CQC report explained · a residential care home
What the CQC found at Umika Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found better infection control and staffing, but care was not always personalised and oversight remained weak.
This was an unannounced, focused inspection on 26 May 2022. Two inspectors spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The home had improved infection control, staffing, staff training and recruitment. People were protected from abuse, visits were supported, and the home worked with health professionals. However, medicines checks had not found two administration errors.
Care was not always delivered in line with people's care plans. Some people did not receive enough conversation, activities or support linked to their preferences. The home also did not have strong enough systems to identify these problems.
The overall rating was Requires Improvement. Safe, Responsive and Well-led were also rated Requires Improvement. This was the third consecutive inspection with this rating, and the home remained in breach of two regulations.
Improved infection control
Inspectors found that people were protected from infection. Staff used appropriate protective equipment and had relevant training.
“The provider had made improvements to their infection prevention and control processes and people were now protected from the risk of infection.” from the report
More staff and better training
Staffing levels had increased since the previous inspection. Staff had received induction, training and practical checks relevant to their roles.
“The provider had increased staffing levels in the service since the last inspection and had assessed and planned how they would manage any future staff shortages” from the report
Safeguarding and complaints
Staff knew how to report safeguarding concerns. People and relatives said they felt able to raise concerns, and the home recorded investigations and actions.
“People and relatives told us they felt able to raise concerns with the provider.” from the report
Health and end of life support
The home worked with health professionals, including hospice and palliative care services. People's end of life wishes were recorded.
“The provider worked in partnership with different healthcare professionals to support people's needs.” from the report
Personalised care was inconsistent
seriousCare was not always delivered in line with people's plans and preferences. One person had limited conversation and activities, and another did not have evidence of the planned one-to-one sessions.
“People's care was not always personalised to reflect their individual needs and preferences.” from the report
Activities and social engagement
needs fixingPeople were not always supported with meaningful activities of their choice. Records did not clearly show how preferred pastimes were being supported.
“People were not always supported to engage in meaningful activities of their choice” from the report
Medicines errors
needs fixingTwo medicines administration errors were found even though a recent stock check had taken place. The provider said it would increase checks and retrain staff.
“However, despite a recent stock check being completed, two medicine administration errors were identified during the inspection.” from the report
Weak quality checks
seriousManagement audits did not identify several problems, including medicines errors and gaps in care records. The provider remained in breach of Regulation 17.
“Robust systems were not in place to monitor the quality and safety of the service.” from the report
Relative involvement varied
minorThe report records different experiences of involvement in care plan reviews. One relative said they had not been involved in a review since the beginning.
“Another relative told us, "We've not been involved in a care plan review since the beginning.” from the report
- 01How are you making sure staff follow each person's care plan, especially when someone becomes distressed or needs emotional support?
- 02How will you record and provide each person's preferred activities and one-to-one sessions?
- 03What changes have been made to medicines checks since the two administration errors, and how do you know they are working?
- 04How will you make sure audits identify gaps in daily care notes, care plans and emotional support?
- 05How are relatives being invited to take part in care plan reviews?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 15 July 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.
What inspectors found, March 2021
Rated Requires Improvement; inspectors found serious infection control, staffing, medicines, training and management shortfalls.
This was an unannounced focused inspection on 12 January 2021. Two inspectors spoke with people, relatives, staff and the manager. They reviewed care records, medicines records, staff files, rotas, training information and quality checks.
The home was in a COVID-19 outbreak. Inspectors found that infection controls were not safe enough. Staff were not separated into infection risk areas, equipment was shared without clear cleaning records, and protective equipment was not always changed between areas or people.
There were also gaps in medicines records, too few staff during sickness, incomplete risk assessments and insufficient staff training and induction. The home's checks had not found these problems. Some people and relatives described positive experiences, including good communication and support.
The overall rating stayed at Requires Improvement, as did Safe, Effective and Well-led. Caring and Responsive were not assessed during this focused inspection, so their previous ratings were used in the overall rating.
Positive experiences
People and relatives gave positive feedback about the support and said people appeared settled and happy.
“Two people we spoke with indicated they were happy with the service and the support they were receiving.” from the report
Communication with relatives
Relatives said they received updates about care and that visiting arrangements had been provided during the pandemic.
“Relatives told us they had been kept informed and updated on their loved one's care.” from the report
Safeguarding
Staff knew how to raise safeguarding concerns, and the manager worked with the local authority when concerns arose.
“Staff knew how to raise safeguarding concerns and had received training in safeguarding and 'whistle blowing.'” from the report
Food and drink
People were provided with food and drinks, and staff recorded intake. The cook described providing nutritious food and extra calories for people with poor appetites.
“People had enough to eat and drink.” from the report
COVID-19 infection control
seriousPeople and staff were at increased risk of infection because areas, staff and equipment were not separated properly. Cleaning records for shared equipment and frequently touched areas were missing.
“Equipment was being shared throughout the service for example there was one standing hoist which needed to be used with both COVID-19 positive and negative people.” from the report
Staffing levels
seriousSickness had reduced staffing and replacement cover was not arranged quickly enough. Staff said people sometimes had to wait and that there was little time beyond basic care.
“Effective arrangements for staffing cover had not been sought. This demonstrated a breach of Regulation 18” from the report
Medicines records
seriousSeven medicines records had gaps, with no explanations. The medicines room had also been left unlocked, with medicines in unsafe storage.
“Seven medication records reviewed showed gaps in recording for December 2020 and January 2021.” from the report
Training and induction
seriousSome staff had not completed practical moving and handling training, a full induction or pandemic-related training. Staff risk assessments for working around infection were also incomplete.
“Effective arrangements were not in place to ensure staff received key practical training or a robust induction.” from the report
Risk assessments and care plans
needs fixingSome individual risks were not recorded clearly, including moving and handling needs and choking risks. Staff were not always aware of important information in care plans.
“Risks were not always assessed and monitored safely.” from the report
Management oversight
seriousAudits had not identified the problems found by inspectors. The manager was therefore not able to show reliable oversight of the home's safety and quality.
“Effective robust arrangements were not in place to monitor the service and identify and address shortfalls.” from the report
- 01What changes have you made to separate staff, areas and equipment for people with different infection risks?
- 02How do you now record and check that medicines have been given as prescribed?
- 03What staffing numbers will be on duty for each shift, and what is the plan when staff are off sick?
- 04Have all staff completed practical moving and handling training and a thorough induction?
- 05How do your current audits identify and correct infection control, medicines and care planning problems?
This was a focused inspection of Safe, Effective and Well-led during a COVID-19 outbreak; Caring and Responsive were not assessed and their previous ratings were carried forward. This explanation was written from the published report of 30 March 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 Umika Lodge Care Home
6 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2018Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2019
Registered with the Care Quality Commission on 12 April 2019.
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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Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
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