CQC report explained · a nursing home
What the CQC found at Horfield Lodge
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, risk assessments and safe medicines management. The home also had infection control procedures and regular safety checks.
- Effective?
- Good
- Staff had training, induction, supervision and support. People received suitable food and drinks, access to healthcare and support based on their individual needs and choices.
- Caring?
- Outstanding
- Staff treated people with kindness, dignity and respect. Inspectors found strong relationships with people and families, and support for equality, faith, relationships and independence.
- Responsive?
- Outstanding
- Care was personalised and adapted when people's needs changed. The home offered varied activities, helped people maintain relationships and provided thoughtful end of life support.
- Well-led?
- Outstanding
- The home had a clear person-centred culture and leaders who were respected by staff and families. Audits, feedback, staff development and links with other organisations were used to improve care.
What inspectors found, March 2020
Rated Outstanding; inspectors found exceptionally caring, responsive and well-led support, with safe and effective care rated Good.
This was an unannounced planned inspection on 20 and 21 November 2019. The inspector spoke with people living at the home, visitors, staff and volunteers, and reviewed care records, staff records, complaints, audits and other documents.
The home was rated Good for Safe and Effective. Inspectors found enough suitably checked staff, safe medicines management, appropriate risk assessments, good infection control and effective support with food, healthcare, training and equipment.
The home was rated Outstanding for Caring, Responsive and Well-led. Inspectors found respectful and individual care, strong support for relationships and activities, thoughtful end of life care, and leaders who used audits, feedback and staff development to improve the service.
Kind and respectful care
Inspectors found that staff understood people's lives, preferences and beliefs. People and relatives described care as compassionate and respectful.
“The service was exceptionally caring and put people at the heart of everything they did.” from the report
Personalised support
People were supported to make daily choices and continue important interests and relationships. Care plans recorded detailed personal preferences.
“The service had a strong, visible, person centred culture.” from the report
End of life support
Inspectors found that people and families were supported with planning, difficult conversations and being together near the end of life.
“Family members are supported and have full involvement.” from the report
Strong leadership
Leaders promoted respect, learning and improvement across the home. Regular audits identified actions and these were followed up.
“Systems in place were sophisticated and contributed to the smooth, effective operation of the service whilst still retaining its personalisation.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and review my relative's risks, including moving, swallowing, weight loss and skin care?
- 02How will you support my relative's food, drink and any special dietary needs?
- 03What activities and community opportunities would match my relative's interests and communication needs?
- 04How would you involve our family in planning and reviewing end of life care?
- 05Are any Deprivation of Liberty Safeguards applications for my relative still waiting to be processed?
This was an unannounced comprehensive inspection covering the overall quality of the home, including both the premises and the care provided; all five CQC questions were rated. This explanation was written from the published report of 6 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, April 2017
Horfield Lodge was rated Good; inspectors found safe, kind and personalised care, with some records and staff guidance needing improvement.
Inspectors made an unannounced comprehensive inspection on 15 and 16 March 2017. They spoke with people living there, visitors, staff and health professionals. They observed care and checked records, medicines, recruitment, training, audits and equipment.
All five areas were rated Good: safe, effective, caring, responsive and well-led. People told inspectors they felt safe and well cared for. Staff were described as kind and respectful, and care plans reflected people's needs, choices and routines.
At the previous inspection in February 2016, the home had breached requirements about medicines and people's hydration needs. Inspectors found that sufficient action had been taken to address those breaches. They still found some minor gaps in records, staff supervision and guidance for certain equipment and treatments.
Previous problems addressed
The home had previously breached requirements about medicines and hydration. Inspectors found sufficient action had been taken by this inspection.
“At this inspection we found sufficient actions had been taken to address the breaches.” from the report
Personalised care
Care plans recorded people's needs, preferences, life histories and routines. Staff knew people well and used this information in their support.
“Care plans reflected people's individual needs and were detailed and informative.” from the report
Activities and social contact
People could join group or one-to-one activities, with support from staff, chaplains, a music therapist and volunteers.
“A comprehensive activity and engagement programme was in place, and the weekly programme confirmed a wide variety of activities offered to people.” from the report
Quality monitoring
The home used audits, feedback and action plans to monitor safety and improvements. Incident information was reviewed for patterns and trends.
“Systems were in place for monitoring quality and safety.” from the report
Cream records
needs fixingThere were gaps in recording when prescribed creams had been applied. The home had identified this and had actions planned.
“We noted there were some gaps in the recording of the application of creams.” from the report
Pressure equipment guidance
needs fixingSome staff did not know when pressure-relieving mattresses should be adjusted. Managers said they would provide clearer guidance.
“The staff we spoke with were not all familiar with the circumstances in which adjustments should be made.” from the report
Staff supervision
needs fixingNot all staff had received supervision as often as the provider's policy required. Managers had a plan to improve the supervision programme.
“Not all staff had received supervision in line with the provider's policy.” from the report
Thickened drinks records
needs fixingStaff knew the required amounts for some people at risk of choking, but the records did not always state those amounts.
“However, the records did not always confirm the amount of thickening required.” from the report
- 01How do you now make sure every prescribed cream application is recorded?
- 02How are staff shown when and how to adjust each person's pressure-relieving equipment?
- 03How do you check that all staff receive supervision in line with your policy?
- 04How are the required amounts of thickener recorded and checked for people at risk of choking?
- 05How do you record complaint investigations and their outcomes?
This was an unannounced comprehensive inspection covering all five questions: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 28 April 2017 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 Horfield Lodge
5 rated inspections over 5 years: the service has improved, from Requires improvement to Outstanding.
- March 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvement
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 21 July 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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40 live-in carers within about an hour of Bristol, City of
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 £1,020 to £1,300 a week. 34 can care for a couple. 11 years' experience on average.
“She became a good friend to my mother in law, chatting with her, dancing with her, knitting with her and the list goes on”
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