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.
- Safe?
- Requires improvement
- Some risks were not fully assessed, monitored or reviewed, and some records showing care had been given were incomplete. Inspectors also found poor kitchen hygiene and that some staff did not wear protective equipment in the kitchen area.
- Effective?
- Good
- People's needs and choices were assessed, staff received training and support, and people were helped to access health professionals. The garden was difficult to access because of uneven paving and a lack of seating.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw staff respecting privacy, offering choices and supporting people to express their views.
- Responsive?
- Good
- Care plans contained information about people's individual needs, preferences and communication. Staff supported activities, relationships, complaints and people's choices about their daily lives.
- Well-led?
- Requires improvement
- The home had audits and checks, but they had not identified or addressed all the issues found during the inspection. The provider remained in breach of Regulation 17 because governance systems were not effective enough.
What inspectors found, September 2023
The Lodge is rated Requires Improvement; inspectors found kind care and improved medicines management, but gaps in risk records, infection control and oversight remained.
This was an unannounced inspection on 12 and 24 July 2023. One inspector and an Expert by Experience spoke with people, relatives, staff and professionals, observed care, and checked care, medicines, recruitment and management records.
The home was rated Good for effective, caring and responsive care. People and relatives said staff were kind and caring, staffing levels were suitable, and people received their medicines as prescribed. Staff supported people with health needs, food and drink, communication and personal choices.
The home was rated Requires Improvement for safe and well-led care. Some risk assessments and care monitoring records were incomplete or out of date. Inspectors also found poor kitchen hygiene and inconsistent use of protective equipment. The provider remained in breach of Regulation 17 because its management systems had not driven enough improvement.
Kind and respectful staff
People and relatives said staff were kind and caring. Inspectors saw respectful, warm interactions and staff supporting privacy, independence and communication.
“People and their relatives told us staff were kind and caring towards them and they felt safe living at the service.” from the report
Enough staff
Inspectors found staffing levels were suitable for people's needs. Recruitment records included the required information and DBS checks had been completed.
“There were enough staff to meet people's needs.” from the report
Medicines had improved
Medicines were stored and administered safely, records were complete, and staff had regular training and competency checks. The home was no longer in breach of the medicines regulation.
“Medication administration records were completed fully and accurately.” from the report
Support with health and food
Staff monitored people's health, made timely referrals and worked with health professionals. People were offered choices of food and drink and staff supported them at mealtimes.
“Staff were proactive in making timely referrals to health professionals when they had concerns around people's health and wellbeing.” from the report
Risk records were incomplete
seriousSome risk assessments were missing, incomplete or out of date. Some care monitoring records did not show that people had received the support needed to reduce risks.
“Risks to people were not always fully assessed, monitored and regularly reviewed in line with their risk management plans.” from the report
Kitchen infection control
seriousInspectors found poor kitchen hygiene and a risk of cross-contamination between kitchen and care staff areas. Some care staff did not wear protective equipment when entering the area.
“The provider failed to ensure safe infection prevention and control were in place.” from the report
Weak management oversight
seriousAudits and checks were in place but had not robustly identified the problems found. The provider remained in breach because governance systems had not driven enough improvement.
“The governance arrangements in place were sometimes ineffective and did not identify and drive up improvements to the service.” from the report
Limited garden access
minorPeople's access to the garden was restricted by uneven paving and an unused patio area without seating. The provider later shared an improvement plan for the garden.
“Access to the garden area was however limited as the area had uneven paving and an unused patio area that did not have any seating for people, restricting people's access to it.” from the report
- 01Which people's risk assessments or care monitoring records were incomplete, and how have you checked that they are now accurate and up to date?
- 02What changes have you made to kitchen hygiene, the kitchen zones and staff use of protective equipment?
- 03What actions and deadlines are in your improvement plan to address the Regulation 17 breach?
- 04How will managers check that audits identify problems promptly and that agreed actions are completed?
- 05What has been done to make the garden safer and easier for people to use?
This was an unannounced inspection covering all five key questions, including infection prevention and control; inspectors spoke with 3 people, 6 relatives or friends and 7 staff, and reviewed care, medicines and management records. This explanation was written from the published report of 2 September 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, December 2021
Rated Requires Improvement; inspectors found kind care, but medicines, infection controls and management checks were not always reliable.
This was a focused inspection on 20 October 2021. Inspectors spoke with people, family members and staff, and reviewed care, medicine, staffing and management records.
The home had enough staff and people and families generally felt well cared for. Staff were described as kind and attentive. People were supported with their choices, food, healthcare and visits from family.
However, medicine records and stock checks were not always accurate. Some care and risk records were out of date. There were gaps in COVID-19 testing records, cleaning records and staff training. The home took immediate action on some issues, but inspectors said its own checks should have found them sooner.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement. The inspection did not assess Caring or Responsive. The home had improved enough to leave Special Measures, but CQC asked for an action plan and will monitor progress.
Kind and reassuring staff
People and families generally said staff treated people well and provided caring, attentive support.
“People told us they liked living at The Lodge and felt staff treated them well.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Staff said they did not feel rushed.
“There were enough staff deployed to meet people's needs and keep them safe from harm.” from the report
Choice and consent
The home had improved its mental capacity and consent processes. Decisions were made in people's best interests where needed.
“The service was now working within the principles of the MCA.” from the report
Open communication
Families said the manager kept them informed and communicated openly about changes or concerns.
“Family members told us the registered manager was open and transparent and ensured any issues were communicated immediately.” from the report
Medicine management
seriousAs-required medicine plans did not always give staff enough guidance. Medicine stocks, disposal and records were not always accurate.
“Medicines were not always managed safely.” from the report
Weak management checks
seriousThe home's own audits and checks had not identified several problems with care records, medicines and infection control. This was a breach of Regulation 17.
“Governance systems had not always been used effectively to identify the shortfalls found during this inspection.” from the report
Training gaps
needs fixingStaff had not accessed all training linked to people's needs, including wound care and nutrition. Practical manual handling training had not been recorded.
“However, additional training specific to people's needs had not been accessed.” from the report
Out-of-date care records
needs fixingSome assessments did not accurately show people's current risks or needs, including skin care and nutrition assessments.
“However, some records such as skin care plans and nutritional assessments did not accurately reflect people's current needs.” from the report
- 01What changes have been made to medicine stock checks, disposal and records for as-required medicines?
- 02How do you now check that care and risk assessments accurately reflect each person's current needs?
- 03What evidence can you show that staff have completed wound care, nutrition and practical manual handling training?
- 04How are COVID-19 testing and daily cleaning records now checked for gaps?
- 05What extra management support and audits have been put in place since the inspection?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and previous ratings for those areas were used in the overall rating. This explanation was written from the published report of 17 December 2021 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 6 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- November 2019Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016
Registered with the Care Quality Commission on 11 July 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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40 live-in carers within about an hour of Wirral
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 £1,230 a week. 37 can care for a couple. 8 years' experience on average.
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.