CQC report explained · a nursing home
What the CQC found at Smyth Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found suitable risk assessments, enough staff, safe medicines systems and good infection prevention.
- Effective?
- Good
- People's nutrition, hydration and health needs were met, and staff had suitable training and support. This rating improved from Requires Improvement at the previous comprehensive inspection.
- Caring?
- Good
- People and relatives said staff were kind, respectful and supportive. Staff involved people in decisions and promoted privacy, dignity and independence.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and important relationships. People could take part in activities, maintain relationships and raise complaints, and this rating improved from Requires Improvement.
- Well-led?
- Good
- The registered manager and staff understood their roles and used audits, meetings and feedback to monitor and improve the service. The home worked with health and social care professionals.
What inspectors found, November 2022
Smyth Lodge was rated Good overall, with inspectors finding safe, kind and well-organised care and improvements since the last inspection.
This was an unannounced inspection on 13 October 2022. Two inspectors and an Expert by Experience spoke with people living in the home, relatives and staff. They observed care and reviewed care plans, medicines records, recruitment files, training records and quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, good infection control, suitable training and effective links with health and social care professionals.
People and relatives described staff as kind, respectful and approachable. People were involved in their care, supported with food and activities, and able to receive visitors without unnecessary restrictions.
The previous overall rating was Requires Improvement, published in February 2021. Inspectors found improvements in nutrition support, the home environment, care plan involvement and the way people were treated. The provider was no longer in breach of regulations.
Safe medicines
Medicines were given as prescribed. Staff were trained and checked as competent, and regular audits were used to identify errors or discrepancies.
“Medicines were managed safely, and people received their medicines as prescribed.” from the report
Enough trained staff
Inspectors saw enough staff deployed across the home. Recruitment checks, induction, training and supervision were in place.
“Throughout our inspection, we observed there were enough staff who were deployed appropriately to meet people's needs.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors observed caring interactions and found that staff respected privacy, dignity and independence.
“Throughout our inspection we observed positive and caring interactions between people and the staff team.” from the report
Improvement since 2021
The home improved its support with eating and drinking, signage and orientation, care plan involvement and the way people were treated. The provider was no longer in breach of regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Activities and relationships
People had access to daily activities, outings and communal facilities. Relatives and friends could visit without unnecessary restrictions.
“People were encouraged and supported to take part in a range of activities and events that the service offered.” from the report
Further personal information being gathered
minorThe provider was still working to obtain more person-centred information about people's life histories and preferences. Families should ask how this information is collected and kept up to date.
“The provider continued to work on obtaining further person centered information about people” from the report
- 01How are staffing levels checked against each person's changing needs?
- 02How will you involve my relative and our family in care plan reviews?
- 03How do you make sure medicines are given correctly and any errors are followed up?
- 04What personal information about my relative's life, preferences and communication needs will be recorded?
- 05How can my relative take part in activities and maintain important relationships?
This unannounced inspection assessed the home and the care provided across all five CQC questions, including infection prevention and control, and the inspectors spoke with people, relatives and staff and reviewed care and management records. This explanation was written from the published report of 25 November 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, February 2021
Rated Requires Improvement; the focused inspection found safe and well-led care, and the home left special measures, but other areas were not reassessed.
Inspectors visited without notice on 29 January 2021. They spoke with people, relatives, staff and managers, and reviewed care plans, recruitment and training records, medicines information, audits and other management records.
The home was rated Good for Safe and Good for Well-led. Inspectors found that risks were assessed and reviewed, staffing levels had improved, medicines were managed safely, and infection control arrangements were in place. They also found better quality checks and management oversight.
The overall rating was Requires Improvement. This was a focused inspection of Safe and Well-led only. The other three key questions were not inspected, so their previous ratings were used. The home had previously been rated Inadequate and placed in special measures, but inspectors found enough improvement for it to leave special measures.
Risk management
Care plans included detailed risk assessments, and staff understood how to support people safely. Risks were reviewed regularly.
“Risks to people were identified, assessed, documented and reviewed to ensure their needs were safely and appropriately met.” from the report
Staffing
Inspectors saw enough staff to meet people's needs promptly. Recruitment checks were also completed before staff started work.
“Throughout our inspection, we observed there were enough staff to meet people's needs in a timely manner with call bells answered promptly.” from the report
Medicines
Medicines were stored, administered and monitored safely. Staff who administered them had training and competency checks.
“Medicines were managed, stored, monitored and administered safely.” from the report
Management oversight
The home had regular audits covering areas such as care records, medicines, incidents and complaints. Inspectors found that actions were taken when needed.
“Audits we reviewed were up to date, conducted frequently and actions were taken when necessary to ensure that care was provided safely and appropriately.” from the report
Infection control
Inspectors were assured that the home had arrangements for preventing and managing infections, including the safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Limited inspection scope
minorThree of the five key questions were not reassessed. Their previous ratings were carried forward, so this report does not give a current inspection picture of Effective, Caring or Responsive.
“The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.” from the report
- 01What are the current ratings or latest evidence for Effective, Caring and Responsive, which were not assessed in this inspection?
- 02How are you checking that the improvements made after the previous Inadequate inspection are being maintained?
- 03How often will my relative's risks and care plan be reviewed, and how will I be involved?
- 04What staffing levels will be in place for my relative's needs, including at busy times such as meals?
- 05How can relatives give feedback or raise concerns, and how will the home show what action was taken?
This was an unannounced focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 25 February 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 Smyth Lodge
4 rated inspections over 3 years: the service has improved, from Inadequate to Good.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Requires improvementup from InadequateSafe: GoodWell-led: Good
- July 2020Inadequatestayed InadequateSafe: Inspected but not rated
- May 2020InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2019
Registered with the Care Quality Commission on 4 February 2019.
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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