CQC report explained · a nursing home
What the CQC found at Market Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Risks, medicines, staffing, recruitment and infection control were managed safely.
- Effective?
- Good
- This area was not inspected during this visit. Its previous rating was carried forward.
- Caring?
- Good
- This area was not inspected during this visit. Inspectors did report that people were treated with dignity and respect.
- Responsive?
- Good
- This area was not inspected during this visit. Inspectors reported that the service could be flexible when people's needs changed.
- Well-led?
- Good
- Inspectors found good systems for audits, feedback, incident learning and oversight. Most people and relatives spoke positively, but one relative felt excluded from involvement in care.
What inspectors found, August 2023
Rated Good overall; inspectors found safe care and strong oversight, but noted a management change and mixed views about family involvement.
This was an unannounced, focused inspection on 5 July 2023. One inspector and one Expert by Experience spoke with people, relatives, staff and a visiting professional. They reviewed care and medicines records, recruitment checks, audits and other management records.
The home was rated Good for Safe and Well-led. People told inspectors they felt safe and cared for. Staff were trained in safeguarding and medicines, risks were assessed, staffing levels were sufficient, and infection control arrangements were judged satisfactory.
Inspectors found caring staff who promoted independence and worked with outside professionals. Most relatives said they were involved in care, although one relative said they had not been involved. There was no registered manager in post during the visit, but a new manager had been appointed.
This inspection did not reassess Effective, Caring or Responsive. Their previous ratings from the comprehensive inspection published on 20 February 2019 were used to calculate the overall Good rating. The inspection followed concerns about people's safety and management, but inspectors found no evidence that people were at risk of harm from those concerns.
People felt safe
People and relatives told inspectors they felt safe. Staff understood safeguarding procedures and how to report concerns.
“People and their relatives confirmed they felt safe being supported by staff.” from the report
Safe medicines practice
Medicines were stored and managed safely. Staff had training and competency checks, and electronic monitoring helped managers identify problems promptly.
“The provider used an electronic medicine monitoring system which allowed staff and managers to view medicines records at all times.” from the report
Enough trained staff
Inspectors found enough staff to meet people's individual needs. Recruitment checks included references and DBS checks.
“We found there were sufficient staff on duty to meet people's individual needs.” from the report
Good oversight
The provider used audits and action plans to identify and address improvements. Staff could raise concerns with managers.
“The management team completed comprehensive audits which identified where improvements were required and ensured timely action was taken to make identified improvements.” from the report
Partnership working
Staff worked with health and social care professionals to support people and improve the service.
“Staff worked closely with external health and social care professionals to ensure people received the support they required, and the home continued to improve.” from the report
Family involvement was not consistent
needs fixingMost relatives said they were involved in care assessments and planning. One relative said they had not been involved and felt let down.
“I should have been involved, I was not involved. I feel personally let down by regional managers.” from the report
No registered manager during the visit
minorThere was no registered manager in post when inspectors visited. A new manager had recently been appointed and was expected to take up the role and register with CQC.
“At the time of our inspection there was not a registered manager in post, however the provider had recently appointed to the registered manager position.” from the report
Some medicine temperature records were missing
minorThere were gaps in medicine storage temperature records. The audit system identified this and action was taken to ensure temperatures were recorded daily.
“When there were gaps in medicine storage temperature records, the manager's medicine audit systems identified this timely.” from the report
- 01Who is currently responsible for managing the home, and when is the new manager expected to register with CQC?
- 02How will our family be involved in care assessments, planning and reviews?
- 03How are medicine storage temperatures recorded every day, and what happens if a record is missed?
- 04How can we raise a safeguarding or other care concern, and how will we be told what action was taken?
- 05How will you keep us informed if our relative's needs change?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the comprehensive inspection published on 20 February 2019. This explanation was written from the published report of 3 August 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, February 2019
Rated Good in all areas; inspectors found safe, kind and personalised care, with no breaches reported.
This was an unannounced planned inspection on 24 January 2019. One inspector and an assistant inspector observed care, spoke with people, a relative, staff and managers, and checked care, medicines and management records.
The home supported nine younger adults with physical disabilities and sensory impairments. Inspectors found enough staff, safe medicines systems, clean surroundings and care that promoted people's safety, dignity, choices and independence.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This means the inspectors found consistently good care and that legal requirements were met. The home had also been rated Good at the previous inspection in July 2016.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicines were received, stored, given and disposed of safely.
“There were sufficient staff to care for people and to promote people's well-being and safety.” from the report
Kind and respectful care
People were relaxed with staff and were treated with dignity. Staff supported personal choices and private care.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans recorded people's histories, preferences and communication needs. Staff supported people to build confidence, spend time in the community and become more independent.
“People's care plans reflected their histories, interested and what mattered to them.” from the report
Good leadership
The manager consulted people, relatives and staff, acted on suggestions and carried out checks on care quality and safety.
“The registered manager checked the quality of the care provided.” from the report
Inspectors raised no specific concerns in this report.
- 01What specialist staff training has been completed since the inspection, and what further training is planned?
- 02How have the changes to care and management staff affected continuity for people living here?
- 03What improvements have been made to the facilities since the manager planned to develop them further?
- 04How are my relative's communication needs recorded and shared with all staff?
- 05How will my relative's wishes for end-of-life care be recorded, reviewed and followed?
This was an unannounced inspection of the whole care home and covered all five CQC questions, including both the premises and the care provided. This explanation was written from the published report of 21 February 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 Market Lodge
3 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Goodstayed GoodSafe: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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
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11 live-in carers within about an hour of Herefordshire, County of
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 £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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.