CQC report explained · a residential care home
What the CQC found at Warren Lodge Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, medicines were given safely, staffing was sufficient and infection control measures were in place.
- Effective?
- Good
- This question was not rated in this inspection.
- Caring?
- Good
- This question was not rated in this inspection, although inspectors described a caring and person-centred culture.
- Responsive?
- Good
- This question was not rated in this inspection.
- Well-led?
- Good
- Inspectors found clear leadership, regular audits, shared responsibility among staff and effective work with health and social care professionals.
What inspectors found, July 2021
Rated Good; inspectors found safe care and strong management, with improvements since the previous inspection.
This was an unannounced inspection on 9 June 2021. Two inspectors spoke with people, relatives, staff and visiting professionals. They observed care, meals, activities and medicines rounds, and checked care records, staff files and management records.
The home was rated Good overall. Safe was rated Good, with inspectors finding that risks, medicines, staffing, safeguarding and infection control were managed well. Staff knew people’s needs and accidents and incidents were reviewed for lessons.
Well-led was also rated Good. Inspectors found clear leadership, regular quality checks and an open, caring culture. The home had improved from Requires Improvement at the previous inspection, published on 1 October 2019.
The report only gives ratings for Safe and Well-led. It does not give new ratings for Effective, Caring or Responsive.
Risk management
People’s risks were recorded clearly, including risks linked to pressure areas, oral health, choking, malnutrition and falls. Staff knew how to support people safely.
“At this inspection people's risk assessments consistently identified and recorded the risks to people in relation to pressure area management and oral healthcare and how to manage them safely.” from the report
Safe staffing
Inspectors found enough staff were deployed, with the right mix of skills. People and relatives also described good continuity from regular staff who knew them well.
“Rotas demonstrated that sufficient suitable staff were consistently deployed in accordance with the dependency tools and assessed staffing needs.” from the report
Medicines
Staff followed medicines plans and gave people time and explanations when supporting them to take medicines. Staff competency was checked regularly.
“People received their medicines as prescribed, at the right time, in a way they preferred, in line with their medicine management plans.” from the report
Infection control
The home was described as clean, with regular cleaning and visitor checks. Inspectors were assured that the home had measures to prevent and manage infection outbreaks.
“Staff maintained high standards of cleanliness and hygiene in the home, which reduced the risk of infection” from the report
Leadership and improvement
The management team used audits, incident reviews and action plans to monitor care and make improvements. Inspectors said the quality assurance system was now embedded.
“At this inspection we found there were robust measures in place to monitor quality, safety and experience of people within the service.” from the report
Partnership working
The home worked with health and social care professionals, including specialist services, to support people with complex needs.
“The registered manager and staff worked effectively in partnership with external health and social care professionals.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess and record my relative’s specific risks, including falls, choking, nutrition, pressure areas or oral health?
- 02How many staff will usually be available on the unit where my relative would live, and how do you adjust staffing when people’s needs change?
- 03How will you support my relative if they need dementia care or help with complex health needs?
- 04How do you review medicines given as required, and how will you check that they are still needed?
- 05What action has been taken since the previous Requires Improvement rating, and how do you check that these improvements continue?
This was an unannounced planned inspection based on the previous rating and focused on Safe and Well-led; Effective, Caring and Responsive were not newly rated. This explanation was written from the published report of 2 July 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.
What inspectors found, October 2019
Warren Lodge Care Centre: Rated Requires Improvement; care had improved, but safety records and management systems were not yet consistently reliable.
Inspectors visited without warning on four days between 31 July and 7 August 2019. They spoke with people, relatives, staff and health professionals. They observed care, meals and activities, and checked care plans, medicines, staffing, recruitment, complaints and quality checks.
The home was rated Good for Effective, Caring and Responsive. People were treated kindly, supported to make choices, helped with food and drink, and offered more meaningful activities. Medicines, recruitment, infection control and responses to incidents had improved.
Safe and Well-led were rated Requires Improvement. Some care records did not clearly show the care given or the action needed to manage risks. Audits and action plans were not always detailed or robust enough, and inspectors wanted to see that improvements lasted.
At the previous inspection, published in June 2019, the home was rated Inadequate and had several breaches. The provider was no longer in breach at this inspection and the home was removed from Special Measures.
Safer medicines
The medicines system had been completely reviewed. Staff gave medicines at the right times, stored them securely and kept the required records.
“People were supported to have their medicines at the right times.” from the report
Kind and respectful care
Inspectors saw warm, considerate interactions. People and relatives said staff were caring, respected privacy and knew individual preferences.
“We observed some very genuine, kind, compassionate and caring interactions between the staff and people.” from the report
More meaningful activities
Activities were more frequent and better matched to people's interests. Staff respected people who did not want to join in and offered individual support instead.
“This resulted in more activities being provided throughout the day.” from the report
Improved health support
Staff were more knowledgeable and made timely referrals. The home worked better with GPs and other health professionals.
“The staff were more knowledgeable, better informed about people's health and wellbeing and referred people to various health professionals when needed.” from the report
Dementia-friendly surroundings
The home had improved signs, colours and room features to help people living with dementia find their way and remain independent.
“The décor of the premises had been improved to suit the needs of people living with dementia.” from the report
Incomplete risk and care records
needs fixingSome records did not consistently show the settings needed for pressure-relieving equipment or explain gaps in oral care records. Managers acted on the issues raised, but further work was needed.
“We reviewed people's care records and found at times the information around specific aspects of care or risk was not recorded consistently.” from the report
Management checks needed strengthening
needs fixingAudits and action plans were not always detailed or robust enough. Inspectors wanted evidence that improvements would become part of everyday practice and continue over time.
“We noted to the management team to review some of the audits and action plans to ensure it was fully detailed and consistently robust.” from the report
End of life planning
needs fixingThe home was not providing end of life care during the inspection. Inspectors did not always see people's preferences recorded, including choices related to resuscitation decisions.
“We did not always see the staff explored people's preferences and choices in relation to end of life care” from the report
Mental capacity records
minorSome mental capacity and best interest records contained much less detail than others. Care plans also needed to reflect conditions linked to liberty safeguards.
“We looked at MCA and Best Interest decisions documentation and found some inconsistencies within the standard of documentation.” from the report
- 01How do you now check that risk records clearly show the correct equipment settings and the action staff must take?
- 02How do you record and monitor oral care, and how do you explain any gaps in the daily records?
- 03What checks show that the improvements made since the last inspection have been sustained?
- 04How are mental capacity and best interest decisions recorded, and how are any conditions reflected in care plans?
- 05How will you record people's end of life wishes and review decisions about attempted resuscitation?
This was an unannounced, planned follow-up inspection covering all five key questions after the previous Inadequate rating and breaches. This explanation was written from the published report of 2 October 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Warren Lodge Care Centre
6 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2019Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- December 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 November 2010.
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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