CQC report explained · a residential care home
What the CQC found at North Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks such as falls, choking, pressure ulcers and bedrail entrapment were assessed and managed. Medicines, infection prevention, staffing and recruitment were also found to be safe.
- Effective?
- Good
- People received support based on their needs, including help with eating, health appointments and decisions about their care. Applications had been made when people were at risk of being deprived of their liberty.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- The manager and staff understood their roles, carried out regular checks and acted on shortfalls. People, relatives and staff were asked for their views, and feedback was used to make changes.
What inspectors found, April 2022
North Lodge Care Home was rated Good; inspectors found clear improvements in safety, effectiveness and management since the previous inspection.
This was an unannounced focused inspection on 10 and 11 March 2022. One inspector spoke with five people, six staff members and three relatives. They reviewed care, medicines, recruitment, training and management records.
The home was rated Good overall, and Safe, Effective and Well-led were each rated Good. Inspectors found that risks were assessed and managed, medicines were handled safely, infection controls were in place, and there were enough suitably checked staff.
The home had improved since the previous inspection, when it was rated Requires Improvement and had breached regulations. The provider had followed its action plan and was no longer in breach. This inspection did not assess Caring or Responsive, so those ratings were carried over from the previous inspection.
Risks were better managed
Inspectors found that risks had been identified, assessed and reduced. This included risks from bedrails, choking, falls and pressure ulcers.
“Risks to people had been identified and mitigated.” from the report
Safe medicines support
People received medicines as prescribed. Records were complete and staff had clear guidance for medicines used when needed.
“People's medicines were managed safely.” from the report
Enough suitable staff
People said staff were available when needed. Recruitment checks, including DBS checks, had been completed.
“People told us there were always enough staff on duty to offer them the care they needed.” from the report
People had choices
Staff supported people to make day-to-day choices and to remain as independent as possible. People helped shape menus and activities.
“We observed people being encouraged to do things for themselves, such as pouring their own drinks.” from the report
Learning from mistakes
The manager apologised when things went wrong, explained investigations and took action to reduce the chance of similar events happening again.
“When things had gone wrong the registered manager had apologised to the person and their relatives.” from the report
Furnishings still needed improvement
minorFeedback from staff identified concerns about the home's furnishings. New chairs and cushions had been bought, but new flooring was still due to be laid after the inspection.
“45% of staff commented that the home furnishings needed improvement.” from the report
- 01What current risk assessments would be completed for my relative, including falls, choking, pressure ulcers or bedrails?
- 02How would staff support my relative to make daily choices and remain as independent as possible?
- 03How are medicines prescribed when needed recorded and reviewed?
- 04What improvements to the furnishings and flooring have been completed since the inspection?
- 05What was the previous rating for Caring and Responsive, and what has changed since that earlier inspection?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used in the overall rating. This explanation was written from the published report of 27 April 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.
What inspectors found, January 2020
North Lodge Care Home was rated Requires Improvement; inspectors found kind, personalised care but serious gaps in risk management and lawful liberty safeguards.
This was an unannounced inspection on 13 November 2019. One inspector and an Expert by Experience spoke with people, staff and managers, observed care, and checked care plans, medicines, recruitment, training and quality records.
The home cared for 19 older people and could support up to 21. People said they felt safe and staff were kind, respectful and responsive. Medicines were managed safely, staffing levels were enough, and people received personalised activities and support to keep in touch with relatives.
There were important problems. Risks were not always assessed or managed properly, including risks from bed rails, choking and the water system. Six people did not have the required DoLS applications submitted, meaning their liberty was restricted without lawful authority. Staff refresher training and quality checks also needed improvement.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. The previous overall rating was Good, published on 13 May 2017.
Kind and respectful staff
People said staff were kind, patient and respectful. Inspectors saw staff respond compassionately when people were anxious or uncertain.
“Staff treated people with care and compassion.” from the report
Enough staff
Inspectors found enough staff on duty to meet people's needs. Staff were available promptly and staffing had been increased when people's needs changed.
“There were enough staff on duty at the home to safely meet people's needs.” from the report
Personalised support
Care plans included people's preferences, routines and abilities. Staff knew people well and followed their care guidance.
“People received personalised support which reflected their individual needs.” from the report
Activities and relationships
People could take part in varied activities and trips. Visitors were welcome, and people were supported to maintain important relationships.
“The provider offered people a range of activities in support of their need for social stimulation.” from the report
Medicines managed safely
Medicines were securely stored, administered by trained staff and recorded accurately. Staff gave people time and support to take them safely.
“Medicines were safely managed.” from the report
Risk assessments were incomplete
seriousInspectors found gaps in assessments for bed rails, choking and legionella. These gaps increased the risk that people might not be kept safe.
“Risks to people had not always been assessed to ensure their safe management.” from the report
Liberty restrictions were not always lawful
seriousThe home had not submitted DoLS applications for six people where this was needed. This meant restrictions on their freedom did not have the required legal authorisation.
“Service users were deprived of their liberty without lawful authority.” from the report
Refresher training was overdue
needs fixingSome staff had not received refresher training required to keep their skills up to date. The report says improvement was needed in this area.
“Staff had not always received refresher training where required, to help ensure they remained up to date with current best practice.” from the report
Quality checks missed problems
needs fixingThe home's checks did not identify some errors in care plans or missing risk assessments. More robust monitoring was needed to drive improvement.
“The provider had quality assurance systems in place, but improvement was required to ensure these were robust in identifying issues and driving service improvements.” from the report
- 01What action has been taken to assess and manage risks from bed rails, choking and the home's water system?
- 02Have DoLS applications now been submitted and authorised for everyone who needs one?
- 03Which staff refresher training was overdue, and has it now been completed?
- 04How often are care plans and risk assessments audited, and how do managers check that problems are corrected?
- 05What changes have been made since the previous Good rating in May 2017?
This inspection covered all five CQC questions and looked at both the care provided and the home premises; the previous rating was Good and had deteriorated in Safe, Effective and Well-led. This explanation was written from the published report of 23 January 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 North Lodge Care Home
4 rated inspections over 7 years: the service has held its Good rating throughout.
- April 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 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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