CQC report explained · a residential care home
What the CQC found at The Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Requires Improvement; inspectors found continuing safety and management failures, including problems with medicines and risk assessments.
This was an unannounced, focused inspection of the home on 10 May 2023. Two inspectors and an Expert by Experience spoke with people, relatives and staff. They reviewed care plans, medicines records and management records, and contacted health professionals afterwards.
The home was not always safe. Some people's risks had not been fully assessed or recorded. Information about textured diets was missing or inconsistent, which could increase the risk of choking. Medicines records and checks were also not reliable. One person had been without a pain relief patch for over a week.
Some important areas were working well. There were enough staff, people were protected from abuse, infection control was judged effective, and people said they felt safe. The previous urgent infection-control condition had been removed.
The overall rating remains Requires Improvement. Safe and Well-led were both rated Requires Improvement. The inspection only checked these two areas, so the other ratings were carried forward from the previous inspection. The home has had this overall rating for the last three inspections.
Enough staff
Inspectors found enough staff, and observed care that was patient and unhurried. People and relatives also said staffing levels were adequate.
“There were enough staff employed. We observed staff providing care which was patient and unhurried, and staffing rotas supported this.” from the report
Protection from abuse
Safeguarding systems were in place. Staff understood safeguarding and had received training, while people said they felt safe.
“Systems, processes and practices safeguarded people from abuse.” from the report
Infection control
Inspectors were assured that the home could prevent and manage infections. An urgent infection-control condition from an earlier inspection had been removed.
“Enough improvement had been made at this inspection and this condition has now been removed.” from the report
Positive views of staff
People and relatives generally spoke positively about the home and staff. Staff were described as friendly, kind and approachable.
“People and relatives spoke positively about the home and the staff.” from the report
Medicines were not managed safely
seriousSome people did not have proper records for topical medicines, and other medicine information was missing or wrong. Staff did not always witness medicines being taken, and one person went without a pain relief patch for over a week.
“Robust documentation was not in place to ensure appropriate follow-up of medicines, for example, one person had been without a pain relief patch for over a week.” from the report
Risks were not fully assessed
seriousSome people had lived at the home for more than a month without all their care risks being assessed or recorded. Information about textured diets and advice from health professionals was also incomplete.
“Risks to people were not always assessed or mitigated against.” from the report
Audits did not find problems
seriousThe home's monitoring systems were completed regularly but failed to identify important medicines and safety concerns. This meant managers did not have effective oversight of the service.
“These were not effective in identifying the concerns found during this inspection.” from the report
Families were not routinely consulted
needs fixingThe home had not held resident or relative meetings or used surveys to seek people's views. One relative also felt that information was not always shared openly.
“The home had not undertaken any resident or relative meetings or sought people's or relatives' views.” from the report
- 01What has changed since the inspection to make sure every resident's risks are assessed and kept up to date?
- 02How do you now record and check topical medicines, self-administered medicines and medicines that need follow-up?
- 03How will you make sure information about textured diets and advice from health professionals is recorded correctly?
- 04When will you hold resident and relative meetings or use another method to gather and act on their views?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 11 August 2023 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 2022
Rated Requires Improvement; inspectors found staffing and infection control had improved, but risks, medicines and oversight were not reliable.
This was an unannounced focused inspection on 15 and 18 February 2022. Inspectors checked whether earlier improvements had been made, looking only at Safe and Well-led. They reviewed care and medicine records, staff recruitment, staffing rotas, quality checks and infection control. They also spoke with people, relatives and staff.
The home had enough staff and recruitment checks were safe. Improvements had also been made to infection control and COVID-19 arrangements. People said they felt safe, relatives were positive, and staff described a supportive team.
However, some risks were not properly assessed or recorded. Medicines were not always given or recorded safely. Quality checks were in place but did not find all the problems, and action was not always taken quickly. The overall rating remained Requires Improvement, as did Safe and Well-led.
Staffing
There were enough staff on duty and they were deployed effectively. A dependency tool was being used to help set staffing levels.
“There was enough staff on duty who had been deployed effectively.” from the report
Recruitment
The home followed safe recruitment processes and completed the required checks before new staff started.
“All appropriate pre-employment checks had been completed prior to new staff commencing in their roles.” from the report
Infection control
The provider had improved its infection control arrangements and was following government guidance on visiting and COVID-19 requirements.
“The provider had taken action to respond to the Infection Prevention and Control (IPC) concerns found at the last inspection, and improvements had been made.” from the report
Positive relationships
People and relatives spoke positively about the home. Staff described a supportive culture and said they could raise concerns with management.
“People and relatives spoke positively about the service describing the home as "very welcoming, warm and friendly.” from the report
Risk records
seriousSome risk assessments were missing, out of date or did not explain clearly enough how risks would be reduced. This included risks linked to stairs and pressure areas.
“Risks to people had not always been assessed, monitored and recorded sufficiently.” from the report
Medicine safety
seriousSome medicines were left in bedrooms even though records said they had been given. Other medicines could not be accounted for, and records for creams were not suitable.
“Medicine had not been administered and recorded appropriately.” from the report
Quality checks
seriousThe home had introduced governance checks, but they were not yet reliable enough to find all the problems. Action was not always taken promptly when concerns were identified.
“However, these were not always effective in highlighting shortfalls.” from the report
Reporting safeguarding concerns
needs fixingSome concerns raised by staff had been dealt with, but they had not always been reported to the local authority. The manager took immediate action after this was discussed.
“We found examples where concerns had been raised by staff and appropriate action taken to safeguard the person, but these had not always been reported to the local authority.” from the report
- 01What risk assessments are now in place for this person, and how are they kept up to date?
- 02How do you make sure every medicine is given, recorded and accounted for, including creams and medicines left for people to take later?
- 03What changes have been made to the quality audits since this inspection?
- 04How quickly are problems found by audits acted on, and how can families see evidence of this?
- 05How are safeguarding concerns reported to the local authority and recorded?
This was a focused inspection of Safe and Well-led, including infection control; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 2 April 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
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2019Goodstayed GoodSafe: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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