CQC report explained · a nursing home
What the CQC found at The Hunters Lodge Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment checks and systems to protect people from abuse and manage risks. Some care plans were not fully up to date, although a new monthly review process was being introduced.
- Effective?
- Good
- People's needs and preferences were assessed, staff were trained and people were supported with food, drink and healthcare. The home was found to be working within the Mental Capacity Act and DoLS requirements.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported people to make choices and to remain as independent as possible.
- Responsive?
- Good
- Care was personalised to people's preferences and communication needs. People had activities, could maintain relationships and knew how to raise concerns.
- Well-led?
- Good
- Inspectors found regular audits, better recruitment and training systems, and managers who understood their legal duties. There was no CQC-registered manager at the time, but the three unit managers were registering.
What inspectors found, March 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors visited on 23 and 24 January 2020. The first day was unannounced and the second was announced. They spoke with people, relatives and staff, and checked care plans, medicine records, staff files and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, kind care, support with food and drink, personalised care plans and activities that reflected people's interests.
Some care plans did not have the latest information. The home had started a new monthly review system to improve this. Some protocols for medicines used to manage behaviour were not detailed, but these were corrected during the inspection.
The previous overall rating was Requires Improvement, published in February 2019. The report says the home had improved in Safe, Effective and Well-led, while Caring and Responsive remained Good.
Staffing and recruitment
People and relatives said there were enough staff. Inspectors found the required pre-employment checks had been completed.
“There was enough staff to keep people safe and staffing levels were regularly reviewed.” from the report
Kind and respectful care
Staff knew people's interests and histories, respected privacy and dignity, and encouraged people to do what they could for themselves.
“People were supported by kind and caring staff who respected their privacy, dignity and independence.” from the report
Food and drink
People could choose meals and change their minds. Special diets were provided and staff offered support, extra portions and drinks.
“People had choices for meals and were able to change their minds and have an alternative.” from the report
Activities and relationships
People took part in activities such as exercise, singing, baking, arts and crafts and shopping. Relatives were welcomed and could join activities or spend private time together.
“Over the two days of inspection we saw seated exercise, one person seeking comfort from a companion cat” from the report
Quality checks
The home had audits covering areas such as care plans, medicines, the environment, staff files and training.
“Quality assurance checks were in place which included the environment, care plans, medicines, challenging behaviour, staff files and training.” from the report
Care plans not always up to date
needs fixingInspectors found that some electronic care plans did not contain the latest information. Managers had identified this and were introducing monthly reviews, but the work was still ongoing.
“some people's plans did not contain the most up to date information about that person.” from the report
Medicine protocols needed more detail
needs fixingProtocols for medicines used to manage behaviour were not detailed enough. The unit manager corrected them immediately during the inspection.
“However, we saw that the protocols for medicines required for behaviour management were not detailed.” from the report
- 01How do you make sure each person's care plan contains the latest information, and can we see how the monthly reviews are recorded?
- 02How are medicines used to manage behaviour authorised, recorded and reviewed?
- 03Who is responsible for managing the home while the unit managers are registering with CQC?
- 04What changes were made after the incident mentioned in the report, and how do you check that those changes keep people safe?
- 05How are falls followed up, including the increased observations and falls training described in the report?
This was an inspection of all five CQC key questions and included the care provided and the premises; it was partly prompted by a specific incident, but the report says it did not examine that incident's circumstances. This explanation was written from the published report of 19 March 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, February 2019
Rated Requires Improvement; inspectors found kind, personalised care but concerns about staffing, medicines, training and decision-making.
Inspectors visited on 20 and 21 December 2018. The first day was unannounced. They spoke with people, relatives, staff and health professionals, and checked care records, medicines, staff files, rotas, complaints and quality checks.
The home was rated Good for Caring and Responsive. People were treated kindly, their care was personalised, and they had support with activities, communication and complaints.
The home was rated Requires Improvement for Safe, Effective and Well-led. Inspectors found inconsistent recruitment checks, concerns about night staffing and staff deployment, medicines monitoring problems, gaps in training and supervision, and incomplete evidence that people had agreed to motion sensors.
This was the home's second successive overall Requires Improvement rating. The provider had fixed the previous breach about quality assurance, but inspectors said further improvements were still needed.
Kind and respectful staff
Inspectors saw staff respond calmly and patiently. People were treated with dignity and encouraged to remain independent.
“During our time at the service, we saw staff supported people in a gentle and caring manner.” from the report
Personalised care
Care plans covered important individual needs, preferences and life histories. Relatives were usually involved in care reviews.
“People received care and support that took into account their individual needs and preferences.” from the report
Open communication
Most people, relatives and staff found managers approachable and felt able to give feedback or raise concerns.
“Most people and relatives spoke positively about their communication and dealings with the management team to date.” from the report
Recruitment checks
seriousSome staff started work or training before all required checks were complete. Inspectors were not assured that one person had been supervised during this period.
“One member of staff had been allowed to start work before their employment references had been received.” from the report
Staffing and supervision
seriousStaff raised concerns about night staffing on Terrace Unit. People in communal lounges were sometimes left without effective monitoring.
“We saw people, who, on occasions, displayed behaviours which impacted negatively upon one another, were left unsupervised in the unit's communal lounges for periods of ten minutes or more.” from the report
Medicines monitoring
seriousControlled drug checks were only monthly rather than weekly. The medicines fridge temperature was outside recommended limits on nine occasions and this had not been reported.
“We also found medicines that required cold storage on Terrace Unit could have been compromised, because the temperature of the medicines fridge had fallen below the recommended limits on nine occasions within the last month.” from the report
Training and supervision gaps
needs fixingSome staff had not completed mandatory or refresher training, and two-monthly supervision meetings had not been provided consistently.
“However, the training records we looked at indicated staff training had lapsed.” from the report
- 01How many staff now work at night on Terrace Unit, and how are people monitored in the communal lounges?
- 02How do you check that every new staff member has completed references, employment history checks and the correct DBS checks before starting?
- 03How are medicines fridge temperatures checked, recorded and acted on when they are outside the recommended range?
- 04How do you record consent and best-interest decisions for infra-red motion sensors and other restrictions?
- 05What is the current position on mandatory training, refresher training and regular staff supervision?
This inspection covered the home's premises and care, and considered all five CQC questions. This explanation was written from the published report of 14 February 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 The Hunters Lodge Care Centre
5 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Hunters Lodge Care Centre →
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Hunters Lodge Care Centre →
- September 2017Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015Goodup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015InadequateSafe: Requires improvementEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 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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