CQC report explained · a nursing home
What the CQC found at Newcombe Lodge
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, September 2021
Inspected but not rated; inspectors found safe, caring and improved support, with some records and planning needing more detail.
This was an unannounced, comprehensive inspection on 16 and 17 June 2021. One inspector visited the home, spoke with two children and staff, and reviewed care, treatment, medicines, recruitment and management records.
Inspectors found that children were safe and protected from harm. Medicines were stored and managed safely. Staff were trained and supported, and children were involved in their care plans and treatment decisions.
The home had improved since the previous inspection. Earlier breaches about risk management and governance had been addressed. Inspectors made recommendations about support-plan detail, controlled-drug records, treatment goals and routine mask use.
The home was inspected but not rated. This means CQC described what it found but did not give an overall rating or ratings for the five key questions.
Children felt safe
Children told inspectors they felt safe. The home had systems to identify and respond to abuse, and staff understood safeguarding procedures.
“Children were safe and protected from harm or abuse.” from the report
Child-centred planning
Children were involved in planning their care and treatment. Their views were included in records and multi-disciplinary team discussions.
“In the records we looked at we saw that all assessments, care and treatment plans and positive behaviour support plans demonstrated collaboration with other professionals and the children.” from the report
Kind and respectful care
Children said staff understood their needs. Inspectors observed calm, respectful and kind interactions.
“All encounters were low key, with no raised voices. Staff spoke respectfully and kindly to children.” from the report
Improved staff support
Training, supervision and development opportunities had improved since the previous inspection. Staff were supported through regular individual and group supervision.
“This means that children were cared for by a staff team that was trained and supported to carry out their role.” from the report
Improved management
The home had clearer leadership, monitoring systems and a statement of purpose. Children's views were sought about how the home could improve.
“There was no longer a breach of this regulation in relation to quality monitoring, strategy and vision and the contribution of children and young people to the running of the home.” from the report
Some support plans lacked detail
needs fixingA small number of interventions did not explain precisely how staff should support an individual child. This could make it harder for staff to respond consistently.
“However, a small number of interventions were described in a generic way.” from the report
Controlled-drug records
needs fixingExtra sheets had been photocopied and inserted into the controlled-drug register. Inspectors said loose sheets could become detached or lost.
“There is a risk that loose sheets could become detached or mislaid and this is not in line with the requirements for the recording of controlled drugs.” from the report
Recovery goals were not easy to track
needs fixingTreatment plans recorded short-term work, but inspectors could not always see how this contributed to each child's main recovery goal.
“It was difficult to draw a direct link to the child's initial principal recovery goal or to determine how their short-term achievements showed progress towards it.” from the report
Routine mask use
minorInspectors said staff wearing masks routinely went beyond the relevant guidance and could make the home feel less like a home. They recommended reviewing the policy.
“The routine wearing of masks by staff detracted from the sense of 'home'.” from the report
Independent-living pathway not yet tested
needs fixingA pathway covering skills such as cooking, education and shopping was planned but had not started during the inspection. Inspectors therefore could not judge how effective it would be.
“This had not yet been implemented so we could not test its effectiveness.” from the report
Complaints system not tested
minorThere was a system for recording and responding to complaints, but there had been no recent complaints from children or families. Inspectors could not assess whether the system worked well.
“However, there had been no recent complaints made by children and young people or their families so we could not assess if the system in place was effective.” from the report
- 01How have you made the interventions in children's support plans more specific and individual?
- 02Have you replaced the photocopied controlled-drug register sheets with a proper replacement book?
- 03How do you now show that short-term achievements contribute to each child's main recovery goal?
- 04Has the independent-living skills pathway started, and what progress has it produced?
- 05What is your current policy on staff wearing masks inside the home?
This was an unannounced comprehensive CQC inspection of the health aspects of the service; Ofsted is responsible for the care and accommodation, and all five CQC questions were inspected but not rated. This explanation was written from the published report of 24 September 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, February 2020
Inspected but not rated; inspectors found caring staff but serious gaps in risk records and service oversight, with two breaches.
