CQC report explained · a residential care home
What the CQC found at 169 Lodge Hill
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, suitable risk plans, improved cleanliness and generally safe medicines management, although one tablet could not be accounted for.
- Effective?
- Good
- Staff had up-to-date training and support. People's eating, drinking, health care, communication and legal consent arrangements were managed appropriately.
- Caring?
- Good
- Staff were caring, kind and respectful. People were involved in choices about their care, and their privacy, dignity, independence and relationships were supported.
- Responsive?
- Good
- Care plans reflected people's individual needs and were reviewed. People took part in home and community activities, although one relative felt activities were not always stimulating enough.
- Well-led?
- Requires improvement
- Management and quality monitoring had improved but were not consistent in every area. A relative reported conflicting information and said they had not been told about an injury, while inspectors also found a strong smell from the medicines room.
What inspectors found, April 2020
Rated Good overall; safe, effective, caring and responsive care was found, but leadership required improvement.
This was an unannounced comprehensive inspection on 13 February 2020. One inspector observed people and staff, spoke with staff and healthcare professionals, reviewed care, medicines and staff records, and later spoke with two relatives.
The home supported six people with learning and physical disabilities. Inspectors found people were safe, treated with kindness and respect, and supported with their health, medicines, food, communication and activities. Staffing, training, infection control and care planning had improved since the previous inspection.
The overall rating was Good. Safe, Effective, Caring and Responsive were rated Good. Well-led remained Requires Improvement because management was not consistently effective, there were concerns about openness with a relative, and the medicines room had a strong smell.
Kind and respectful staff
Inspectors observed positive interactions. Staff supported people's dignity, privacy, choices and independence.
“People were supported by staff that were caring, kind and respectful.” from the report
Individual care
Care plans covered people's health, communication, personal care, medicines, eating and drinking, mobility and activities. Staff knew people's individual needs.
“Care and support was planned and delivered to meet individual needs.” from the report
Health support
People were supported to use health services, and the home worked with community learning disability and other health professionals.
“People were supported to access healthcare services and had received treatment from GPs, optician, dentists and from a group of professionals” from the report
Improved staffing and training
Inspectors found enough staff, more stable staffing arrangements and up-to-date training in key areas.
“Staff completed training the provider considered mandatory and staff training records were now up to date” from the report
Leadership and openness
needs fixingThe well-led rating remained Requires Improvement. A relative reported conflicting information from managers and care staff, and said they were not told about an injury.
“However, a relative told us the service was not well led because managers were not always open and honest.” from the report
Smell in medicines room
needs fixingInspectors found a strong smell from the medicines room that had been present for several days. The home said professionals had been contacted after the inspection.
“At our inspection, there was a pungent smell coming out from the medicines room which had been present a few days.” from the report
Medicines stock discrepancy
minorMedicines were stored and recorded safely overall, but inspectors found that one tablet did not match the stock records. The manager said this would be investigated.
“when we checked the number of medicines in stock against the numbers recorded, one tablet could not be accounted for.” from the report
Further refurbishment needed
minorSome areas had been improved, but the bathroom and flooring still needed work to bring the home environment up to the required standard.
“However, other aspects of the home such as the bathroom and the floor could be improved.” from the report
- 01What has been done to make sure relatives receive clear and consistent information about care, incidents and injuries?
- 02How do you check that medicines stock always matches the records, and what was the outcome of the missing tablet investigation?
- 03Has the smell from the medicines room been permanently resolved, and how are hygiene levels now checked?
- 04What refurbishment has been completed since the inspection, and when will the bathroom and flooring work be finished?
- 05What new activities are now available for people whose needs were not being fully met by the previous activities?
This was an unannounced comprehensive inspection covering all five questions, including the premises and care, and checking improvements required after the previous inspection. This explanation was written from the published report of 21 April 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, March 2019
Rated Requires Improvement; inspectors found kind and responsive care, but concerns about staffing, cleanliness, training and management.
