The Lodge

Updated 11 August 2023

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

Two inspectors and an Expert by Experience undertook this inspection. 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

The Lodge is a ‘care home’. People in care homes receive accommodation and nursing care as a single package under one contractual agreement dependent on their registration with us. The Lodge is a care home without nursing care. 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 a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 10 May 2023 and ended on 11 May 2023. We visited the service on 10 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 11 relatives during the inspection. We spoke with the registered manager, the deputy manager, 3 care staff, a cook and a cleaner. We looked at 3 people’s care plans in full and aspects of 5 other people’s care plans. We looked at a number of records relating to medicines administration, policies and a range of records relating to the management of the home. Following the inspection we spoke with health professionals.

Updated 11 August 2023

About the service

The Lodge is a residential care home providing personal care to up to 38 people. At the time of our inspection there were 33 people using the service. The home accommodates people in one adapted building with private garden access.

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

Risks to people were not always assessed nor their safety monitored. Proper and safe use of medicines was not established. Medicines audits had not identified any of the concerns found during our inspection. The governance framework had not identified the safety concerns found during inspection.

Systems, processes and practices safeguarded people from abuse. Sufficient numbers of suitable staff were employed. People were protected by the prevention and control of infection. Accidents and incidents were monitored. The home had undertaken a programme of substantial refurbishment with more planned.

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.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 1 April 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 15 and 18 February 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve assessments of risks, proper and safe management of medicines, and effective systems to assess, monitor and improve the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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 not changed and remains requires improvement. This is based on the findings at this inspection.

The last rating for this service was requires improvement (published 2 April 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to assessment of risk, medicines and management oversight.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

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.