CQC report explained · a nursing home
What the CQC found at Princess Lodge Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff understood safeguarding procedures. Care plans and risk assessments were up to date, medicines were managed safely and infection control arrangements were in place.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. The report nevertheless said staff were caring and promoted people's dignity.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Audits, action plans, staff supervision and training provided management oversight. People, relatives and staff were able to give feedback, and the management team understood its reporting responsibilities.
What inspectors found, August 2022
Rated Good; inspectors found people were safe and well supported, but some recruitment records and culturally appropriate meals needed attention.
This was an unannounced, focused inspection on 23 May 2022. One inspector spoke with people, relatives, staff and professionals, and checked care records, medicine records, staff recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found that people felt safe, staff understood safeguarding, risks were assessed, medicines were managed safely and infection control arrangements were effective. Staff were caring and respected people's dignity.
The home had improved from Requires Improvement at the previous inspection in 2019. The inspection only looked at Safe and Well-led because it followed safeguarding concerns. The ratings for the other key questions were carried forward from the previous inspection.
People felt safe
People and relatives said they felt safe. Staff knew how to recognise and report abuse.
“People and their relatives told us they felt safe.” from the report
Clear risk planning
Care plans and risk assessments contained current information about people's needs and risks. Staff understood how to support people safely when their needs changed.
“Care plans and risk assessments identified people's individual support needs and ways to help people stay safe.” from the report
Kind and respectful care
Inspectors saw staff treating people with kindness and protecting their dignity. Care plans included people's histories, preferences and interests.
“We saw that staff were caring and promoted people's dignity.” from the report
Management oversight
The home used audits, action plans, staff training and checks to monitor care and make improvements.
“Audits provided regular oversight of any concerns regarding action plans to ensure that they are still timely and relevant.” from the report
Infection control
Staff had infection control training and knew how to use protective equipment. Inspectors found enough protective equipment stored safely.
“There were enough stocks of PPE stored safely within the home.” from the report
Incomplete recruitment records
needs fixingThree staff files did not contain interview records. The home said records were being moved to a digital system, but that process was incomplete.
“However, we found that three staff files did not include records of interviews. This meant that recruitment was not always consistent.” from the report
Culturally appropriate meals
needs fixingOne person's care plan said they should receive culturally appropriate meals, but this did not always happen. The home said it would try to increase the number of suitable meals.
“However, the person told us that this did not always happen and they often relied on family members to provide such food.” from the report
Manager registration not complete
minorThere was no manager registered with CQC when the inspection took place. An application had been made, but the process had not finished.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01Have all staff recruitment files now been completed, including records of interviews?
- 02How will you provide culturally appropriate meals consistently for my relative?
- 03Has the application for a registered manager been completed, and who is legally responsible for the home now?
- 04How often are care plans and risk assessments reviewed when a person's needs change?
- 05What action plans are currently open following medicines, care or quality audits?
This was a focused inspection of Safe and Well-led following safeguarding concerns; the other key question ratings and the overall rating calculation used ratings from the 2019 inspection. This explanation was written from the published report of 18 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.
What inspectors found, October 2019
Princess Lodge Limited was rated Requires Improvement; care was kind and effective, but staffing and oversight were not reliable enough.
This was an unannounced inspection on 15 and 22 August 2019. Inspectors spoke with people living at the home, relatives and staff. They observed care and reviewed care plans, medicines records, staff files and management records.
People generally felt safe and described staff as kind, respectful and caring. Medicines, recruitment, risk assessments and responses to safeguarding concerns were handled appropriately. People received good support with food, healthcare, choices and daily care.
The main problem was staffing. Staff sickness meant the home was often below the level identified as needed. Inspectors saw call bells ringing for long periods and people waiting for help. Records showing that some care had been completed were also not always complete.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe fell from Good to Requires Improvement, while Well-led remained Requires Improvement. The home was not placed in special measures in this report.
Kind and respectful care
People described staff positively. Inspectors saw warm, respectful interactions and staff protecting people’s dignity during personal care.
“We observed interactions between staff and people to be warm and respectful.” from the report
Good medicines arrangements
Medicines were stored safely, records were correctly completed and staff had regular checks of their skills.
“Staff had been trained to administer medicines and had their competencies regularly observed.” from the report
Support with health and nutrition
People were offered food choices, drinks and snacks. The home worked with health professionals when people’s health needs changed.
“We observed people were offered drinks and snacks throughout the day.” from the report
Approachable manager
People, relatives and staff said the manager listened and was visible in the home. Staff felt supported and involved in the improvement plans.
“People told us they could speak to the manager about anything and she would listen and do their utmost to resolve issues for them.” from the report
Staffing and call-bell delays
seriousStaff sickness meant the home was not consistently staffed at the level identified by its own dependency tool. Inspectors saw people waiting for support and call bells ringing for prolonged periods.
“On our first day of inspection, we observed on a number of occasions that call bells rang out for prolonged periods of time as staff worked to respond to them.” from the report
Incomplete care records
needs fixingRecords did not always show that people had been repositioned as required or that prescribed creams had been applied. The manager said this would be followed up.
“Paperwork that was to be completed by staff that would provide oversight of the delivery of people's care were not always consistently completed.” from the report
Limited activities for some people
needs fixingPeople cared for in bed did not have planned activities. People also said they rarely went into the gardens.
“However, for people who were cared for in bed, there were no planned activities in place.” from the report
Consent policy not followed
needs fixingThe provider had obtained consent for photographs but had not followed its own policy to obtain consent for filming. The manager agreed to address this immediately.
“However, the provider had failed to follow their own policy and obtain people's consent to be filmed.” from the report
- 01How many staff are planned for each shift, and how do you cover sickness at short notice?
- 02What are the usual call-bell response times, especially at weekends, and how are delays monitored?
- 03How do you check that people are repositioned as required and that prescribed creams are recorded as given?
- 04What activities are now available for people who are cared for in bed?
- 05How do you obtain and record consent for photographs and filming?
This was a planned, unannounced inspection covering all five CQC questions, with observations, discussions and reviews of care, medicines, staffing and management records. This explanation was written from the published report of 9 October 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 Princess Lodge Limited
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2015Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 2 February 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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