CQC report explained · a nursing home
What the CQC found at Lodore Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines were stored, managed and given safely, risks were assessed and infection control measures were in place. They noted that a sluice room and a storage room were not locked, which posed safety risks.
- Effective?
- Good
- This was not assessed during the focused inspection, so no separate rating was given.
- Caring?
- Good
- This was not assessed during the focused inspection, so no separate rating was given.
- Responsive?
- Good
- This was not assessed during the focused inspection, so no separate rating was given.
- Well-led?
- Requires improvement
- The manager had improved medicines and infection-control audits and communication was described as open. However, the care-record audit was limited and some care-plan updates were difficult to read.
What inspectors found, March 2021
Rated Good overall; inspectors found safe care and improved medicines management, but the home's leadership and care-record checks still required improvement.
This was a focused inspection on 28 January 2021. Inspectors looked mainly at safety and how the home was run. They spoke with people, staff and relatives, observed the service, checked medicines and reviewed care records and other documents.
The home was rated Good for Safe. Medicines, including Warfarin, were managed more safely than at the previous inspection. Staff followed infection control guidance, used protective equipment and carried out testing. Risks to people were assessed, although two rooms were not locked when they should have been.
The home was rated Requires Improvement for Well-led. The care-record audit was not detailed enough, and some updates to care plans were difficult to read. The overall rating improved from Requires Improvement to Good because the home had made improvements and was no longer in breach of regulations. The other three key questions were not assessed during this focused inspection.
Safer medicines management
Inspectors found that earlier problems with medicines, including Warfarin, had been addressed. Records were accurate and medicines were stored securely.
“At this inspection we found additional processes had been implemented to ensure closer monitoring of all medicines, including Warfarin.” from the report
Infection control
Staff had infection-control training and followed guidance on protective equipment, testing and managing outbreaks. The home also had a comprehensive cleaning schedule.
“Staff had received training on infection prevention and control and were adhering to the government guidance in response to the COVID-19 pandemic” from the report
Staffing and communication
People and relatives said they felt safe and could get help when needed. Staff and relatives described communication with the manager as open and supportive.
“People told us there were sufficient staff at the service and they could obtain support when they needed it.” from the report
Positive satisfaction feedback
The 2020 satisfaction survey showed a high level of reported satisfaction among people and relatives.
“We saw the findings from 2020 showed 97% overall satisfaction with the service they received.” from the report
Care-record checks were limited
needs fixingThe audit did not show enough detail about the quality of care records, what needed improving, what action was taken or when. Inspectors told the manager this would be followed up.
“the care records audit was limited and did not include details about the quality of care records or identify if improvements were required, what action was taken and when.” from the report
Care-plan updates could be hard to read
needs fixingAlthough records were reviewed regularly, repeated updates on the original care plan could make changes to people's needs difficult to identify. This created a risk that staff might miss changes in how support should be provided.
“Care records were reviewed regularly, however, due to the number of reviews on the original care plan at times these were difficult to read.” from the report
Two rooms were not locked
seriousInspectors found that a sluice room and a storage room were unlocked. They said this posed risks to people's safety, and the manager said the issue would be addressed.
“We found a sluice room and a storage room were not kept locked which posed risks to people's safety.” from the report
- 01What has changed in the care-record audit since the inspection, and how do you record required improvements and the action taken?
- 02How do you make sure updates to care plans are clear and easy for staff to read?
- 03Were the sluice room and storage room secured after the inspection, and how are similar safety checks monitored now?
- 04How do you support people to use communal areas when there is no COVID-19 outbreak, and how do you reduce social isolation during restrictions?
- 05How are medicines such as Warfarin monitored and checked now?
This was a focused inspection of Safe and Well-led, including infection control and specific safeguarding concerns; the ratings for Effective, Caring and Responsive were not assessed and the report does not give new ratings for them. This explanation was written from the published report of 5 March 2021 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, January 2020
Rated Requires Improvement; inspectors found kind, personalised care, but medicines safety and oversight were not reliable.
This was an unannounced inspection on 27 November 2019. Inspectors spoke with people, relatives and staff, observed care, and reviewed care, medicines, staffing and management records.
The home had enough staff, suitable recruitment checks and good systems for assessing people's needs. People were treated kindly and respectfully, received personalised care, had access to healthcare, and were supported with activities and end of life wishes.
The main problem was medicines management. Records and checks did not reliably show that all medicines were accounted for or given as prescribed. The home also lacked regular formal medicines audits, so errors might not be found quickly. The overall rating fell from Good at the previous inspection to Requires Improvement.
Enough staff
Inspectors found enough staff to meet people's needs and provide support promptly. Recruitment checks were also in place.
“There were sufficient staff to meet people's needs and provide them with timely support.” from the report
Personalised support
Staff knew people's histories, preferences and care needs. Care plans were reviewed when people's health changed.
“People received personalised care that met their needs. Staff were knowledgeable about the people using their service including their life history” from the report
Medicines were not always safe
seriousThe home did not have robust checks for all medicine stocks or to confirm that medicines were given as prescribed. Inspectors said this increased the risk of harm.
“Robust procedures were not in place regarding the management of medicines. This placed people at risk of harm.” from the report
Weak medicines audits
seriousRegular formal internal audits did not cover all medicines processes. This meant errors might not be identified in good time.
“There was a lack of regular formal internal medicines audits and staff had not identified the errors we found” from the report
Records not always kept private
needs fixingInspectors saw care and medicines records left where people or visitors could have accessed them. The manager said staff were reminded about confidentiality after the inspection.
“We observed care records and medicine administration records being left out and people or visitors could have accessed them.” from the report
Faint smell on one floor
minorA faint unpleasant smell was noticed throughout the day on one floor. The management team said they would investigate and take action if needed.
“However, we identified on one floor there was a faint malodour throughout the day.” from the report
- 01What changes have been made to check medicine stocks and confirm that each person receives medicines as prescribed?
- 02How often are medicines now formally audited, and who reviews the results?
- 03What action was taken after records were found where people or visitors could access them?
- 04What was done about the faint malodour on one floor, and how is this checked now?
- 05How will you show families that the problems identified in this inspection have been corrected?
This was a planned, unannounced inspection covering all five CQC questions; the report says the previous rating was Good, published on 8 June 2017. This explanation was written from the published report of 3 January 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 Lodore Nursing Home
4 rated inspections over 6 years: the service has held its Good rating throughout.
- March 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 5 December 2012.
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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