This was an unannounced inspection over two days in August 2019. Inspectors spoke with five young people, eight staff members and two visiting professionals. They checked care records, medicines records, staff files, training records, policies and quality checks.
The home was not always safe, effective, caring, responsive or well-led. Risk assessments and care records were incomplete or out of date. Some young people did not have enough privacy, and staff needed more face-to-face training for self-harm risks.
There were also positive findings. Young people said staff listened to them and supported them. They had access to healthcare and medicines were recorded in care plans. Inspectors found two breaches, covering safe care and treatment and good governance.
The service was inspected but not rated. This means CQC did not give Good, Requires improvement or Inadequate ratings for the five questions. CQC asked for an action plan and said it would monitor progress with Ofsted and return to inspect again.
Supportive staff
Young people said staff listened to them and provided help when needed. Inspectors also saw staff speak respectfully and take time to talk.
“Young people told us they were supported by caring staff who listened to them and help was provided when this was needed.” from the report
Safeguarding response
Staff understood how to recognise and report abuse. Referrals and follow-up actions were seen when young people disclosed alleged abuse.
“Information showed that when young people had made disclosures about alleged abuse, the provider had made referrals to the local authority” from the report
Healthcare access
Young people could access healthcare services, including support from a psychologist, occupational therapist and a GP with a specialist interest in mental health.
“Young people had access to healthcare services to support them with healthcare needs and included health practitioners.” from the report
Choice and involvement
Inspectors found that young people were supported to make choices and that staff used the least restrictive approach and acted in their best interests.
“Young people were supported to have maximum choice and control of their lives” from the report
Incomplete risk information
seriousRisk assessments and care plans did not always explain the risks to young people or the steps staff should take to reduce them. Some records were inconsistent and information may have been copied between records.
“Risks associated with children and young people's health and wellbeing lacked clear information about how risk should be managed to reduce the likelihood of harm.” from the report
Weak service oversight
seriousQuality assurance systems failed to identify all the concerns found by inspectors. Actions in the improvement plan had not been completed promptly.
“Systems were not continually monitored by the registered manager and there was a lack of oversight about how the service was run.” from the report
Privacy during care
needs fixingHourly observations in bedrooms did not always respect privacy. The treatment room was in the dining area during the inspection, although it was later moved to a more private place.
“This did not provide young people with privacy whilst living in the home.” from the report
Specialist training
needs fixingStaff needed more face-to-face training for self-harm, wound care and ligature cutter use. The provider later provided some training, but CQC could not yet judge its lasting effect.
“However, as there were so many children and young people self-harming, e-learning would not be enough to ensure staff developed specialist skills reflective of their needs.” from the report
Complaints not recorded
needs fixingA complaint discussed at a young people's meeting was not recorded as an informal complaint, and inspectors could not see what action had been taken.
“This was not logged this as an informal complaint and we could not see what action was taken in relation to this.” from the report
- 01Have all young people's risk assessments and care plans now been reviewed, and how are changes in health and self-harm risks recorded?
- 02What face-to-face training have staff completed for self-harm, wound care and ligature cutter use, and how is its effectiveness checked?
- 03How are young people's privacy protected during observations, medicines and wound care?
- 04Are initial assessments, education plans, regular one-to-one meetings and transition plans now complete and up to date?
- 05How are informal complaints and young people's feedback now recorded and acted on?
This was a planned, unannounced inspection of the CQC-regulated treatment of disease, disorder or injury; Ofsted regulated the premises and personal care, and all five CQC questions were inspected but not rated. This explanation was written from the published report of 4 February 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 Newcombe Lodge
2 rated inspections over a year: the service has held its Good rating throughout.
- September 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- February 2020Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- September 2012
Registered with the Care Quality Commission on 19 September 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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Most charge £950 to £1,160 a week. 30 can care for a couple. 10 years' experience on average.
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