CQC report explained · a residential care home
What the CQC found at The 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, April 2020
The Lodge was rated Good overall, but inspectors found that some safety records and medicine instructions needed improvement.
This was an unannounced, planned inspection on 27 January 2020. Inspectors spoke with people living in the home, relatives, professionals, managers and care staff. They also checked care, medicine, recruitment, training and management records.
The home was rated Good for Effective, Caring, Responsive and Well-led. People were described as receiving kind, personalised support. Staff helped people build independence, enjoy activities, maintain relationships and access healthcare.
Safe was rated Requires Improvement. Some records did not clearly explain when to use certain medicines, physical restraint or other support during distress. Records of agency staff inductions were also missing. The inspectors made recommendations about medicines, incident records and Mental Capacity Act recording.
Kind relationships
People had relaxed, positive relationships with staff who treated them with kindness and respect.
“People shared meaningful relationships with the staff who supported them. Interactions were relaxed and friendly and people clearly enjoyed staff's company.” from the report
Activities and independence
Staff supported people to take part in activities, work opportunities and hobbies, while building skills and independence.
“People were supported to take part in regular and meaningful activities to avoid social isolation.” from the report
Effective support
Staff worked with professionals and relatives to understand people's needs and improve their quality of life.
“Staff worked closely with professionals to make sure they provided effective care.” from the report
Medicine instructions
seriousInstructions were not always clear about when medicines prescribed for use only when needed should be given. Inspectors recommended reviewing good practice on reducing over-medication.
“Clear information was not always recorded about when to administer medicines prescribed to be taken only when needed.” from the report
Plans for distress
seriousSome care plans did not give staff enough detail about what support or physical restraint to use and when. Inspectors also found that incidents of distress were not always analysed fully.
“Care plans did not always include enough information to guide staff about what intervention to use and when to help reduce anxiety or distress and make sure people's support was consistent.” from the report
Learning from incidents
needs fixingRecords did not always analyse anxiety or distress in enough detail to show how future support should improve.
“Incidents of anxiety or distress were not always analysed in detail to help identify how staff could change or develop their approach in future to better meet people's needs.” from the report
Agency staff induction
needs fixingThe home used agency staff to cover rota gaps, but it had not recorded their inductions. Management sent inspectors an induction they planned to use after the visit.
“Inductions had not been recorded to make sure they had been given the information they needed before starting work at the service.” from the report
Mental Capacity Act records
minorCare plans considered consent and mental capacity, but some records had gaps. Inspectors recommended reviewing good practice for recording decisions under the Mental Capacity Act.
“Care plans showed issues around consent and people's mental capacity were considered, although there were some gaps where clearer recording was needed.” from the report
- 01What has changed since the inspection to make sure 'when needed' medicines have clear instructions?
- 02How are care plans kept up to date about the support to use during anxiety or distress, including any physical restraint?
- 03How do you record and review incidents of anxiety or distress, and how do you show that lessons have been learned?
- 04How do agency staff receive and complete their induction before working in the home?
- 05How are decisions about consent and mental capacity recorded, and how are families involved in reviews?
This was an unannounced planned inspection covering all five CQC questions and the overall service, including care, medicines, staffing and management records. This explanation was written from the published report of 16 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.
What inspectors found, August 2017
Rated Good in all five areas; inspectors found safe, kind and person-centred care, with medicine storage needing review.
This was an unannounced comprehensive inspection on 19 and 26 June 2017. Inspectors spoke with two people using the home, four relatives, the manager and six staff. They observed care and reviewed care files, medicines records, staff records, rotas and other documents.
The inspectors found people were safe and supported by enough staff. Care plans and risk assessments were detailed. Staff understood safeguarding, received training and supported people with food, healthcare, choice and daily activities. Medicines were managed safely overall, although storage temperatures needed checking.
Staff were kind and respectful. People received care based on their individual needs and preferences. The home had systems for complaints, feedback, safety checks and quality monitoring. All five areas were rated Good. This was the first inspection since the home was registered under a new provider in December 2016.
Kind and respectful staff
Inspectors saw staff respond warmly when people were unsettled and support their privacy, dignity and choices.
“Staff treated people with kindness and were caring towards them.” from the report
Personalised support
Care plans included people's preferences and routines. Staff knew people's needs and supported individual interests and activities.
“Staff provided person-centred care to meet people's needs.” from the report
Good safety arrangements
The home had suitable staffing, safeguarding training, detailed risk assessments and checks for emergencies and the building.
“This showed us systems were in place to ensure people's needs would continue to be met in the event of an emergency.” from the report
Activities and community life
People were supported to go out, attend college, pursue hobbies and maintain important relationships with relatives.
“People who used the service were supported to engage in a range of meaningful activities and to access their wider community.” from the report
Active management checks
The manager used regular checks and audits to monitor care, medicines, incidents, safety and repairs.
“We saw there was a comprehensive system of weekly, monthly, quarterly and annual checks of all aspects of the service.” from the report
Medicine storage temperature
minorOn the inspection day, medicines were not stored at the recommended temperature. Inspectors recommended reviewing storage and seeking pharmacy advice if this happened again.
“We recommend the provider reviews the safe storage of medicines.” from the report
One care plan needed rewriting
minorInspectors found that part of one person's care plan was not as person-centred as it could be. The manager agreed to review and amend it.
“We identified parts of one person's care plan could be re-written to promote a more person-centred approach to providing care and support.” from the report
Advocacy support
minorOne person did not have a named local authority worker or advocate. Inspectors discussed whether advocacy would help represent that person's views.
“We identified another person at the service did not have a named worker at the local authority or someone to advocate on their behalf” from the report
- 01How are medicine storage temperatures checked now, and what action is taken if they are too high?
- 02Was the care plan identified by inspectors rewritten, and how is it reviewed today?
- 03Was advocacy support arranged for the person who did not have an advocate?
- 04How do you make sure there are enough staff for people to go out when they want to?
- 05How are people's views and complaints recorded and acted on?
This was an unannounced comprehensive inspection covering all five CQC questions; it was the first inspection of the location since registration under the new provider in December 2016. This explanation was written from the published report of 3 August 2017 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016
Registered with the Care Quality Commission on 14 December 2016.
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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28 live-in carers within about an hour of North Yorkshire
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 £1,010 to £1,290 a week. 27 can care for a couple. 12 years' experience on average.
“Carla has been a god send with the implementation of bringing mum back home from respite care.”
“She was always 'just present enough': attentive, available, kind and engaging, but without ever over-stepping any boundary”
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.