CQC report explained · a residential care home
What the CQC found at York Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by trained staff, suitable staffing levels, safe recruitment and appropriate safeguarding arrangements. Medicines, falls, fire safety, infection control and accidents were managed safely.
- Effective?
- Good
- People's food, drink and health needs were met. Staff had suitable training and worked with health professionals, while people were supported to make choices in line with the law.
- Caring?
- Good
- Inspectors saw people treated with kindness, dignity and respect. Staff supported independence, involved people in everyday choices and helped them stay in contact with relatives.
- Responsive?
- Good
- Care was personalised to people's needs, preferences and communication methods. Activities were varied, visitors were welcomed and end-of-life care was described as compassionate and respectful.
- Well-led?
- Requires improvement
- The management team had quality checks and a culture of openness, but some care plans were hard to use and did not clearly record changes, outcomes or guidance. Best-interest decisions were not always documented, including decisions about sensor mats and covert medicines.
What inspectors found, January 2020
York Lodge was rated Good overall, but inspectors found that leadership and care records required improvement.
Inspectors visited on 20 December 2019. The first day was unannounced and the second day was announced. They spoke with people, visitors, staff and health professionals, observed care, and checked care records, medicines, recruitment files and management records.
People were found to be safe, supported by trained staff and given appropriate medicines, food and health care. Inspectors also found kind and respectful care, personalised activities, good communication support and help to maintain family relationships.
The home was rated Good for Safe, Effective, Caring and Responsive. Well-led was rated Requires Improvement, the same as at the previous inspection. Some care records did not clearly explain people's current needs, best-interest decisions, sensor mats or covert medicines.
Safe staffing and medicines
There were enough staff, recruitment checks were completed and medicines were given by trained staff who had been assessed as competent.
“We observed staff administering medicines safely to people ensuring that they were offered the medicines, given time to take them in the way that they preferred and signed for once they were taken.” from the report
Kind and respectful care
People appeared relaxed and happy with staff. Their privacy, dignity and independence were promoted.
“People were treated with kindness and care by staff. Staff spoke respectfully to people and showed a good awareness of people's individual needs and preferences.” from the report
Personalised support
Staff knew people's preferences, communication needs and health conditions. Activities included group sessions, one-to-one support and trips out.
“People received personalised care that was responsive to their needs.” from the report
Good family and health links
Visitors were welcomed, relatives were kept informed and the home worked positively with health and social care professionals.
“People were supported to maintain relationships that were important to them. Visitors were made welcome at the service at any time.” from the report
Care plans were not always clear
needs fixingSome records identified a care need but did not explain the expected outcome or give staff clear guidance. Important information could also be difficult to find.
“Some care plans whilst highlighting the person's care need, lacked an outcome and guidance for staff to follow.” from the report
Decisions were not always recorded
seriousBest-interest decisions and the reasons for them were not always documented. This included the use of sensor mats and medicines hidden in food or drink.
“Information about best interest decisions had not always been documented.” from the report
Pharmacist not involved in covert medicines
seriousAlthough covert medicines had been agreed by the GP and included in the liberty safeguards application, the dispensing pharmacist had not been involved.
“Some people received their medicines covertly (hidden in either food or drinks) and whilst this had been agreed by the GP and included with the DoLS application, the dispensing pharmacist had not been involved.” from the report
- 01Have all care plans been updated so that current needs, outcomes and staff guidance are easy to find?
- 02How are best-interest decisions recorded, including the reasons for using sensor mats?
- 03If medicines are given covertly, how are the GP, pharmacist, family and staff involved and kept up to date?
- 04How do you make sure new or agency staff can quickly find the information they need to provide safe care?
- 05What checks now show that the improvements to documentation have been completed and maintained?
This was a planned inspection covering the home, care provided and all five key questions; the first day was unannounced and the second day was announced. This explanation was written from the published report of 24 January 2020 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 2017
Rated Good overall; inspectors found safe, kind and personalised care, but the home was not consistently well-led.
Inspectors visited the home without warning on 21 April 2017. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, staff records, accidents and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. People were kept safe, received their medicines properly, and were supported by trained staff. Inspectors found kind relationships, personalised care, good activities and support with food, drink and health care.
The home was rated Requires Improvement for Well-led. Its checks did not always find important shortfalls, including incomplete mental capacity assessments, gaps in controlled drug checks and weaknesses in accident monitoring. These issues had not affected people's care, and inspectors did not identify a breach of regulation.
People felt safe
People and relatives told inspectors they felt confident about safety. Staff understood safeguarding, risks and how to respond to behaviour that might cause distress.
“People told us they felt safe living at York Lodge.” from the report
Kind and respectful care
Inspectors saw positive relationships and a relaxed atmosphere. Staff supported privacy, dignity, choice and personal identity.
“People were supported by staff that were kind, caring and compassionate. Positive relationships had been developed.” from the report
Personalised support
Care plans included people's preferences, life histories and abilities. Staff changed support when people's needs changed, including changing the form of medicines when swallowing became difficult.
“People received personalised and individualised care that was tailored to their needs and preferences.” from the report
Activities and community links
People could choose from many activities, including one-to-one support and regular trips in the home's minibus. Activities were also provided for people who stayed in their rooms.
“A wide range of activities were available for people to participate in and considerable thought and energy created an environment that provided stimulation and interaction.” from the report
Quality checks missed shortfalls
needs fixingThe home's monitoring systems did not consistently identify problems. Inspectors recommended that the provider seek guidance on a stronger quality assurance system.
“Quality monitoring systems and procedures did not always establish best practice or identify all areas for improvement.” from the report
Controlled drug checks
needs fixingChecks of controlled drug stocks were not regular, and some medicines had been signed in by only one staff member. Inspectors found no impact on people's care, but the audit had not found the problem.
“stock checks on controlled drugs (CDs) were not taking place on a regular basis” from the report
Mental capacity records
needs fixingA person's bedroom door was locked at times, but the required decision-specific mental capacity assessment had not been completed to show the restriction was in their best interests.
“a mental capacity assessment had not been completed to demonstrate that that individual lacked capacity” from the report
Recruitment records
minorSome staff files had gaps in employment history without evidence that the gaps had been followed up. The manager agreed to take action.
“We identified in a couple of staff files, gaps in employment history and documentation failed to evidence whether these gaps were followed up.” from the report
- 01What changes have you made to your quality checks since inspectors found that they missed shortfalls?
- 02How often are controlled drug stocks now checked, and do two staff members sign medicines in?
- 03How do you record and review mental capacity assessments when a person's bedroom door or movement is restricted?
- 04How are accidents and falls reviewed by time of day and location?
- 05Has an activity coordinator been appointed, and how are activities planned for people who do not join group activities?
This was an unannounced inspection covering all five CQC questions; the home had previously been rated Requires Improvement in March 2016. This explanation was written from the published report of 20 May 2017 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 York Lodge
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- June 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.