CQC report explained · a residential care home
What the CQC found at Titchfield Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- The inspectors found safe recruitment, sufficient planned staffing, detailed risk assessments and safe medicines management. The home had systems to safeguard people, manage infections and learn from incidents.
- Effective?
- Good
- Care assessments involved people, families and other professionals. Staff received relevant training, people were supported with healthcare and nutrition, and the home followed legal processes when people could not make particular decisions.
- Caring?
- Good
- Inspectors observed respectful and positive interactions. Staff used communication methods such as Makaton, pictures and objects of reference, and supported people's privacy, dignity and independence.
- Responsive?
- Good
- Care plans reflected people's preferences, routines, cultural needs and communication needs. People took part in activities they enjoyed, and staff used positive behavioural support plans to respond to individual needs.
- Well-led?
- Good
- The home had audits, governance checks, staff meetings and systems for sharing information between shifts. Families were involved, although it was not always clear when feedback recorded as people's views came from people themselves rather than staff.
What inspectors found, June 2019
Rated Good; inspectors found safe, kind and personalised care, with people's views not always clearly separated from staff views.
This was a planned, announced and comprehensive inspection. One inspector reviewed care, support and medicines records, staffing and training records, and quality checks. They observed people's support, spoke with staff and the manager, and gathered views from families and healthcare professionals.
The inspectors found that people experienced positive outcomes. Staff supported independence, health, community involvement and communication. There were suitable staffing levels, safe recruitment, detailed risk plans and safe medicines systems. Staff also used positive behavioural support to reduce risks when people became distressed.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home had also been rated Good at the previous inspection, so the overall rating remained Good.
Supporting independence
The home supported people to build independence, improve their health and take part in the community.
“People were supported to develop their independence and to improve their health and community involvement.” from the report
Safe staffing
Staffing was planned around people's high support needs, including one-to-one support in the community.
“There were sufficient staffing levels planned to meet people's needs safely.” from the report
Accessible communication
Staff understood how people communicated and used different tools to help people express themselves and make choices.
“We saw examples of staff using good communication with people, including Makaton, pictures and objects of reference.” from the report
Learning from incidents
Managers reviewed incidents, supported staff afterwards and changed risk assessments or procedures when needed.
“There were systems to learn from incidents and from people and the service was open about when things had gone wrong.” from the report
People's feedback was not always clear
minorThe home helped people complete feedback forms, but inspectors could not always tell whether the views recorded were the person's own or those of staff supporting them.
“People using the service were also given the opportunity to complete similar forms with the support of staff, but it was not always clear that these were people's views rather than those of the support team.” from the report
- 01How do you make sure people's own views are recorded separately from staff observations when gathering feedback?
- 02How do you maintain safe staffing levels during sickness or staff absence?
- 03How are positive behavioural support plans reviewed when a person's needs or triggers change?
- 04How do you check that medicines remain necessary and that people are not over-medicated?
- 05What legal authorisations and best-interest decisions are currently in place for any restrictions on people's liberty?
This was a planned, announced and comprehensive inspection covering all five CQC questions and both the accommodation and personal care provided. This explanation was written from the published report of 4 June 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.
What inspectors found, November 2016
Rated Good; inspectors found safe, caring support, with some relatives wanting better communication and noting the effect of staff changes.
This was an unannounced inspection on 7 October 2016. One inspector observed care, spoke with relatives, the registered manager and staff, and checked care records, medicines, risk assessments, recruitment, training, complaints and quality checks.
The home supported four people with learning disabilities. Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. They found safe medicines practice, enough planned staff, suitable training and support, personalised care plans, individual activities and systems to monitor improvements.
At the previous inspection in July 2015, the provider had breached three regulations covering staffing, medicines and quality assurance. This inspection found that appropriate action had been taken and those breaches had been met.
Safe medicines and staffing
Medicines were securely stored and administered as prescribed. Staffing levels were planned around people's needs, and the home no longer used agency workers.
“Medicines were stored safely and administered as prescribed.” from the report
Kind and respectful care
Inspectors saw calm, positive interactions. Staff knew people well and supported their privacy, choices and independence.
“People were treated with dignity and privacy and their independence was promoted.” from the report
Personalised support
Care records included people's preferences, likes and dislikes. The home provided activities tailored to individuals and adapted bedrooms and outdoor areas to people's interests.
“Activities were personalised and people were trying new activitites.” from the report
Improvement since the last inspection
The provider had acted on the three breaches found in July 2015. Inspectors found the related requirements had been met at this inspection.
“At this inspection we found the provider had taken appropriate action to ensure the breaches had been met.” from the report
Some staff training was incomplete
needs fixingThe training records showed that not all staff had completed every subject. In one medication area, 75% of staff had completed the training, although the home said a trained member of staff was always on duty.
“The training matrix identified that not all staff had completed training in various subjects, for example only 75% of staff had only received training on a particular medication.” from the report
Relatives wanted more updates
minorSome relatives said they were told about significant events but wanted more regular, informal information about their relatives. The registered manager was addressing this with a monthly form.
“A couple of relatives told us they would like more communication about their relatives.” from the report
Staff changes had worried some relatives
needs fixingSome relatives felt staff changes over the previous year had negatively affected people. They also said longer-serving staff were well skilled.
“Some relatives told us they were concerned about staff changes which had taken place over the last year as they felt the changes had a negative effect on people living at the home.” from the report
Small medicines record error
minorInspectors found one very small error when recording the stock of one medicine. They reported that it had no impact on anyone.
“We found one very small error in the recording of one stock of medicine but this had no impact on any person.” from the report
- 01Has all staff training in medication and other subjects now been completed?
- 02How do you make sure a staff member with the right medication training is always on duty?
- 03How will my relative's family receive regular informal updates, not only information about significant events?
- 04What has changed to reduce the effect of staff changes on people living in the home?
- 05How are personalised activities reviewed to make sure they continue to match each person's preferences?
This was an unannounced inspection of the overall quality of the home and all five key questions, with records checked for two people. This explanation was written from the published report of 11 November 2016 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 Titchfield Lodge
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2014
Registered with the Care Quality Commission on 7 July 2014.
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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26 live-in carers within about an hour of Hampshire
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 £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.