The Lodge Care Home

Updated 10 November 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

The inspection was carried out by 2 inspectors 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

The Lodge Care Home 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. [Care home name] is a care home [with/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 no registered manager in post, however the manager told us they intended to submit an application to register as the manager.

Notice of inspection

This inspection was unannounced.

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. 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. 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.

During the inspection

Inspection activity started on 10 August 2023 and ended on 20 August 2023. We visited the service location on 10 August 2023. We spoke with 7 people who used the service and 4 relatives about their experience of the care provided. We spoke with 9 members of staff including the area manager, the manager, a nurse, care workers, a chef, and the laundry operative.

We reviewed a range of records. This included care records for 4 people and multiple medicine records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 10 November 2023

About the service

The Lodge Care Home is a residential care home providing personal and nursing care to up to 40 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 26 people using the service.

The Lodge Care Home accommodates people in one purpose-built building across 2 floors. Each floor has communal areas and kitchen facilities.

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

Medicines were not always safely managed, protocols for ‘as and when’ medicines were not consistent with prescribers instructions. Storage was not secured, temperatures of storage areas was not consistently monitored and action had not been taken where temperatures were higher than medicine manufactures guidance. Medicine records were not always completed. Medicine disposal bins were overflowing and refuse bags were tied to medicine trollies. People at risk of choking were sometimes left without support when drinking fluids. Hygiene practices did not always promote safety .

Quality assurance systems were not always effective. Actions taken in response to audits had not always improved practice. Audits had not always identified issues such as high temperatures in the medicine room and storage areas not being secured.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; Restrictive ‘bucket’ chairs prevented people from standing up, and we observed one person required assistance from 2 staff to stand from a bucket chair. The policies and systems in the service did not support this practice.

There were enough staff to meet people’s needs, however feedback we received about staffing levels was mixed. Staff were recruited safely. People were protected from the risk of abuse by trained staff. Staff were caring and knew people well. Staff spoke positively about the manager and told us the manager had taken action in response to concerns they had raised. The provider worked in partnership with other organisations.

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 01 November 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections. 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 had made improvements, however they remained in breach of regulation 17 good governance.

Why we inspected

We previously carried out an unannounced focused inspection of this service on 13 September 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 safe care and treatment and good governance.

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.

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 remained requires improvement. This is based on the findings at this inspection.

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.

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

Enforcement and Recommendations

We have identified breaches in relation to governance systems and medicines management. Please see the action we have told the provider to take at the end of this report.

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.