CQC report explained · a residential care home
What the CQC found at Talbot Woods Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2024
Talbot Woods Lodge is rated Requires Improvement; inspectors found caring support and enough staff, but serious gaps in consent, governance and reporting incidents.
This was an unannounced focused inspection after concerns about safeguarding. Inspectors visited on three dates, spoke with people, relatives and staff, and checked care, medicine, staffing and management records.
People were generally happy and relaxed. Staff knew people well, supported healthcare access and provided enough help. The home was clean and well maintained, and relatives were mostly positive about the care.
However, best-interests decisions were missing for physical restraint and were incomplete for some medicines given covertly. There were also gaps in guidance for some as-required medicines, and the systems for checking quality had not found these problems.
The overall rating changed from Good at the previous inspection to Requires Improvement. The ratings for Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive were not assessed in this focused inspection.
Enough staff
Inspectors found enough staff to support people in the way they preferred. Relatives also described staffing levels positively.
“Enough staff were on duty to provide the care and support people needed in the way they preferred.” from the report
Staff knew people well
People appeared relaxed with staff, and staff understood their wishes and support needs.
“People were relaxed and at ease with staff.” from the report
Access to healthcare
With staff support, people routinely used medical, dental and primary healthcare services. The home worked with other organisations to support people's health.
“With support from staff, people routinely accessed medical, dental, and primary healthcare services as they needed.” from the report
Home environment
The home was clean, comfortable and maintained well. People could use their bedrooms, communal areas and enclosed garden freely.
“The premises were clean, comfortable and well maintained.” from the report
Incomplete best-interests decisions
seriousThere were no best-interests decisions for physical restraint. A decision about covert medicines did not cover all the medicines involved, creating a risk that care could be unlawful.
“Best interests decisions had not been completed in relation to the use of physical restraint” from the report
Weak quality checks
seriousAudits and reviews had not identified the problems with consent, DoLS, notifications, medicines and restraint planning. The provider was in breach of the good governance regulation.
“Although there were regular audits and reviews of various aspects of the service, these had not identified the breaches in regulation and areas for improvement that we found.” from the report
Incidents not always reported
seriousSome legally notifiable incidents were not reported to CQC promptly or using the required format. This included safeguarding allegations, a police investigation and DoLS-related matters.
“Notifiable incidents had not always been notified to CQC without delay, in the specified format.” from the report
Gaps in medicine guidance
needs fixingStaff understood when some as-required medicines were needed, but written instructions were not available for every as-required medicine.
“However, such written guidance should be available for all PRN medicines.” from the report
- 01What has changed to make sure every use of physical restraint has a professional risk assessment and a best-interests decision?
- 02How do you check that covert medicines are authorised and covered by a complete best-interests decision?
- 03What written guidance is now available for every as-required medicine?
- 04How are DoLS conditions, expiry dates and notifications to CQC now checked?
- 05How will relatives receive updates and have opportunities to attend relatives' meetings?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not assessed, and their ratings were not given in this report. This explanation was written from the published report of 3 January 2024 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 person-centred care, with some Mental Capacity Act paperwork needing improvement.
This was an unannounced planned inspection on 17 and 19 February 2020. One inspector spoke with people, relatives, staff and the manager, observed care, and checked care, medicine, recruitment, safety and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were happy. Inspectors found enough staff, safe medicine systems, personalised support, good activities and kind relationships.
There were some areas to improve. Mental Capacity Act assessments did not clearly identify the specific decision being considered, and consent had not always been recorded properly. Three days of medicine storage temperature checks were also missing, although inspectors found no pattern of gaps.
People felt safe
People and relatives said they felt safe. Inspectors found clear risk assessments, enough staff and appropriate safeguarding arrangements.
“People told us they were happy and felt safe.” from the report
Kind and respectful staff
People and relatives described staff as kind and caring. Staff respected privacy and supported people to communicate and make choices.
“People and relatives told us staff were kind and caring.” from the report
Personalised support
Care plans reflected people's likes, dislikes and changing needs. People were supported to develop skills, access the community and maintain relationships.
“Care plans were personalised and updated in response to people's changing needs.” from the report
Good management checks
The management team carried out checks on care records, medicines, staff records, safety and infection control. Incidents were reviewed so lessons could be shared.
“There was an effective system in place which meant these were reviewed, analysed and used as a learning opportunity.” from the report
Mental Capacity Act records
needs fixingMental capacity paperwork did not clearly state which specific decision was being considered. Some relatives had been asked for consent even though they did not have legal authority, and consent was not always recorded for people thought to have capacity.
“However, the paperwork was not clear about the specific decision being made.” from the report
Medicine storage checks
minorThe previous three days of medicine storage temperature checks had not been completed. Inspectors found no pattern of missed checks and judged the wider medicine arrangements to be safe.
“the past three days showed that temperature checks had not been completed.” from the report
- 01How do you now record the specific decision being considered in each Mental Capacity Act assessment?
- 02How do you check and record consent for care, information sharing and photographs?
- 03How are relatives' legal powers checked before they give consent on someone's behalf?
- 04How are medicine storage temperatures recorded each day, and what happens when a check is missed?
- 05How will you involve the person and family in discussing end of life wishes?
This was an unannounced planned inspection covering all five CQC questions, with care, premises, records and management arrangements reviewed. This explanation was written from the published report of 10 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 Talbot Woods Lodge
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2020Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 21 December 2010.
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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