CQC report explained · a nursing home
What the CQC found at Harrier Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2020
Rated Good; inspectors found safe, well-managed care and improvements since the previous Requires Improvement rating.
This was an unannounced focused inspection on 7 October 2020. Two inspectors spoke with six people, observed care, reviewed eight care plans and checked medicines, safety records, staff information and quality checks. They also spoke with staff, managers and relatives.
The home was rated Good for Safe and Well-led. Inspectors found people were protected from abuse, risks were managed, medicines were handled safely and there were enough staff. Infection control arrangements, including the use of personal protective equipment and testing, were also found to be suitable.
The home had improved since the previous inspection, which was rated Requires Improvement. Earlier concerns about risk management and quality checks had been addressed. This inspection did not assess Caring, Effective or Responsive directly, so those ratings were carried forward from the earlier comprehensive inspection.
Safe staffing
Inspectors found enough nurses and care staff on duty. Shifts were reliably filled and no agency nursing or care staff were being used.
“There were enough nurses and care staff on duty. Records showed shifts were being reliably filled and no agency nursing or care staff were being used.” from the report
Medicines
Medicines were stored, administered and recorded safely. Staff who gave medicines had been trained and assessed as competent.
“Prescription and administration records were complete and accurate.” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infection, including during the coronavirus pandemic.
“We were assured that the provider was using PPE effectively and safely.” from the report
Stronger oversight
The home had improved its quality audits and checks of paper care plans. Actions to fix shortfalls were recorded and monitored.
“Quality audits were robust and comprehensive and actions taken to address any shortfalls were documented and monitored.” from the report
Kind and organised care
People and relatives gave positive feedback about the care and how the home was run.
“The home is well organised without being regimented. The residents come first.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure paper and electronic care plans stay accurate and up to date?
- 02How do you check that there are enough nurses and care staff on every shift, including when staff are absent?
- 03What infection control and visiting arrangements are currently in place, and how will relatives be updated if they change?
- 04How do you monitor medicines, including as-required medicines, and how often are these checks reviewed?
- 05What changes have been made since the previous inspection to reduce risks such as choking, pressure damage and catheter problems?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 14 November 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, February 2020
Rated Requires Improvement; inspectors found kind, effective care but gaps in risk guidance and quality checks put people at risk.
This was the home's first inspection since it registered. It was unannounced and took place on 30 December 2019. Inspectors spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
People were treated kindly and respectfully. Inspectors rated the home Good for effective, caring and responsive care. Medicines were managed safely, people were supported to make choices, and relatives were encouraged to stay involved.
The home was not always safe because staff did not have enough up-to-date guidance about choking risks, repositioning people, and catheter care. Records were sometimes incomplete or out of date. Audits had not found these problems, so the home was rated Requires Improvement for Safe and Well-led.
The provider sent updated risk assessments, care plans and an action plan after the inspection. CQC said it would monitor progress and return to check improvements.
Kind and respectful staff
People and relatives said staff were caring. Inspectors saw staff tailor their approach to individuals and support people's dignity.
“People were treated with kindness and respect by staff.” from the report
Safe medicines support
Medicines were given at the correct time and records raised an alert when this did not happen. Instructions for as-needed medicines were also available.
“People's medicines were managed safely.” from the report
Choice and independence
People were supported to make day-to-day choices and do as much as possible for themselves. Residents could also influence how the home was run.
“People were supported to have maximum choice and control of their lives” from the report
Support for health
Staff monitored people's health, contacted GPs when needed and made referrals to other professionals. Staff also supported people's eating and drinking needs.
“Staff worked with healthcare professionals to ensure people stayed well and free from pain.” from the report
Family involvement
Relatives could visit at any time and give views through meetings, surveys, email or phone. The home also shared actions taken after feedback.
“Relatives told us they visited on a regular basis and were always made welcome by staff.” from the report
Incomplete risk guidance
seriousStaff did not always have the instructions needed to manage choking, repositioning and catheter risks. This could increase the risk of harm.
“The provider had failed to ensure that staff had the guidance required to manage risk.” from the report
Out-of-date care records
seriousSome paper care files had not been updated when people's needs changed. Staff mainly used these files, so they could follow incorrect instructions.
“Some files had not had the most up to date information placed into the files.” from the report
Weak quality checks
seriousAudits had not identified the gaps in care guidance, monitoring and record keeping. This meant the home's systems did not give enough assurance that risks were controlled.
“Audits had not identified the gaps in the guidance and monitoring relating to risks to people.” from the report
Waiting for support
needs fixingSome people and staff said people sometimes had to wait for help, particularly first thing in the morning. The manager said staffing allocation would be reviewed.
“Some people and staff told us that at some times of the day, such as first thing in the morning, people had to wait for support.” from the report
End of life plans
needs fixingSome end of life care plans did not contain enough detail about people's wishes and preferences. The home said it was reviewing these plans.
“Some people's end of life care plans would benefit from more detail and information about their wishes.” from the report
- 01What has changed since the inspection to make sure staff have current guidance about choking risks, repositioning and catheter care?
- 02How do you check that paper care files are updated whenever a person's needs or instructions change?
- 03What action has been taken to prevent people waiting for support during busy periods?
- 04How have end of life care plans been updated to record each person's wishes and preferences?
- 05Has the shortage of minibus drivers been resolved, and how often can residents now go on outings?
This was an unannounced first inspection covering all five CQC questions, including the care provided and the home's premises. This explanation was written from the published report of 20 February 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 Harrier Lodge
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- November 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2020Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2019
Registered with the Care Quality Commission on 2 January 2019.
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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39 live-in carers within about an hour of Kent
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 £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.