CQC report explained · a nursing home
What the CQC found at Lotus Care Marmaduke Street
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found safe care, but training, communication and records needed fixing.
This was an unannounced inspection on 23 January 2024 by two inspectors and a medicines inspector. They looked at four care plans, medicines records, recruitment files and other documents. They also spoke with people living at the home, staff, a relative and a healthcare professional.
The home was rated Good for Safe. People said they felt safe. Risk assessments were detailed and regularly reviewed. Medicines were managed safely, infection control was good and there were enough staff to meet people's needs.
The home was rated Requires Improvement for Effective and Well-led. Some staff training was incomplete. There were concerns about communication and delays in escalating health concerns. Some records were incomplete, out of date or conflicting. There was no registered manager in post.
The overall rating was Requires Improvement. The provider had already identified some problems and had an action plan, but inspectors found that improvements were still needed. The inspection identified a breach of Regulation 17 about good governance and records.
Good risk management
Risk assessments clearly explained the action staff should take to reduce harm. They were reviewed monthly or when people's needs changed.
“Risk assessments were robust, and clearly described the course of action staff were expected to take in order to mitigate harm.” from the report
Safe medicines
Medicines were stored, administered and recorded safely. Medicines audits were completed and action was taken when problems were found.
“We found medicines were administered and recorded safely and at the correct times.” from the report
People felt safe
People spoken with said they felt safe and well looked after. Staff had completed safeguarding training and knew what to do if they suspected abuse.
“People we spoke with told us they felt safe and well looked after.” from the report
Positive teamwork
Staff and people were involved through regular meetings. Inspectors found a positive culture and staff said they felt supported by the interim manager.
“There was a positive and open culture at the service.” from the report
Incomplete staff training
needs fixingNot all staff had completed required training. Healthcare professionals had also raised concerns that staff did not always know how to respond to some situations.
“There were gaps in the training matrix which meant not all staff had completed their required training.” from the report
Weak records and oversight
seriousSome records were out of date, conflicting or incomplete. Audits had not always identified these problems, which was part of the Regulation 17 breach.
“Some records required updating because they contained out of date and conflicting information.” from the report
Communication and escalation
needs fixingCommunication with healthcare professionals was improving, but there were concerns that health concerns were not always escalated quickly enough.
“We did however, receive some concerns the home was not always acting in a timely manner when it came to escalating concerns.” from the report
No registered manager
needs fixingThere was no registered manager when inspectors visited. An interim manager was in post and the provider had taken steps to recruit a manager.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What is the current timetable for completing all required staff training, and how do you check staff are competent afterwards?
- 02How are you making sure health concerns are escalated promptly to healthcare professionals?
- 03What changes have been made to check that care records are accurate, current and consistent?
- 04How are you progressing the recruitment of a registered manager?
- 05What progress has been made against the action plan sent to CQC after the Regulation 17 breach?
This was a focused inspection prompted by concerns about medication, risk assessments, staffing, staff skills and end-of-life care; it covered Safe, Effective and Well-led, while Caring and Responsive were not assessed. This explanation was written from the published report of 28 February 2024 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 2020
Inspected but not rated; inspectors were assured that infection control measures were keeping people safe.
This was a targeted, announced inspection about infection prevention and control during the coronavirus pandemic. The inspection was carried out because several people at the home had tested positive for COVID-19.
Inspectors found safe arrangements for admissions, including a negative COVID-19 test and 14 days of self-isolation. They also found regular testing, suitable protective equipment, social distancing measures and a separate area for people who tested positive or developed symptoms.
The home was following the infection control measures inspectors checked. The service was not given an overall quality rating, and the Safe question was recorded as inspected but not rated.
Safe admissions
New residents were admitted only after evidence of a negative COVID-19 test and had to self-isolate for 14 days.
“People were only admitted following evidence of a negative COVID-19 test.” from the report
Protective equipment
The home kept suitable stocks of protective equipment. Staff were observed using and disposing of it correctly.
“Stocks of the right standard of personal protective equipment (PPE) were well maintained and staff used and disposed of it correctly.” from the report
Testing and outbreak planning
People living at the home and staff could access regular testing. The home had a separate area for people who tested positive, developed COVID-19 or showed symptoms.
“There was a dedicated part of the service identified to accommodate people should they test positive for COVID-19, develop COVID-19 or show symptoms.” from the report
Family contact
Staff supported people to keep in contact with family and friends using technology during the pandemic.
“Staff reassured people throughout the pandemic and provided them with the support they needed to maintain regular contact with their family and friends through the use technology.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, and how have they changed since October 2020?
- 02How are new residents tested and supported during any isolation period?
- 03How often are residents and staff tested when there is an infection concern?
- 04How are visits managed now, including protective equipment and support for family contact?
- 05What arrangements are used if a resident develops COVID-19 symptoms or tests positive?
This was a targeted inspection of infection prevention and control measures only; the overall service and the other key questions were not rated. This explanation was written from the published report of 27 November 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 Lotus Care Marmaduke Street
3 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- February 2024Requires improvementcurrent ratingSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2020Inspected but not ratedSafe: Inspected but not rated
- July 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Requires improvement
- June 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017
Registered with the Care Quality Commission on 5 May 2017.
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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