This was an unannounced inspection on 16 and 17 January 2019. One inspector spoke with staff and a relative, observed care, and checked care plans, risk assessments, medicines records, staff files and management records. People could not share their views verbally, so the inspector also used observation.
The home supported six people with learning disabilities and physical disabilities. Inspectors found caring staff, respect for privacy and dignity, personalised care plans, suitable activities and support with food, drink and healthcare. The home also followed the Mental Capacity Act requirements.
However, the home was not always clean, medicines were not always stored safely and there were concerns about staffing levels. Some staff training, including fire safety training, was out of date. Quality checks did not find or fix all these problems, and the home did not consistently seek useful feedback.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. This was a fall from the previous Good rating published in July 2016.
Kind and respectful staff
Inspectors saw positive interactions and found that staff understood people's individual needs. People were treated with dignity and their independence was supported.
“People were supported by staff who were kind and caring towards them.” from the report
Personalised communication
Care plans included people's preferences and communication needs. Staff knew how people communicated through body language, facial expressions and other methods.
“People's communication needs had been assessed and each person had a communication passport which outlined their preferred mode of communicating” from the report
Good activities and choices
People were supported to choose food, clothing and activities. Activities included day centre visits, shopping, music sessions, a hydro pool and access to the local community.
“People were supported to participate in activities that met their needs.” from the report
Healthcare and nutrition
People were supported to eat and drink enough and had access to a range of healthcare professionals. Staff used hospital passports and worked with other professionals.
“People were supported to maintain good health and had access to healthcare services.” from the report
Cleanliness and infection control
seriousSeveral areas were dirty or untidy, including the kitchen, toilets, medicines room and garden. Food in the fridge was not always labelled, creating a risk of expired or contaminated food.
“People were put at risk of infections because staff had not followed appropriate infection control procedure to keep the premises clean.” from the report
Staffing levels
seriousThe rota matched the planned staffing numbers, but relatives and staff said more staff were needed at some times. Inspectors concluded that people could be at risk when enough staff were not available.
“People were put at risk of receiving unsafe care and support because sufficient staff were not always available to support their needs.” from the report
Fire safety training
seriousSeven of nine staff had not had their fire safety training refreshed annually, and one person had not refreshed it since March 2015. One staff member said they would not feel confident evacuating people safely.
“The lack of staff knowledge and skills about fire safety procedures put people at risk of unsafe care and support in the event of an emergency.” from the report
Weak quality checks
seriousThe home's checks did not find all the problems inspectors identified, including problems with health and safety, infection control and medicines storage. Some issues found by the home were not acted on effectively.
“The lack of robust quality assurance meant people were at risk of receiving poor quality care” from the report
Medicines storage
needs fixingNew medicines were stored on top of a medicines cabinet rather than in line with national guidance. The provider later sent evidence of an additional lockable cabinet and a cleaned medicines room.
“Medicines were not consistently stored safely.” from the report
Healthcare guidance and appointments
needs fixingHealthcare professionals said staff did not always follow communication or feeding guidance. Staff were not always prepared for appointments, and one relative had to rebook an appointment after receiving wrong information.
“We received mixed feedback from healthcare professionals that staff did not always follow appropriate guidelines when supporting people.” from the report
- 01What staffing levels are now in place at the times when people need two-to-one support?
- 02How do you check that cleaning, fridge labelling and infection control tasks are completed properly?
- 03Has every staff member completed and refreshed fire safety training, and have they taken part in an evacuation drill?
- 04How are medicines stored now, and how is this checked?
- 05How do you record and act on feedback from relatives, staff, advocates and healthcare professionals?
This was an unannounced inspection covering all five CQC questions, with observations, discussions and checks of care, medicines, staffing and management records. This explanation was written from the published report of 12 March 2019 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 169 Lodge Hill
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 16 March 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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