CQC report explained · a residential care home
What the CQC found at Howard Lodge Care Centre
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks were reviewed, staffing was sufficient, medicines were managed safely during the inspection and lessons were taken from accidents and incidents.
- Effective?
- Good
- People received care based on assessments of their physical, mental, social and cultural needs. Staff were well trained and supported, and worked with health professionals to achieve good outcomes.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people well, involved them in decisions and encouraged independence.
- Responsive?
- Outstanding
- Care was highly personalised and went beyond people's basic needs. The home supported interests, relationships, community involvement, communication needs and end of life wishes.
- Well-led?
- Outstanding
- Leadership was exceptional and created a very positive, inclusive culture. Feedback was actively sought and audits, partnerships and new ideas were used to improve care.
What inspectors found, February 2020
Rated Outstanding; inspectors found exceptionally responsive and well-led care, with safe, effective and caring support rated Good.
This was an unannounced inspection on 28 October 2019. Inspectors spoke with people, relatives, staff and health and social care professionals. They observed care and reviewed care plans, medicines records, staff files, training records and quality checks.
The overall rating was Outstanding. Safe, effective and caring were rated Good. Responsive and well-led improved from Good to Outstanding since the previous inspection in April 2017.
People and relatives gave universally positive feedback. Inspectors found kind staff, consistent teams, personalised care, meaningful activities and strong links with the local community. The home also had regular checks to monitor safety and quality.
The inspection considered concerns about unsafe medicines management after a specific incident. Inspectors found no evidence that people were at risk of harm from this concern and described it as an isolated incident. The circumstances of the person's death were not examined because they were under investigation.
Personalised care
The home adapted support to individual wishes and interests. Its wishing tree helped people choose activities and experiences, including outings and meeting animals.
“People received personalised care and support which met and exceeded people's needs and preferences.” from the report
Kind and respectful staff
People and relatives described staff as kind, patient and respectful. Inspectors saw warm relationships, careful support and efforts to maintain people's independence.
“Staff engaged with people in meaningful conversations and demonstrated warmth, using touch appropriately to convey affection and reassurance.” from the report
Meaningful activities and community links
People were supported to continue past interests, try new activities and stay connected with the local community. Activities included visiting groups, schools, churches and charities.
“This work enabled people to enjoy an active social life and continue to feel like a valued part of their local community after the transition to residential care.” from the report
Strong leadership
Inspectors found visible leadership, a stable staff team and an open culture. The home used feedback, audits and training to improve care.
“The provider and registered manager demonstrated exceptional leadership and lead by example, promoting a highly caring and person-centred ethos” from the report
End of life support
The home explored and recorded people's end of life wishes. It also offered remembrance events and bereavement support for relatives and staff.
“The provider demonstrated a strong commitment to providing excellent end of life care which considered the physical, spiritual and emotional needs of people, their relatives and staff.” from the report
Food variety
minorSome people said the food was good but wanted more variety, including fewer repeated meals. The provider had responded to earlier food concerns by changing the menu.
“People said the food was nice though some said they would like more variety.” from the report
Previous medicine incident
needs fixingA specific incident involving the unsafe management of medicines led to concerns being raised with CQC. Inspectors found no evidence of current harm and described it as isolated, but the incident remained under investigation.
“The information CQC received about the incident indicated concerns about the unsafe management of medicines.” from the report
- 01What extra checks were introduced after the medicine error, and how are staff's medicines practice observations recorded?
- 02How will you make sure my relative's food choices and requests for variety are reflected in their menu?
- 03How will my relative's personal interests, wishes and community activities be identified and reviewed?
- 04How are staffing levels and the continuity of staff on each hamlet maintained?
- 05How will you involve our family in planning and reviewing end of life care if this becomes necessary?
This was an unannounced inspection covering all five questions; it examined medicine management risks but did not examine the circumstances of the death linked to the incident because that was under investigation. This explanation was written from the published report of 21 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.
What inspectors found, April 2017
Howard Lodge Care Centre was rated Good; inspectors found safe, kind and person-centred care, with all five areas rated Good.
Inspectors visited unannounced on 2 March 2017. This was a comprehensive inspection. They reviewed seven care records and records about medicines, staff, accidents, complaints and quality checks. They also spoke with managers and eight staff members.
The home had 71 residents when it was inspected, and was registered for up to 72 older people needing personal care. Inspectors found people were safe, medicines were managed correctly and there were enough staff. Staff received training and support.
People were treated with kindness and respect. Their choices, routines, care plans and activities were taken into account. The home had a complaints process and systems to check and improve its quality. The Good rating remained unchanged from the previous inspection.
Safety and safeguarding
Staff understood how to recognise and report abuse. Risks were assessed and managed while allowing residents to keep as much independence as possible.
“People were safe from the risk of abuse, staff had knowledge of safeguarding and understood their responsibilities to report any concerns.” from the report
Safe medicines
Inspectors found that medicines were stored, given and recorded correctly. Only trained and assessed staff administered them.
“We looked at people's medicine records and saw that they had received their medicines as prescribed.” from the report
Kind and respectful care
Residents described warm relationships with staff. Inspectors saw that privacy, dignity and personal choices were respected.
“There were positive relationships between people and members of staff.” from the report
Personalised support
Care plans included people's likes, dislikes, interests and backgrounds. Staff knew residents well and adapted their approach to individual needs.
“Care plans reflected people's likes and dislikes and helped staff to care for people in a way in which met their individual needs.” from the report
Quality oversight
Managers used audits, surveys and meetings to monitor the service. They recorded actions when checks identified something to improve.
“The service had systems in place to monitor and improve the safety and quality of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure staffing levels remain sufficient when residents' needs change or staff are absent?
- 02How often will my relative's care plan be reviewed, and how will we be able to comment on it?
- 03How will you support my relative to join activities that match their interests and preferred routines?
- 04How do you check that medicines are given correctly and that records remain accurate?
- 05How are complaints investigated, and how will we be told what action has been taken?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. 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 Howard Lodge Care Centre
3 rated inspections over 5 years: the service has improved, from Good to Outstanding.
- February 2020Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Registered with the Care Quality Commission on 28 September 2014.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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