CQC report explained · a nursing home
What the CQC found at The Lodge - Dementia Care with Nursing
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2024
The Lodge - Dementia Care with Nursing is rated Requires Improvement; inspectors found kind care and enough staff, but medicines and management checks were not consistently safe.
This was an unannounced, focused inspection on 13 December 2023. Inspectors reviewed information from before the visit, spoke with people, relatives and staff, and checked care plans, risk assessments, medicines records, audits, rotas and recruitment files.
The home was clean and comfortable, with enough staff and safe recruitment. Staff were trained, worked with health professionals and supported people with food, drink, dementia care and decision-making. Relatives described staff as caring.
However, medicines were not always stored or recorded safely. Management audits had failed to find these problems, including issues that had also been found before. The home breached regulations on safe care and treatment and good governance. The overall rating stayed Requires Improvement. Effective improved to Good, while Safe and Well-led remained Requires Improvement.
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks, including references and DBS checks, had been completed.
“People were supported by enough staff who had been recruited safely.” from the report
Skilled and supported staff
Staff had relevant training, a proper induction and regular supervision and team meetings.
“The registered manager provided a robust induction and staff training was up to date in relevant areas.” from the report
Health and nutrition support
Staff worked with health and community services. People were supported with balanced meals, modified diets and referrals to dieticians and speech and language therapy.
“Staff worked with other agencies to provide care and supported people to live healthier lives.” from the report
Kind atmosphere
Relatives described staff as kind and caring. Inspectors found a positive culture and staff who were committed to care.
“Staff are very kind and caring, I am happy with the staff.” from the report
Medicine records and storage
seriousMedicine fridge and room temperature records had gaps. Thickener was not always recorded or stored securely, and a controlled-drugs cupboard key was left on top of the cupboard.
“Systems had not been established to make sure medicines were managed safely. This placed people at risk of harm.” from the report
Management checks missed problems
seriousThe medicine audit did not identify the issues inspectors found. The same concern had also been identified at the previous inspection.
“Although there was a schedule of audits, the medicine's audit had not identified the issues we found during the inspection in order to make changes.” from the report
Limited guidance on safe holds
needs fixingSome care plans referred to safe holds but did not give enough person-specific information to guide staff. CQC recommended getting guidance on how to document these care strategies.
“We recommend the provider seek guidance about how to document information regarding care strategies, so they are specific for each person.” from the report
Infection control practice
minorSome staff did not follow the home's bare-below-the-elbow policy. The manager said this would be addressed immediately.
“We observed that some staff did not adhere to the service's 'bare below the elbow' policy.” from the report
- 01What specific changes have been made to medicine fridge and room temperature checks, and how are missed checks now followed up?
- 02How do you make sure staff record the amount of thickener added to drinks and store thickener securely?
- 03What guidance is now available for staff administering medicines prescribed as and when required?
- 04How are medicine audits being checked to make sure they identify problems before they put people at risk?
- 05What person-specific guidance is now recorded for anyone supported with safe holds?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and the overall rating used the previous ratings for questions not inspected. This explanation was written from the published report of 7 February 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, February 2022
The Lodge: Inspected but not rated; inspectors found good infection-control arrangements during a targeted COVID-19 inspection.
The inspection was unannounced and took place on 24 January 2022. It was targeted, meaning inspectors looked at infection prevention and control, staffing pressures linked to COVID-19, and concerns about staff isolation periods.
Inspectors were assured that the home was using protective equipment safely, arranging testing, managing outbreaks, supporting safe admissions and visits, and following infection-control guidance. They also found the home clean and well maintained.
The service was inspected but not rated overall. The Safe area was also inspected but not rated. The other four areas were not assessed in this inspection.
Infection control
The home had infection-control policies, audits, training and up-to-date guidance. Inspectors were assured that infections could be prevented and managed.
“Infection control policies and audits helped ensure that the home adopted best practice which complied with current guidance.” from the report
Clean surroundings
The home was clean and well maintained. Cleaning schedules and audits were in place, and extra domestic staff had been recruited.
“The service was clean and well maintained, with some communal areas having recently undergone refurbishment and some still in progress.” from the report
Contact with loved ones
The home supported face-to-face visits in designated areas and also offered garden and virtual visits.
“The service supported people to maintain contact with those who were important to them, to aid their emotional and psychological well-being.” from the report
Health support
The home had links with external health professionals, with virtual consultations arranged when needed.
“The service had close links with external health professionals to enable people to receive the care and intervention they needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing staff absence and staffing pressures caused by COVID-19?
- 02What are your current arrangements for testing residents and staff?
- 03How do you manage visiting if there is an infection outbreak or a visitor has symptoms?
- 04How do you check that staff use protective equipment correctly?
- 05How quickly can residents see external health professionals when they need care or treatment?
This was a targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it did not rate the service overall or assess the other four key questions. This explanation was written from the published report of 12 February 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.
Every inspection of The Lodge - Dementia Care with Nursing
5 rated inspections over 9 years: the service has held its Requires improvement rating throughout.
- February 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Lodge - Dementia Care with Nursing →
- February 2022Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at The Lodge - Dementia Care with Nursing →
- September 2021Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- June 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- June 2017Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2015
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 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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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.