CQC report explained · a residential care home
What the CQC found at Worsley Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2018
Rated Good; inspectors found safer, kind and personalised care, but the home still needed to improve its management of records and information.
This was a follow-up inspection on 25 and 27 September 2018. Inspectors checked whether improvements had been made since January 2018. They reviewed care, medicines, staffing, training, complaints and management records. They also spoke with people living in the home, relatives and staff, and observed meals and care.
The home had made significant improvements. Medicines were managed safely, staffing had increased, risks were assessed, and support with food and drink had improved. People told inspectors they felt safe and that staff were kind and caring. Care was personalised, activities were available, and people's health needs were followed up.
The overall rating was Good. Safe, Effective, Caring and Responsive were all rated Good. Well-led was rated Requires Improvement because some records were difficult to find or were not available quickly enough. Inspectors said the manager needed to make sure the improvements were maintained.
Safer medicines
Inspectors found that medicines were now managed safely, with accurate records and better control of stocks and creams.
“Records were accurate, time sensitive medicines had been recorded properly, stocks were well managed and accurate” from the report
Kind and respectful staff
People and relatives praised the staff. Inspectors saw staff supporting dignity, choice and independence.
“Staff were seen to be skilled at maintaining peoples' dignity and promoting choice and independence.” from the report
Personalised care
Care plans included people's histories, preferences and important events. Plans were reviewed when needs or wishes changed.
“The six care plans we reviewed contained detailed histories and background information that included people's life story, likes and dislikes and important events.” from the report
Activities and outings
The home offered regular activities, encouraged social contact and provided trips in its minibus, while respecting people who preferred not to join in.
“During the week there were activities twice a day including; quizzes, armchair exercise, singing, pamper sessions, reminiscing, movie afternoons and a cheese and wine party.” from the report
Records and information
needs fixingSome records were archived too quickly or were not readily available. The local safeguarding team had also experienced delays in receiving information.
“There were some delays in getting some information for the inspection.” from the report
Staffing levels
needs fixingStaffing had increased, but some people and relatives still felt there were too few staff. Recruitment was still ongoing.
“Some people living in the home told us they felt there were still too few staff.” from the report
Meal timing and menus
minorThe food did not always match the displayed menus. On some occasions breakfast and lunch were close together, and inspectors saw this affected how much some people ate.
“We found the food served did not always match the menus displayed outside the dining rooms.” from the report
- 01What systems are now in place to make sure care records and training records can be found quickly?
- 02How will you make sure information is provided promptly if there is a safeguarding investigation?
- 03What are the current staffing levels on each floor and each shift, including agency staff?
- 04How have you changed meal times so breakfast and lunch are not too close together?
- 05What progress has been made on the improvements to dementia-friendly signs and memory boxes?
This was a follow-up inspection covering all five rating areas and checking improvements after the January 2018 inspection. This explanation was written from the published report of 16 November 2018 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, May 2018
Rated Inadequate and placed in special measures; inspectors found unsafe medicines management and weak oversight despite kind, personalised care.
This was a comprehensive inspection over three days. Two days were unannounced. Inspectors reviewed medicines, care plans, staffing and training records, spoke with people, relatives and staff, and observed care.
The home was rated Inadequate overall. Safe and Well-led were Inadequate. Effective Requires Improvement. Caring and Responsive were Good.
Inspectors found medicines were still not managed safely. Some medicines were out of date, records were unclear and stocks did not match the records. They also found risks from access to boiling water, missing fire exit signs, poor monitoring, insufficient agency staff induction and inconsistent nutritional support.
There had been a significant improvement in cleaning and infection control. People were generally treated kindly, and care was tailored to their needs. Because the overall rating was Inadequate, the home was placed in special measures and was due to be kept under review.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors observed staff being patient, polite and reassuring.
“We observed staff interactions throughout the inspection and saw staff behaving with kindness.” from the report
Personalised care
Care plans included people's preferences, interests and communication needs. The home also supported people's choices at the end of life.
“People living at the home received care that was tailored to their individual needs, preferences and interests.” from the report
Improved cleanliness
Inspectors found significant improvement in hygiene and housekeeping compared with the previous inspection.
“At this inspection we found there had been significant improvements; the home was clean, there had been some refurbishment and decorating.” from the report
Safe recruitment records
The staff files inspected included the expected recruitment checks and documentation.
“Staff had been recruited properly and safely.” from the report
Medicines were unsafe
seriousSome medicines were out of date, stocks did not match records and instructions for medicines given when needed were unclear. Cream application records were also incomplete.
“Stocks of medication were not accurate so we could not be confident people had always had their medication as prescribed.” from the report
Unmanaged environmental risks
seriousA kitchen door was left open near a boiling water geyser, creating a scalding risk. Fire exit direction signs had been removed and not replaced.
“Serious harm could have occurred to people who were unsupervised and unable to recognise the risks posed.” from the report
Weak audits and oversight
seriousRequired checks and meetings were often missed. The audits that were completed did not find the problems identified by inspectors.
“The audits undertaken had been ineffective in identifying the concerns we found during this inspection.” from the report
Agency staff induction
seriousTwo agency staff did not know the home's fire evacuation procedure. This could have put people at risk during a fire.
“Both gave answers which indicated they were not aware of the service's fire evacuation procedure and could have put people at risk of harm if there had been a fire.” from the report
Nutrition was not followed consistently
seriousOne person did not consistently receive the enriched diet recommended by a dietician. Weight checks were also missed.
“People had not been supported to meet their nutritional needs as recommended by the dietician.” from the report
Delays in responding to people
needs fixingSome people reported waiting a long time for help after pressing their call bell. Inspectors observed one person waiting 15 minutes.
“During the inspection we saw one person waited a quarter of an hour for a response to their buzzer.” from the report
- 01What has changed to make sure medicines are in date, stocks are accurate and instructions for medicines given when needed are clear?
- 02How do you now prevent unsupervised access to the kitchen and boiling water geyser?
- 03Have the fire exit direction signs been replaced, and how are fire evacuation procedures checked with agency staff?
- 04How do you make sure people receive the diets and regular weight checks recommended by health professionals?
- 05What checks now show that audits and monitoring identify problems before they affect people?
This was a comprehensive inspection covering all five key questions, including the care and accommodation provided to 38 people living in the home. This explanation was written from the published report of 19 May 2018 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 Worsley Lodge
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- November 2018Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- December 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 2011.
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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