Worstead Lodge

Updated 23 February 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was conducted by three inspectors, a member of the CQC medicines team and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Worstead Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Worstead Lodge is a care home without nursing. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had very recently started in post and had started the process to apply to register with CQC.

Notice of inspection

This inspection was unannounced on the first day. We undertook an out-of-hours visit on 11 January that was also unannounced. The third visit of the inspection was announced.

What we did before the inspection

We reviewed the information we had received about the service since the last inspection from commissioning local authorities, relatives of people who use the service and staff working there. We reviewed notifications of important events the service is required to send to us and other information we held such as safeguarding records.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who use the service. An Expert by Experience spoke with 4 people’s relatives over the telephone. We observed how people interacted with staff in communal areas and some aspects of care and support staff provided. We reviewed people’s personal care and support records, staff recruitment records, staffing rotas and staff training records. We reviewed medicine administration and associated records for 10 people, observed people receiving their medicines and spoke with 3 members of staff about medicines. We reviewed records relating to the management of the service such as audit records, safety checks and emergency plans.

We spoke with 5 care workers, the activities coordinator, the maintenance coordinator and 1 volunteer who spends time at the home. We spoke with 5 members of the management team including the home manager, deputy manager, the provider’s regional support manager, the director of the provider company and the provider’s operations director who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Updated 23 February 2024

About the service

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Worstead Lodge is a residential care home providing accommodation for persons requiring nursing or personal care to up to 20 people. The service provides support to autistic people and people with a learning disability. At the time of our inspection the home supported 19 people. 8 people lived in an adapted detached house, while 11 people lived in smaller self-contained flats and bungalows on the premises, sharing with 2 or 3 others. The provider company had changed ownership in April 2023, however this did not require any changes to the provider’s registration with CQC.

People’s experience of using this service and what we found

Right Support:

People were generally happy living in Worstead Lodge and many had lived there for a very long time. However, recent changes brought about by the change of ownership of the provider company had destabilised the support people received and left them feeling vulnerable and ill-at-ease in their home.

People were at risk of not receiving safe care. People’s personal care and support records did not always reflect their needs, and some documents had been destroyed leaving newer and agency staff without the guidance they needed to support people safely. Medicines were not always administered safely. Maintenance checks were regularly undertaken and emergency plans were in place.

The home was larger than that indicated by best practice guidance, however this was mitigated in part by the inclusion of smaller, self-contained flats and bungalows within the care home’s grounds.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Staff were not always effectively deployed to ensure people received person-centred care. The systems in place did not always protect people from financial abuse. Staff were kind and caring in their interactions with people and people were comfortable with the staff they knew well. Staff were recruited safely and had been appropriately trained.

Right Culture:

A closed culture had developed in the home due to a lack of management oversight, however the provider had taken appropriate action as soon as they had become aware of this. A new management team had been very recently appointed and a new position created to improve oversight of the support people received. New systems had been introduced however these had not yet been fully implemented so we could not be assured of their effectiveness at the time of our inspection. The new management team were committed to improving the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 December 2021).

Why we inspected

We received concerns in relation to safeguarding, staffing, management of medicines, and the leadership and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Worstead Lodge on our website at www.cqc.org.uk.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.