CQC report explained · a residential care home
What the CQC found at River Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Staffing, risk management, recruitment, medicines and infection control were all found to be suitable.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- Inspectors found that management checks had improved and were effective. Managers understood their responsibilities and had taken action when shortfalls were identified.
What inspectors found, March 2023
River Lodge rated Good; inspectors found safe, well-led care and improvements since the previous Requires Improvement rating.
This was an unannounced, focused inspection on 1 and 7 February 2023. One inspector spoke with one person living at the home, three relatives and six staff. They also reviewed care, medicines, recruitment and management records.
Inspectors rated Safe and Well-led as Good. They found enough staff, suitable safety checks, detailed risk plans and safer medicines management. Infection prevention arrangements were also found to be suitable.
The home had previously been rated Requires Improvement. Inspectors found that improvements had been made, including stronger checks on quality and safety. The provider was no longer in breach of Regulation 17.
This was not a full inspection of all five areas. The overall Good rating used the new findings for Safe and Well-led, with the other ratings carried over from the previous inspection.
Staffing
Inspectors found enough staff were available to meet people's needs. Relatives also said staffing levels had improved.
“There were sufficient numbers of staff deployed across the home to meet people's needs.” from the report
Medicines
Medicines management had improved since the last inspection. Stock checks matched the records used to record medicines being given.
“Medicine stock checks were accurate and corresponded with medicine administration records.” from the report
Management checks
The systems used to monitor quality and safety had improved. Audits were completed regularly and actions were taken when problems were found.
“The governance systems in place had improved and were effective in assessing the quality and safety of the service.” from the report
Family feedback
minorRelatives were consulted regularly, but they had not received formal questionnaires or surveys. Management said they would look at introducing a written feedback system.
“People's relatives said they had not received formal questionnaires or surveys to feedback their thoughts and views but were consulted regularly.” from the report
- 01How will you support my relative to understand and take ownership of their medicines?
- 02How often will my relative's risk assessments and positive behaviour support plans be reviewed?
- 03What written feedback system is now available for families?
- 04What are the current ratings and evidence for Caring, Effective and Responsive, which were not inspected during this visit?
- 05What further changes have been made since the previous inspection's Requires Improvement rating?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 8 March 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, December 2021
River Lodge was inspected but not rated; inspectors found good risk guidance but incomplete monitoring records and some premises issues.
This was an unannounced, targeted inspection on 2 and 8 November 2021. One inspector spoke with one relative and three staff, and reviewed one person's risk records and documents about COVID-19.
Inspectors found that people's risks were recorded in care plans and that staff understood how to support them. They also found person-centred information that supported people's dignity, privacy, communication and independence.
There were some shortfalls. Staff did not always complete records for one person's newly increased monitoring. A fire risk assessment was not readily available, some parts of the home needed repair, and not all staff were bare below the elbow.
The home was inspected but not rated. This was because the inspection looked only at specific concerns within Safe and at infection prevention and control. The previous overall rating of requires improvement remains in place.
Risk guidance
People's risks were assessed and recorded in their care plans. Staff understood people's individual risks and how to manage them.
“People's risks were assessed and monitored and detailed in their care plan.” from the report
Staff knowledge
Staff knew the people living in the home and understood how to support their needs.
“Staff we spoke to were aware of people's individual risks and how to monitor and manage them.” from the report
Person-centred care
Care plans included information designed around people's communication needs, dignity, privacy, human rights and independence.
“People's care plans included documentation which were person-centred and promoted people's dignity, privacy and human rights” from the report
Infection controls
Inspectors were assured about several infection control arrangements, including PPE, testing, visits and the management of possible outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Incomplete monitoring records
needs fixingOne person had recently needed increased monitoring, but staff did not consistently complete the required records. The monitoring had only recently been introduced.
“One person had recently required increased monitoring, however we found staff were not consistently completing the required documentation.” from the report
Fire risk assessment
needs fixingThe deputy manager could only find a fire risk assessment dated December 2019. A new assessment had been arranged but had not yet taken place.
“The deputy manager could only locate a fire risk assessment dated December 2019” from the report
Areas needing repair
minorSome areas, including door frames, had chipped paint. The provider had set aside money for renovation and redecoration.
“some areas such as door frames had chipped paint therefore would be harder to keep clean.” from the report
Agency staff
minorA relative raised concern about the number of agency staff. The provider said it was using the same agency staff to improve consistency.
“However, they told us, they were concerned with the number of agency staff used.” from the report
- 01How are you now checking that increased monitoring records are completed every time?
- 02Has the new fire risk assessment taken place, and what actions did it identify?
- 03What work has been completed to repair chipped paint and refurbish the areas that were harder to keep clean?
- 04How many agency staff are currently used, and how do you maintain consistency for people living in the home?
- 05What is the current position on the care plan updates mentioned in the report?
This was a targeted inspection of specific concerns about Safe, including risk monitoring and infection prevention and control; it did not assess the other key questions or change the previous rating. This explanation was written from the published report of 17 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.
Every inspection of River Lodge
3 rated inspections over 4 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Inspected but not ratedSafe: Inspected but not rated
- July 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- June 2019GoodSafe: GoodWell-led: Good
- September 2017
Registered with the Care Quality Commission on 4 September 2017.
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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