CQC report explained · a residential care home
What the CQC found at Rose Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2020
Rose Lodge is rated Good overall, but inspectors rated Safe Requires Improvement because staff deployment and some safety checks were not always effective.
This was an unannounced focused inspection, carried out on 7 and 22 October 2020. Inspectors reviewed records, medicines, staffing, recruitment, the building and infection control. They observed care and spoke with people and staff.
The home had improved since the previous inspection. Medicines, risk assessments, care records and quality checks were better. The home was no longer in breach of the regulations found at the previous inspection.
However, staff were not always deployed in the right places, which affected support on the first floor. Inspectors also found gaps in infection control arrangements, accident analysis and the environment for people living with dementia.
The overall rating was Good. Safe was Requires Improvement, while Effective and Well-led were Good. Caring and Responsive were not assessed during this inspection, so their previous ratings were carried forward.
Medicines and risk assessments
Medicines were managed safely and records contained the information staff needed. People's risks were assessed with their involvement and reviewed regularly.
“Medicines were managed safely and in line with best practice guidance.” from the report
Improved records and oversight
Records and quality checks had improved since the previous inspection. The management team used audits and monitoring to identify improvements.
“The quality and assurance systems in place efficiently monitored the quality and care provided to people.” from the report
Food and drink
People could access food and drinks throughout the day, with choices suited to their dietary needs.
“A trolley of snacks and drinks was made available to people throughout the day from staff members who were knowledgeable about people's dietary needs.” from the report
Infection control measures
The home had an up-to-date infection prevention policy and used testing, shielding and social distancing measures during the pandemic.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Staff deployment
seriousThere were enough staff overall, but they were not always placed where they were needed. This affected support for people on the first floor, although the management team changed the arrangements during the inspection.
“There were enough staff to safely support people, but we found that staff were not suitably deployed to enable people on the first floor to have adequate support.” from the report
PPE changing arrangements
needs fixingStaff did not have identified places on the first floor to change protective equipment when moving between areas. The provider said it had addressed this through the new deployment arrangements.
“We did find that issues caused by staff deployment resulted in staff not having designated areas/stations to change their PPE whilst moving between floors and units.” from the report
Falls analysis
needs fixingThe home reviewed accidents and incidents, but its analysis did not always identify repeated falls in particular communal areas.
“We did find that the analysis of accidents hadn't always identified trends in falls, such as falls reoccurring in communal areas.” from the report
Dementia-friendly environment
needs fixingThe building needed clearer signs and better use of colour to help people with dementia find bedrooms, bathrooms and toilets.
“There was a lack of signage and colour consideration for people with a dementia to be able to identify bedrooms, bathrooms and toilets.” from the report
Time for one-to-one contact
minorPeople had positive relationships with staff but said staff did not always have enough time to spend quality time with them individually.
“People commented that they had positive relationships with staff, but they felt that staff did not always have enough time to spend quality one-to-one time with them.” from the report
- 01How are staff now deployed on each floor, and how do you check that people receive enough support?
- 02What designated areas are now available for staff to change PPE between floors and units?
- 03What changes have been made to identify repeated falls, particularly in communal areas?
- 04What is being done to improve signs and colour contrast for people living with dementia?
- 05How do you make sure staff have enough time for quality one-to-one contact with residents?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 19 December 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.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, records, risk management and cleanliness were not always safe.
This was an unannounced planned inspection on 30 September and 1 October 2019. Inspectors spoke with people using the service, visitors and staff. They also checked 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. Inspectors found kind staff, personalised care, activities and good links with health professionals.
There were important shortfalls. Medicines records were not always correct, risks were not always reflected in updated care plans, some areas needed cleaning, bathing temperature records were very low, and records were not always complete. The provider was in breach of Regulations 12 and 17.
Kind and respectful staff
People described staff as kind and caring. Inspectors saw staff treating people with patience, respect and consideration.
“Staff were observed to be kind, patient, respectful and considerate.” from the report
People felt safe
People said they felt safe and secure. Staff understood how to identify and report safeguarding concerns, although some were unsure how to report concerns externally.
“People told us they felt safe and secure living at the home.” from the report
Staff training and support
Staff received regular supervision, appraisals and training. Recruitment checks had been completed to check new staff were suitable.
“Staff received regular support through supervisions and a yearly appraisal.” from the report
Activities and relationships
People were supported to spend time as they wished, take part in activities and maintain relationships with relatives and the community.
“People were supported to spend their time as they wished.” from the report
Medicines records
seriousRecords did not always show that medicines were being managed safely. Stock figures were sometimes wrong, and patch records were not robust.
“Records did not support the safe management of medicines.” from the report
Risks and cleanliness
seriousCare plans were not always updated when people's needs changed. Some areas needed cleaning, and bathing temperature records were recorded as very low.
“Risks to people were identified and assessed, however, care plans were not always updated when people's needs changed.” from the report
Dining experience
needs fixingPeople and relatives gave mixed views about food quality and choice. People could wait a long time, and those living with dementia needed more support during meals.
“The dining experience needed improving. People were left waiting for a long time.” from the report
Incomplete records
seriousSome care and monitoring records were not complete or up to date. This included records of people's position changes during the night.
“Records were not always fully completed or kept up to date.” from the report
- 01What changes have been made to medicine stock checks, patch records and daily medicine records?
- 02How do you make sure care plans are updated when a person's risks or needs change?
- 03What has been done to improve cleanliness and check bathing water temperatures?
- 04How has the dining experience changed, including waiting times and support for people living with dementia?
- 05How do you now check that care records and night-time repositioning records are complete and accurate?
This was a planned, unannounced inspection covering all five key questions, with the previous Good rating from 2017 reassessed. This explanation was written from the published report of 19 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 Rose Lodge
4 rated inspections over 6 years: the service has held its Good rating throughout.
- December 2020Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 14 October 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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