CQC report explained · a residential care home
What the CQC found at Queens Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Records of distressed behaviour, accidents, incidents and falls were not always effective or regularly reviewed. One person's specialised health equipment was not used regularly, although this was acted on immediately when identified.
- Effective?
- Requires improvement
- Mealtimes were not enriching, some health referrals were delayed, and some mental capacity and best-interest records needed improvement. People were supported to eat and drink safely and staff understood their communication and care needs.
- Caring?
- Good
- People received kind and compassionate care. Staff respected privacy and dignity, supported people's choices, and knew their routines and preferences.
- Responsive?
- Requires improvement
- People did not spend enough time doing activities they enjoyed or going out, and support for regular contact with some loved ones needed improvement. There was no system for people to set, review and work towards personal goals.
- Well-led?
- Requires improvement
- Management quality checks had not been completed since March 2022 and oversight of care records, incidents, training and supervision had lapsed. The provider had started using consultants and an action plan, and returned the deputy manager to the home full time.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found kind care, but weaknesses in safety records, activities and management oversight.
The inspection was unannounced and took place on 27 June and 1 July 2022. One inspector spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home cared for four people. People were treated kindly and with dignity. Staff knew people well, supported their communication and gave medicines safely. There were enough staff to provide safe care.
However, records of distressed behaviour, accidents and falls were not always properly reviewed. Some health needs were missed, activities and family contact were not regular enough, and mealtimes were not enriching. Management checks had lapsed and the home did not have a registered manager in post.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement. Caring was rated Good. The provider had begun an action plan, and CQC said it would monitor progress and return to inspect again.
Kind and respectful care
People were treated with kindness, dignity and respect. Staff were patient, attentive and supported people's preferred routines.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Staff knew people well
The deputy manager and most of the care team had worked at the home for a long time. This helped provide consistency.
“The deputy manager and most of the care team had worked in the service for a long time, which supported people to receive consistent care from staff who knew them well.” from the report
Safe medicines support
Staff gave medicines in the way people preferred and used an electronic system that was working well. Medicines were not used excessively to control behaviour.
“We saw people were given their medicines in the way which best suited them, and staff knew people's preferences.” from the report
Enough staff
Inspectors found enough staff to provide safe care. Staff worked together to maintain one-to-one support when needed.
“There were sufficient staff to provide safe care to people.” from the report
Good communication with people
Staff understood different ways people communicated and offered choices in ways people could use.
“Staff had good awareness, skills and understanding of individual communication needs, they knew how to facilitate communication” from the report
Safety records and reviews
seriousRecords of distressed behaviour, accidents, incidents and falls were not consistently recorded or reviewed. This meant the home could miss patterns and actions needed to prevent harm.
“Records of accidents, incidents and falls were not regularly reviewed by the management team.” from the report
Missed health support
seriousA person's specialised health equipment was not used regularly, and two people needed dietician reviews that had not been arranged promptly. These issues were acted on when inspectors raised them.
“Records showed this was not done regularly. This placed the person at heightened risk of not receiving care which met their health needs.” from the report
Too few activities and outings
needs fixingPeople did not regularly go out, take part in activities they enjoyed or spend time with some loved ones. There was also no system for setting and reviewing personal goals.
“People did not spend enough time out and about doing things they enjoyed.” from the report
Unfulfilling mealtimes
needs fixingPeople were not given enough involvement or preparation for meals. The dining area was not arranged as a distinct and attractive mealtime space.
“People were not supported to have enriching mealtime experiences.” from the report
Weak management oversight
seriousKey management checks had not been completed since March 2022. Some records, staff support arrangements and legal decision-making documents needed updating.
“Management quality assurance checks of key areas of the service had not been completed since March 2022.” from the report
- 01What changes have been made to record and review distressed behaviour, accidents, incidents and falls?
- 02How do you now make sure each person's health equipment, health reviews and routine appointments happen on time?
- 03What regular activities, outings and family visits are now available for each person?
- 04How are people involved in choosing meals and making mealtimes more enjoyable?
- 05Who is currently responsible for management oversight, and how often are care, medicines, incident and staff-support checks completed?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control; the report also compares each question with the previous inspection rating. This explanation was written from the published report of 30 July 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, April 2020
Rated Good; inspectors found safe, kind and personalised care, with only minor record-keeping issues noted.
The inspection took place on 10 March 2020. One inspector met people living in the home, watched staff support them, and spoke with a relative, staff and managers. They also checked care records, medicines records, recruitment files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from harm, received their medicines safely, had their health needs met and were supported by trained staff.
People were treated with kindness and respect. Their care was personalised, and they were supported to make choices, take part in activities and become more independent. The home had systems for complaints, audits and learning when things went wrong.
Safe medicines care
Medicines were stored, administered and checked safely. Staff had training and understood how to manage medicines taken only when needed.
“Medicines were managed and stored safely. Effective systems were in place to ensure people received their medicines as prescribed.” from the report
Kind and respectful staff
Inspectors saw staff communicating patiently and kindly. People appeared comfortable with the staff supporting them.
“During our inspection we saw staff support and interact with people in a kind and caring manner.” from the report
Activities and independence
People took part in activities suited to their interests. The service focused on helping people gain skills and become more independent.
“People were able to take part in activities that were suited to them.” from the report
Active management
Managers used detailed audits to identify and address problems. Staff felt supported and understood their responsibilities.
“Regular and detailed audits took place to identify areas for improvement and act upon them.” from the report
Some daily records lacked detail
minorThe report says that daily care records had sometimes not included enough detail. Managers had raised this with staff and were working to improve the records.
“when daily care records were lacking sufficient detail, this was raised with the staff team to improve upon.” from the report
- 01How do you check that daily care records contain enough detail about my relative's support?
- 02How will you support my relative's communication needs and choices in day-to-day decisions?
- 03What activities and community outings would be suitable for my relative?
- 04How do you review risk assessments when a person's needs or behaviour changes?
- 05How will you involve our family in reviewing and updating the care plan?
This was a planned inspection covering all five CQC questions, and all five ratings remained Good from the previous inspection. This explanation was written from the published report of 7 April 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 Queens Lodge
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- July 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 20 July 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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