CQC report explained · a residential care home
What the CQC found at Lavender Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were stored, checked and recorded safely. Inspectors also found improved infection control, suitable staffing, regular risk reviews and trained staff who knew how to report abuse.
- Effective?
- Good
- People's capacity and changing needs were reviewed. Staff had relevant training, and people were supported with healthy food, personal choices and access to healthcare.
- Caring?
- Good
- Staff knew people well and treated them with kindness, dignity and respect. People and relatives were involved in planning and reviewing care.
- Responsive?
- Good
- Care plans were personalised and kept up to date. People were supported with their interests, activities, relationships and weekly goals, and complaints were dealt with promptly.
- Well-led?
- Good
- The home had audits, staff meetings, competency checks and action plans for improvements. People, relatives and staff were positive about how the home was run, although there was no registered manager at the time.
What inspectors found, November 2018
Rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
The inspection was unannounced on 28 September 2018. The inspector spoke with people living at the home, staff and managers. They reviewed care plans, staff files, training records, complaints and other documents. Relatives were contacted by telephone on 4 October.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that medicines, infection control, staffing, safeguarding and risk management had improved. People were supported with healthy food, healthcare, activities and their own choices.
The previous inspection in October 2017 found breaches in care planning, medicines, infection control and quality monitoring. This inspection found that the provider had made the required improvements. There was no registered manager at the time, although the deputy manager had applied to register.
Medicines and safety
Medicines were checked regularly and records were completed correctly during the inspection. Risk assessments, accident reviews and emergency plans were also in place.
“We completed a random stock check of medicines and found the stock levels correct, and staff had completed documentation correctly.” from the report
Personalised support
Care plans included people's likes, dislikes, cultural and religious needs. People were supported to follow interests such as cooking, shopping, holidays and community activities.
“Care plans were personalised and captured the individual well and all the details that mattered to that person were included.” from the report
People's choices
People had regular house meetings and one-to-one time with keyworkers. They were supported to choose food, set goals and take part in decisions about their home.
“People had regular weekly house meetings to discuss all areas of living at Lavender lodge.” from the report
Improved management
The home had introduced audits, action plans, staff meetings and competency checks. Inspectors found that the provider had acted on the problems identified at the previous inspection.
“At this inspection we found the provider had made the required improvements.” from the report
No registered manager
minorThere was no registered manager when inspectors visited. The deputy manager had applied to register, but the application had not yet been completed.
“However, the deputy manager had recently been promoted to the manager's position and has applied to register with CQC as the registered manager.” from the report
End of life care records
minorThe home had started introducing easy-read documents about people's end of life wishes. The report says these documents were still due to be completed for all care plans.
“The manager assured us that all care plans will be completed with this information by October 2018.” from the report
- 01Has the manager now been registered with the CQC, and who is responsible for the home if the application is still pending?
- 02How are medicines audits and daily medicine checks carried out now, and what happens if a recording error is found?
- 03How are care plans reviewed when a person's needs, risks or preferences change?
- 04Have all residents' end of life preferences now been recorded in an accessible format?
- 05How are people supported to choose their meals, activities and weekly goals?
This was an unannounced inspection looking at the overall quality of the home and all five CQC questions, with follow-up telephone calls to relatives on 4 October 2018. This explanation was written from the published report of 1 November 2018 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, November 2017
Lavender Lodge was rated Requires Improvement; inspectors found kind staff but unsafe medicines, weak management and gaps in personalised care.
This was an unannounced inspection on 18 and 23 October 2017. The inspector spoke with five people living at the home, two relatives and three staff members. They reviewed two care plans, three staff files and other records.
Inspectors found problems with medicines, infection control, risk reviews, staffing levels and record keeping. Care plans were not regularly updated. People were not always supported with their health, activities, choices or interests. There was no registered manager at the time, and staff lacked clear guidance.
There were also positive findings. Staff were kind and knew people well. People said they felt safe and happy, and their privacy and records were generally respected. However, all five areas were rated Requires Improvement, meaning the home was not consistently meeting people's needs and needed to make significant improvements.
Kind and familiar staff
Staff were caring and knew the people they supported well. People said they were happy and liked living at the home.
“People were cared for in a kind and compassionate way by staff that knew them well and were familiar with their needs.” from the report
Privacy and secure records
Inspectors saw staff respect private spaces, and confidential records were kept securely.
“People's privacy and dignity were respected and records were kept safe and stored securely.” from the report
Recruitment checks
The provider followed recruitment procedures, including references and background checks, before staff were employed.
“All staff had been through recruitment procedures which involved obtaining satisfactory references and background checks with the Disclosure and Barring Service (DBS) before they were employed by the service.” from the report
Access to healthcare
People had access to local healthcare services and specialists. Staff arranged appointments when people became unwell.
“People had access to local healthcare services and specialists.” from the report
Medicines were not consistently safe
seriousMedicine records had gaps, prescribed creams were not always given, and stock records did not match the medicines remaining. Fridge and storage temperatures were not checked daily.
“There were gaps in the medicine administration records chart (MAR) and there was confusion from staff around the application of prescribed creams.” from the report
Poor infection control
seriousLaundry and cleaning arrangements created risks of contamination. Mops, linen and clothing were not stored or handled safely, and cleaning schedules were incomplete.
“We asked to look at the cleaning schedules and found that they had not been completed.” from the report
Care plans and risk reviews were out of date
needs fixingCare plans, risk assessments and records of accidents and incidents were not regularly updated. This meant changing needs might not be identified.
“Records such as care plans, risk assessments, accidents and incidents all required updating to ensure people were receiving the appropriate support.” from the report
Not enough personalised activities
needs fixingPeople did not always receive support to pursue their interests, goals or community activities. One person said they were bored and another wanted to go swimming but lacked staff support.
“People were not supported to maintain social interests and take part in meaningful activities relevant to their needs.” from the report
Weak leadership and checks
seriousThere was no registered manager, staff lacked regular supervision and audits did not identify known problems. Staff said management changes were confusing.
“Systems were not in place to quality assure the services provided, manage risks and drive improvement.” from the report
- 01How are medicine records, prescribed creams and as-needed medicine stock checked now?
- 02How do you make sure cleaning schedules and laundry arrangements prevent infection risks?
- 03How often are care plans, risk assessments and capacity assessments reviewed and updated?
- 04How many staff are on each shift, including at weekends and at night, and how do you support people's preferred activities and personal care preferences?
- 05What action has been completed since the inspection, and how is the service checking that improvements have lasted?
This was an unannounced comprehensive inspection covering all five CQC questions, with the previous overall rating of Good from 3 November 2014 replaced by Requires Improvement. This explanation was written from the published report of 25 November 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 Lavender Lodge
3 rated inspections over 4 years: the service has held its Good rating throughout.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
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.
- February 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Hertfordshire
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 £1,300 a week. 82 can care for a couple. 12 years' experience on average.
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.