CQC report explained · a residential care home
What the CQC found at Walmer Lodge Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicine records were not always accurate or complete. Inspectors were also not assured that staffing levels had been properly calculated, although recruitment and infection control arrangements were suitable.
- Effective?
- Requires improvement
- This focused inspection did not inspect the Effective key question. Its rating was carried over from the previous inspection.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect, involved them in decisions and supported their independence. This rating improved from Requires Improvement at the previous inspection.
- Responsive?
- Good
- This focused inspection did not inspect the Responsive key question. Its rating was carried over from the previous inspection.
- Well-led?
- Requires improvement
- Quality audits and checks did not reliably identify risks or secure improvements. The provider remained in breach of Regulation 17.
What inspectors found, July 2023
Rated Requires Improvement; inspectors found kind care, but medicines records and quality checks were not reliable.
This was an unannounced focused inspection. Two inspectors visited on 18 and 24 May 2023, with inspection activity running from 18 May to 2 June. They spoke with five people and four staff, observed care, and checked care, medicine, staff and management records.
People were generally treated kindly and with respect. They were supported to make choices, stay independent and access the community. The home was clean, infection control arrangements were suitable, and earlier problems with dignity, risk management and fire safety had improved.
There were important weaknesses in medicine records, staffing checks and quality monitoring. The provider remained in breach of Regulation 17 on good governance. The overall rating stayed Requires Improvement, as did Safe and Well-led. Caring improved from Requires Improvement to Good.
Kind and respectful care
People were involved in decisions and staff supported their privacy, dignity and independence. Inspectors saw warm relationships between people and staff.
“People's privacy and dignity was maintained and staff treated people with respect.” from the report
Stable staff team
Many staff had worked at the home for several years. This meant they knew people well and provided continuity of care.
“This helped ensure continuity of care for people with staff who were familiar and knew them well.” from the report
Improvements since the last inspection
Earlier problems with risk management and dignity had been addressed. The home was no longer in breach of the parts of Regulations 12 and 10 covered by those issues.
“Enough improvement had been made at this inspection and the provider was no longer in breach of this part of regulation 12.” from the report
Medicine records
seriousCream charts were incomplete, guidance for some 'as required' medicines was inaccurate or missing, and one person's changed medicine time had not been reviewed since 2018. Three staff had not had medicine training for seven years or more.
“Medicine records were not managed safely. This was a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008” from the report
Staffing levels
needs fixingThe manager could not show how staffing numbers had been calculated. Care staff also completed cooking and cleaning, which reduced the time available to spend with people.
“We were not assured there were always enough staff to meet people's needs and keep them safe.” from the report
Weak quality checks
seriousAudits did not find the medicine, hot water, infection control and fire drill recording problems identified by inspectors. The provider remained in breach of Regulation 17.
“Quality audits and checks were in place, however these were not always effective in identifying risks and securing improvements.” from the report
Environmental risks
needs fixingHot water temperatures were above the recommended level, and one bedroom had an unguarded hot radiator and heaters. The manager dealt with these issues during the inspection.
“Records of hot water temperature checks showed these exceeded the 44 degrees centigrade recommended by the Health and Safety Executive.” from the report
- 01How are medicine records checked now, including cream charts, 'as required' medicine protocols and changes to medicine times?
- 02When did each staff member last complete medicine training, and how is annual refresher training being arranged?
- 03How do you calculate the number of staff needed for the people living here, especially when staff are also cooking and cleaning?
- 04What checks now make sure hot water temperatures, heaters and fire drills are recorded and acted on?
- 05What actions are in the Regulation 17 improvement plan, and how will you show that they have been completed?
This was a focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their ratings were carried over from the previous inspection. This explanation was written from the published report of 6 July 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, November 2019
Walmer Lodge Residential Home is rated Requires Improvement; inspectors found caring staff and good personalised support, but safety, dignity and management needed improvement.
This was an unannounced inspection on 11 September 2019. Inspectors spoke with people, staff, relatives and a healthcare professional. They also reviewed care records, medicines information, audits and other records.
The home was generally caring and had enough staff. Medicines were generally managed safely, people's health needs were followed up, and the home responded well to people's individual needs, communication needs and complaints.
However, fire safety checks were not reliable, parts of the building were tired, and the home could not provide enough evidence that some people's money was managed safely. Inspectors also saw people being treated in ways that were not always respectful or person-centred.
The overall rating was Requires Improvement. Safe, Effective, Caring and Well-led were also Requires Improvement. Responsive was rated Good. The home had three breaches of regulations, covering dignity and respect, safe care and treatment, and good governance.
Staffing and recruitment
People and relatives said there were enough staff. Inspectors found staffing levels were maintained and recruitment checks were in place.
“Staffing levels were maintained, and people received regular and timely support.” from the report
Healthcare support
The home worked with health professionals and responded promptly when people's health needs changed.
“We spoke with a healthcare professional who confirmed staff responded promptly to changes in people's health needs.” from the report
Personalised support
The home recorded people's likes, dislikes and communication needs. Staff were described as responsive and flexible.
“Peoples' care plans contained information about how they liked to be supported.” from the report
Food hygiene
Inspectors found that food was stored and prepared appropriately.
“The service had received a five-star food hygiene rating.” from the report
Fire safety
seriousSome fire doors did not close properly and fire strips had been painted over. Inspectors said safety systems were not robust enough and referred their concerns to the fire officer.
“We found some fire doors were not closing properly and some fire strips had been painted over.” from the report
People's finances
seriousThe provider held some people's money but did not provide enough evidence to reassure inspectors that it was being managed safely.
“We did not receive sufficient evidence of this, so we could not be assured people's finances were being safely managed.” from the report
Dignity and respect
seriousInspectors saw little positive interaction at mealtimes and examples of people being referred to by room number. Some notices and practices were not person-centred.
“In a conversation with a staff member people were referred to by their room number rather than their name.” from the report
Weak audits
seriousThe home's checks did not identify problems with the fire system and premises. Inspectors found the governance systems were not robust enough.
“Issues relating to the fire system and premises checks had not been identified through audits.” from the report
Tired environment
needs fixingSome areas needed a deep clean, and parts of the building were tired. A strong smell was found on the first floor and damaged lino needed repair.
“Some of the décor was tired and did not create a homely feel.” from the report
- 01What has been done to repair the fire doors and fire strips, and when was the fire risk assessment completed by a suitably competent person?
- 02How are residents' finances held, recorded and checked now, and can families see the relevant safeguards?
- 03How do managers monitor whether staff treat people respectfully, including during meals and in written notices?
- 04What refurbishment and cleaning work has been completed since the inspection, and what remains outstanding?
- 05How are capacity assessments and best-interest decisions recorded and reviewed?
This inspection looked at all five CQC questions, including the premises and care provided; it was a planned inspection based on the previous Requires Improvement rating and was carried out without notice. This explanation was written from the published report of 27 November 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.
Every inspection of Walmer Lodge Residential Home
2 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- July 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Walmer Lodge Residential Home →
- November 2019Requires improvementSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
Read what inspectors found at Walmer Lodge Residential Home →
- September 2018
Registered with the Care Quality Commission on 25 September 2018.
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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