CQC report explained · a nursing home
What the CQC found at Newstead Lodge Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing and recruitment were safe, and the home was clean and maintained. They noted that medicine administration times were not always recorded.
- Effective?
- Good
- People's needs and choices were assessed, staff had suitable training, and people were supported with food, drink and access to health professionals.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says the rating from the previous inspection was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says the rating from the previous inspection was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found improved quality checks, a positive culture and better oversight of care, medicines, fire safety and the environment. There was no registered manager in post, but the provider was managing the home temporarily while recruiting.
What inspectors found, December 2023
Newstead Lodge Nursing Home is rated Good; inspectors found kind, safe care and improvements since the previous inspection, but medicines recording needed attention.
Inspectors made an unannounced, focused visit on 15 November 2023. They spoke with people, a relative, staff and the provider. They also checked care records, medicines records, recruitment files and quality checks.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found enough suitable staff, safer risk assessments, clean and maintained surroundings, kind care and better quality checks. People were supported to make choices and staff worked with health professionals.
The previous overall rating was Requires Improvement, and the home had breached regulations at the March 2023 inspection. Inspectors found enough improvement for those breaches to be closed. However, they found that staff had not always recorded the time medicines were given. There was also no registered manager in post, with the provider managing the home temporarily while recruiting.
Kind and attentive staff
People were supported by staff who knew them well. Inspectors saw staff spending time with people and responding calmly to those who were anxious.
“People were supported by staff who knew them well and were kind and attentive to them.” from the report
Safer care planning
The home had improved its risk assessments and staff followed plans for health conditions, behaviour, moving around and choking risks.
“At this visit we found risks to manage specific behaviours or health conditions were known, recorded and followed by staff.” from the report
People had choice
Staff asked people about their preferences and supported them in the least restrictive way. Inspectors found that unnecessary restrictions had been removed since the previous visit.
“During our visit we saw staff always ask people for their preferred choice.” from the report
Improved leadership checks
Quality monitoring had improved and was being used to check care, medicines, fire safety, cleanliness and equipment.
“At this visit, improvements to quality assurance systems and processes had driven improvements.” from the report
Medicine times were not always recorded
needs fixingInspectors found that staff did not always record the time medicines were given. They said this information was needed for safe medicines management, and staff said they would address it without delay.
“We found staff had not always recorded what time people received their medicines.” from the report
No registered manager in post
minorThere was no registered manager when inspectors visited. The provider was managing the home four days a week as an interim measure while recruiting.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What checks are now in place to make sure the time every medicine is given is recorded?
- 02When do you expect a permanent manager to be appointed and registered?
- 03What evidence can you show that the improvements made after the previous inspection are being maintained?
- 04What were the previous ratings for Caring and Responsive, and when will these areas next be reviewed?
- 05How are people and relatives involved in reviewing care plans and decisions about daily routines?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 5 December 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, May 2023
Rated Requires Improvement; inspectors found risks, medicines and management checks were not always handled safely.
This was an unannounced focused inspection. Inspectors visited on 29 March 2023 and reviewed Safe, Effective and Well-led. They spoke with people, relatives, staff and a health professional, observed care and checked care, medicines, recruitment and management records.
The home was not always safe. Risks such as skin damage, hot water, legionella and some health conditions were not managed consistently. Medicines records and procedures also needed improvement, including for time-critical medicines, patches and medicines given when needed.
People were not always supported to make choices or to receive care in the least restrictive way. Inspectors were also not assured that some people received enough fluids. There were positive findings about infection control, access to healthcare, staff training and safeguarding awareness.
The overall rating is Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. This rating changed from Good at the previous inspection, published in February 2020. Caring and Responsive were not inspected in this visit, so their previous ratings were used when calculating the overall rating.
Infection control
Inspectors were assured that the home was taking steps to prevent and manage infections, including using protective equipment safely.
“Staff adhered to infection control procedures and protected people from the risk of infection.” from the report
Access to healthcare
Staff worked with healthcare professionals when people's needs changed. People were supported to see doctors, dentists, dietitians and speech and language therapists.
“People were supported to access healthcare services when required.” from the report
Staff training
Staff received an induction and spoke positively about their training. They had opportunities to get support from managers.
“Staff spoke positively about the training they received.” from the report
Feedback and complaints
Relatives said they knew how to raise concerns and felt these would be acted on. The home restarted meetings for relatives after the pandemic period.
“Relatives told us they knew how to raise any concerns or complaints they had and felt these would be acted upon.” from the report
Risk management
seriousSome risks were not properly assessed, reduced or monitored. Examples included a health condition, skin damage, legionella and dangerously hot water outlets.
“Risks to people's health and welfare were not always assessed and managed safely.” from the report
Medicines
seriousRecords and procedures did not always show that medicines were stored or given safely. This included patches, medicines given when needed and medicines that had to be given at specific times.
“Some people required time critical medicines, to be given at a specific time of day, to manage their health.” from the report
Fluid intake
needs fixingThe home did not record consistently whether one person received the recommended amount of fluid. Inspectors could not be assured that people always received enough to maintain their health.
“We could not be assured people were offered the recommended daily fluid they needed, to maintain their health.” from the report
Choice and restraint
seriousStaff did not always ask people before supporting them with drinks. One person was restrained in a wheelchair without evidence of a best-interest discussion, contrary to the home's policy.
“One staff member had strapped a person into their wheelchair to restrain them.” from the report
Management checks
needs fixingThe home's audits and governance systems had not identified several of the problems found by inspectors. This meant leaders did not have reliable oversight of safety and quality.
“Governance procedures had failed to identify the concerns we found at our inspection.” from the report
- 01What changes have been made to medicines records, including patch rotation, PRN maximum doses and time-critical medicines?
- 02How do you now check that risk plans, including repositioning plans, are followed and recorded?
- 03What has been done to reduce the risk from hot water outlets and to complete legionella checks?
- 04How do you record and review daily fluid intake for people who need monitoring?
- 05What evidence can you show that restraint is only used following a lawful, documented best-interest decision?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. 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.
Every inspection of Newstead Lodge Nursing Home
5 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2023Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- February 2020Goodstayed GoodSafe: GoodEffective: Requires improvementWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 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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