reviewed care plans, medicines, training and management records.
The home had enough staff and people received their medicines on time. Staff were described as skilled, kind and respectful. Mealtimes and oral care had improved since the previous inspection, and people had access to health professionals.
However, some care records were incomplete. Mental capacity assessments and best-interest decisions were not always completed when needed. The home's audits did not identify these problems, so inspectors said people could be at increased risk of harm.
The overall rating remains Requires Improvement. The home was still in breach of the rules on consent and good governance. The provider must send an action plan, and progress will be monitored by the CQC and local authority.
Enough staff
Inspectors found enough staff to meet people's needs without unreasonable waiting. Relatives and staff also said staffing was adequate.
“There were enough staff to meet people's needs. Staff attended to their needs in a reasonable time when requesting their assistance.” from the report
Medicines were managed well
People received medicines on time and as prescribed. Records were complete, and staff had training and competency checks.
“People received their medicines on time and as prescribed.” from the report
Improved meals and oral care
The report found improvements since the previous inspection in oral care and mealtimes. People were supported to choose food and received help with eating and drinking when needed.
“People were supported to choose what they wished to eat. A picture menu and plated foods helped people make choices.” from the report
Kind and respectful interactions
Inspectors observed sensitive reassurance, respectful conversation and appropriate humour. People appeared relaxed and settled with staff.
“Interactions included sensitive reassurance, respectful dialogue and appropriate banter.” from the report
Access to health professionals
Relatives and health professionals said staff were knowledgeable and followed professional guidance. The report said this supported people's health and wellbeing.
“People had timely access to health and social care professionals and staff followed their guidance.” from the report
Consent decisions were not always recorded
seriousSome people who could not make particular decisions did not have the required mental capacity assessments or best-interest decisions. This included a recent move into the home and a temporary room move.
“Where people lacked capacity to make individual decisions, mental capacity assessments were not always undertaken.” from the report
Care records had gaps
needs fixingRecords of oral care support and bed rail checks were inconsistent. Inspectors said incomplete records could mean people did not receive care safely.
“Recording related to risk management was not always sufficient. This included inconsistent recording of oral care support and bed rails checks.” from the report
Quality checks did not find problems
seriousThe home's audits did not identify the gaps in care records or the missing consent assessments and best-interest decisions. Inspectors said oversight was not robust.
“Audits were not always effective as they did not identify the issues we found with mental capacity assessments, best interest decisions and the gaps in care recording.” from the report
- 01How do you now make sure every person who may lack capacity has a decision-specific mental capacity assessment?
- 02How are best-interest decisions recorded, including for room moves or other changes to someone's care?
- 03How do senior staff check at the end of each shift that oral care, bed rail checks and other care records are complete?
- 04What action has been taken in response to the two continued breaches, and when will its impact be reviewed?
- 05How can relatives give feedback now, given that the last survey received no responses from relatives or professionals?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings were carried forward to calculate the overall rating. This explanation was written from the published report of 15 March 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, July 2022
Grove Lodge rated Requires Improvement; inspectors found kind care and enough staff, but serious gaps in records, consent, oral care and oversight.
This was an unannounced focused inspection on 8 and 20 April 2022. Inspectors reviewed Safe, Effective and Well-led. They spoke with people, staff, relatives and a health professional, observed care, and checked records including 12 people's care plans, care records and medicines records.
People generally felt safe and well cared for. There were enough staff, infection control measures were in place, and staff were described as kind and supportive. However, records about risks, medicines, fluids and personal care were not always complete or accurate.
Inspectors found that some decisions for people who could not make their own decisions were not properly recorded under the Mental Capacity Act. Oral care was not adequately assessed or recorded. Mealtimes did not always support choice. The home breached Regulations 9, 11 and 17.
The overall rating changed from Good at the previous inspection, published in October 2018, to Requires Improvement. The CQC will request an action plan, monitor progress with the provider and local authority, and return for another inspection.
Enough staff
Inspectors found enough staff to meet people's needs. Staff deployment was changed when one person's routine changed.
“People were supported by enough staff to meet their needs.” from the report
Kind relationships
People and relatives were positive about staff. Inspectors saw calm, reassuring and familiar interactions.
“We saw staff interacting with people in ways that reflected these views.” from the report
Health support
People had access to health care, and staff followed professional guidance. Relatives were informed about changes in their loved one's wellbeing.
“The staff worked in partnership with other professionals to ensure people's needs were met.” from the report
Infection control
Inspectors were assured that the home had measures covering PPE, hygiene, testing, social distancing and infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Inaccurate care records
seriousRecords did not always show people's fluid intake, personal care or medicines accurately. This made it harder to identify risks and check whether care had been provided properly.
“Recording related to risk management was not sufficient.” from the report
Medicines records
seriousRecords for topical creams were missing or did not show that creams had been given as prescribed. Records for medicine used when someone was agitated were also not accurate.
“However, recording errors and omissions put people at risk.” from the report
Consent and best interests
seriousSome decisions for people who lacked capacity were not completed within the Mental Capacity Act framework. Relatives without legal authority had sometimes been asked to give consent.
“This is a breach of regulation 11 (Need for Consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014” from the report
Oral care
seriousPeople's oral care needs and preferences were not properly assessed or recorded. Inspectors found toothbrushes that had not been used, were dry or had dry toothpaste on them.
“People's oral health care was not adequately assessed and planned for.” from the report
Mealtime choice
needs fixingPeople did not always have good opportunities to choose their meals or enjoy meals at their own pace. Inspectors recommended further review of the mealtime experience.
“People had varied mealtime experiences.” from the report
Weak oversight
seriousThe home's audits and monitoring had not identified or properly dealt with all the problems. Inspectors found that an identified medicines error had not been escalated to examine its cause.
“Systems to monitor and improve the quality of people's care had not been effective.” from the report
- 01What has changed in the records for topical creams, fluid intake and personal care since this inspection?
- 02How do you now make and record Mental Capacity Act and best interests decisions, including the role of legal representatives?
- 03How do you assess each person's oral care needs and check that daily oral care has been provided?
- 04What changes have you made to give people more choice and a better experience at mealtimes?
- 05How do your audits now identify and investigate care and medicines recording errors?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and previous ratings for those questions were used in the overall rating. This explanation was written from the published report of 8 July 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 Grove Lodge
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- October 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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