CQC report explained · a nursing home
What the CQC found at Raunds Lodge Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff on shift, safe recruitment, suitable risk assessments, safe medicines management and effective infection control. Some people, relatives and staff gave mixed views about staffing levels.
- Effective?
- Good
- Care plans were reviewed and updated, staff had suitable training and people received support with food, drink and healthcare. A small number of staff needed to update some training.
- Caring?
- Good
- This question was not inspected during this visit.
- Responsive?
- Good
- This question was not inspected during this visit.
- Well-led?
- Good
- The provider and registered manager had improved quality checks, reviewed incidents and sought feedback from people and relatives. The previous Regulation 17 breach had been resolved.
What inspectors found, December 2021
Rated Good; inspectors found kind, safe care and clear improvements since the previous inspection.
This was an unannounced follow-up inspection. Inspectors visited on 19 October, 21 October and 18 November 2021. They spoke with people living in the home, relatives and staff, and checked care plans, recruitment records, training information and quality checks.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. Inspectors found kind and person-centred care, safe medicines practice, suitable staffing arrangements, effective infection control and care plans that reflected people's needs.
The previous rating was Requires Improvement, with a breach of Regulation 17 about good governance. Inspectors found that improvements had been made and that the home was no longer in breach.
Caring and Responsive were not inspected during this visit. The report says ratings from earlier comprehensive inspections for questions not reviewed were used when calculating the overall rating.
Kind, personal care
Staff were described as kind and caring. They understood people's needs and preferences and adapted support around them.
“Staff were kind and caring and provided people with warm, person-centred care.” from the report
Safe medicines
Medicines were stored and given safely. Records were completed accurately and staff had their medicines skills checked.
“Medicines were stored and administered safely.” from the report
Good care planning
Care plans described people's needs, choices and risks. Staff reviewed them regularly and involved other professionals when needed.
“Care plans were regularly reviewed and updated to ensure they reflected people's changing needs and wishes.” from the report
Infection control
Inspectors were assured that the home had measures in place to prevent and manage infections, including COVID-19.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Improved leadership
The provider had strengthened quality checks and used incident information to identify learning and improvements.
“Since our last inspection the provider had taken action to improve quality assurance processes.” from the report
Mixed views about staffing
needs fixingInspectors found enough staff on shift, but some people, relatives and staff felt more staff were needed. The management team used a contingency plan and regular agency staff during shortages.
“There were enough staff on shift to respond to people's needs, although we received some mixed feedback about staffing levels.” from the report
Loud call bell
minorInspectors found that the call bell alarm was very loud and could have a negative effect on people and staff. The provider said they would look into resolving this.
“During the inspection, we noted the call bell alarm in the service was very loud, which potentially could impact negatively on both people living in the service and staff.” from the report
Some training updates needed
minorThe training records were generally comprehensive, but a small number of staff needed to update some training. The registered manager said this would be addressed immediately.
“The training record was comprehensive and showed a small number of staff who needed to update some areas of training.” from the report
- 01How many staff are normally on each shift, and how do you cover sickness, annual leave and recruitment gaps?
- 02What action has been taken about the loud call bell alarm?
- 03Which staff training needed updating, and has all of it now been completed?
- 04How do care staff and kitchen staff coordinate during mealtimes?
- 05What were the Caring and Responsive ratings at the last comprehensive inspection, and what has changed since then?
This was an unannounced follow-up inspection focused on the areas linked to the previous improvement action and infection control; Safe, Effective and Well-led were reviewed, while Caring and Responsive were not inspected and earlier ratings were carried forward. This explanation was written from the published report of 15 December 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, April 2020
Raunds Lodge Nursing Home was rated Requires Improvement; inspectors found kind, responsive care but staffing, risk checks and management oversight needed improvement.
This was an unannounced, planned inspection on 12 February 2020. Inspectors spoke with seven people, three relatives and seven staff. They reviewed care records, medicines records, staff files and management records.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were rated Good. The home was clean, staff were kind and people were supported with healthcare, activities and relationships.
Inspectors found that staffing levels did not always meet people's needs. Some risk assessments and records were incomplete or inconsistent. Management checks had not found these problems. The provider made several changes immediately after the inspection, including increasing staffing and updating records.
The previous overall rating was Good, published in August 2017. The report says the home breached Regulation 17 on good governance. CQC asked for an action plan and said it would monitor progress and return for another inspection.
Kind and respectful staff
People and relatives said staff were patient, kind and caring. Staff respected privacy, dignity, communication needs and preferences.
“People and relatives described staff as, patient, kind and caring.” from the report
Medicines and healthcare
Medicines were given as prescribed, and staff worked with GPs, nurses and community healthcare teams. Staff had appropriate medicines training.
“Medicines were managed safely and were administered as prescribed.” from the report
Personalised support
Care plans included people's physical and emotional needs, preferences and communication needs. People had named keyworkers and personalised bedrooms.
“Each person had a named keyworker.” from the report
Complaints handling
People and relatives knew how to complain. The report found that complaints were responded to within the provider's stated timescales.
“All complaints made were fully responded to within the timescales specified within the providers policy.” from the report
Staffing levels
seriousPeople and staff reported that there were not always enough staff. Inspectors saw people waiting for support, and staffing affected when some people could get up or go to bed.
“People and staff told us they didn't feel there were enough staff on duty.” from the report
Incomplete risk information
seriousSome people using bed rails did not have comprehensive risk assessments. Information about equipment used for skin care was also conflicting or incorrect in some records.
“However, people who used bedrails did not have comprehensive risk assessments in place.” from the report
Fire alarm response
seriousDuring a fire alarm, all staff went to the fire panel and people were left alone in communal areas. The provider agreed to discuss a safer approach with the fire officer.
“All staff convened by the fire panel, leaving people alone in communal areas.” from the report
Management checks
seriousAudits and other oversight systems did not consistently identify problems or ensure follow-up action. This led to a breach of Regulation 17 on good governance.
“The provider failed to have systems and processes in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of people.” from the report
Activities when the coordinator was away
needs fixingInspectors saw no evidence of activities being offered when the activities coordinator was not at work. The manager said this was a recording error and agreed to improve recording.
“When the activities co-ordinator was not at work, we saw no evidence of activities being offered.” from the report
- 01What staffing levels are now in place, and how do you check that they meet each person's needs?
- 02Have all bed rail risk assessments and equipment records been reviewed and kept up to date?
- 03What is the agreed procedure for supporting people safely if the fire alarm sounds?
- 04How do your current audits identify problems with medicines records, risk assessments and staffing?
- 05What activities are offered when the activities coordinator is away, and how are these recorded?
This was an unannounced, planned inspection covering all five CQC questions; the previous Good rating from 2017 was reviewed and Safe, Effective and Well-led had deteriorated to Requires Improvement. This explanation was written from the published report of 4 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 Raunds Lodge Nursing Home
4 rated inspections over 6 years: the service has held its Good rating throughout.
- December 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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