CQC report explained · a residential care home
What the CQC found at Lotus Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer recruitment checks, safeguarding systems, reviewed risk assessments and safe medicines management. Guidance for one as-needed medicine was not yet in place.
- Effective?
- Good
- This area was not inspected during this focused visit. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This area was not inspected during this focused visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found improved quality monitoring, clear staff roles and an open, inclusive and person-centred culture. Relatives and staff said the service had improved.
What inspectors found, May 2023
Rated Good; inspectors found safe, person-centred care and improved management, but guidance for one as-needed medicine was missing.
This was an unannounced, focused inspection on 3 April 2023. The inspector checked whether improvements had been made after the previous inspection, which had found breaches about staffing checks and quality monitoring.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safer recruitment checks, suitable safeguarding arrangements, accurate medicines records and systems for reviewing accidents and incidents. They also found better quality checks and an open, person-centred culture.
The inspection did not assess all five areas of care. The ratings for the other areas were carried over from the previous inspection. The overall rating improved from Requires improvement to Good, and the home was no longer in breach of regulations.
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. Staffing levels matched the person's assessed needs.
“There were enough staff working at the service to meet people's needs and keep them safe.” from the report
Improved recruitment
The home had addressed the previous problem with employment references and also carried out other checks on new staff.
“At this inspection we found this issue had been addressed.” from the report
Safe care systems
Risk assessments covered several areas, including medicines, mobility, community access and nutrition. Accidents and incidents were reviewed for lessons.
“Accidents and incidents were reviewed to learn lessons about how to reduce the likelihood of similar accidents re-occurring.” from the report
Person-centred support
Inspectors found that care was based around individual needs and that people were supported to do activities they wanted.
“The provider had a culture that was person -centred so it achieved good aims for people.” from the report
Better quality monitoring
The home had introduced audits and regular reviews of care plans and risk assessments to help improve care.
“Systems were in place to monitor and improve the quality of care and support provided.” from the report
Missing medicine guidance
needs fixingOne person had an as-needed medicine, but written guidance for when staff should give it was not in place. The deputy manager said this would be developed with the prescribing GP.
“However, there was no guidance in place about this.” from the report
- 01What written guidance is now in place for the as-needed medicine identified in the report?
- 02Who is currently responsible for managing the home while there is no registered manager?
- 03What were the ratings for Effective, Caring and Responsive at the previous inspection?
- 04How often are care plans, risk assessments and medicines audits reviewed?
- 05How will you involve my relative in choosing activities and deciding how they are supported?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 13 May 2023 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, August 2022
Lotus Lodge was rated Requires Improvement; inspectors found enough staff and kind, person-centred care, but recruitment checks and quality monitoring were not reliable.
This was an unannounced focused inspection on 28 June 2022. Inspectors checked whether the home had acted on its previous improvement plan, looking only at Safe and Well-led. They spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The home had enough staff to meet people's assessed needs. People said they felt safe and were happy with the care and staff. Risk assessments were personalised, infection control arrangements were satisfactory, and the home learned from accidents.
However, three of five staff files did not contain the required employment or character references. Medicines were not always stored, recorded or administered safely. The systems used to check quality had not identified these problems. The home breached Regulations 17 and 19, and remained rated Requires Improvement overall, as it was at the previous inspection.
Enough staff
Inspectors saw enough staff on duty, including one-to-one support where this had been assessed as necessary.
“There were enough staff to meet people's needs.” from the report
Personalised risk support
Risk assessments described the risks each person faced and how staff should reduce them. They were reviewed as people's needs changed.
“Assessments were person-centred, based around the risks each person faced.” from the report
Positive culture
People said they liked the staff and were happy living at the home. Staff described managers as supportive and approachable.
“The provider promoted a positive, open and inclusive culture to achieve good outcomes for people.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely and had arrangements to prevent and manage infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Missing recruitment references
seriousThree of the five staff files checked did not contain employment or character references. This was a legal breach because the checks were not completed reliably before employment.
“However, for three of the five staff, the provider had not obtained employment or character references for staff who were employed to work at the service.” from the report
Medicines management
needs fixingStaff did not always have the information needed to give medicines through PEG tubes. Records contained discrepancies, and storage arrangements did not always meet requirements.
“Staff did not always follow systems and processes to administer and store medicines safely.” from the report
Inconsistent family communication
minorRelatives gave mixed views about whether they were kept informed about accidents, falls or illness. One relative reported that the home had inconsistent contact details.
“Relatives had mixed views about whether they were kept informed about significant incidents.” from the report
- 01Have all current staff files now got the required employment and character references, and are these checked before anyone starts work?
- 02How do you check that medicines are recorded accurately and that staff have clear instructions for medicines given through PEG tubes?
- 03Has the controlled drugs cabinet been securely attached and are fridge temperatures now recorded with a suitable minimum and maximum thermometer?
- 04What changes have you made to your quality audits so they identify recruitment and medicines problems promptly?
- 05How will you make sure relatives' contact details are recorded correctly and that they are told about significant incidents?
This was a focused inspection of Safe and Well-led only; the other three ratings carried over from the previous inspection. This explanation was written from the published report of 10 August 2022 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 Lodge
5 rated inspections over 7 years: the service has held its Good rating throughout.
- May 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-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
- June 2014
Report published without a new overall rating.
- December 2013
Registered with the Care Quality Commission on 10 December 2013.
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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