Bowland Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Risks to people were not always effectively recorded. Staff were safely recruited, but had not always received necessary training. Improvements to medicines management had been made, but further and sustained improvements were needed. The provider had improved the safety of the premises and infection prevention and control practices. Systems were in place to deal with accidents and incidents.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe at the service and that staff supported them well. However, our assessment found the provider’s governance processes did not meet expected standards which impacted on the support people received.

Staff spoke positively about the leadership of the registered manager, and the improvements made since our last inspection. However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such as people’s care records and medicine management. This showed that further improvement was needed in the learning culture at the service.

The provider had improved the systems used to monitor and respond to incidents. Individual accidents and incidents were investigated and acted on. However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such as people’s care records and medicine management. This showed that further improvement was needed to create an effective learning culture at the service.

People did not raise any concerns about the safety of their placements. Some people were seeking to move on to independent living, and the service was supporting them with this. However, our assessment found the provider’s governance systems did not meet expected standards, which impacted on areas such as people’s care records and medicine management. This showed that further improvement was needed to establish and maintain safe systems of care.

The registered manager assessed people’s support choices and needs before they moved into the service, to ensure that appropriate care was available. People were also supported to transition out of the service where appropriate. However, our assessment found the provider’s governance systems did not meet expected standards, which impacted on areas such as people’s care records and medicine management. This showed that further improvement was needed to establish and maintain safe systems of care.

Partners did not raise any concerns about people’s transition into the home. However, our assessment found the provider’s governance systems did not meet expected standards, which impacted on areas such as people’s care records and medicine management. This showed that further improvement was needed to establish and maintain safe systems of care for people.

A new digital care planning system had been implemented which would be used to develop assessments of people’s care needs. In some cases care plans had not been drawn up based on these assessments. The registered manager said the process for doing this would be reviewed and improved.

Most people told us they felt safe at the service. One person said, “I feel safe here and it’s like home to me.” However, the provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

Staff told us they would not hesitate to report any concerns they had and knew how to use the provider’s safeguarding processes. However, the provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

The provider was carrying out a refurbishment of the home to address risks to people’s safety. Improvements had been made since our last inspection, and ongoing work was planned. However, the provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

Not all staff had safeguarding training recorded. The registered manager said this had been completed, but we were not shown records confirming this during the inspection. The provider had a safeguarding policy, and allegations of abuse had been investigated and appropriately referred to the local authority safeguarding team. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests (BI) and legally authorised under the Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The provider was meeting the requirements of the MCA. Where needed, authorisations for people being deprived of their liberty had been approved. Not all staff had MCA training recorded. The registered manager again said this had been completed, but we were not shown records confirming this during the inspection. The provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

People said they received safe support. Some people raised specific issues with us regarding their care, which the registered manager was already aware of and acting on. However, the provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

Staff told us they felt the service had improved and that people’s safety was well managed. One member of staff said, “The residents are always put first.” However, the provider’s failure to address ongoing issues with medicines, care plans and governance continued to place people at potential risk.

The safety of the premises had improved since our last inspection. For example, new fencing had been installed to help people to enjoy outdoor areas safely. However, further and sustained improvement was needed in other areas of the premises.

In some areas assessments were not in place around specific risks. For example, one person was at high risk of falls but information relating to this was not included in their care plan. We spoke with the registered manager about this, who said action would be taken to update care plans to ensure risk was identified and addressed.

People generally said they felt safe at the home. One person told us, “I’m quite content.”

Staff said they had noticed improvements in how the environment was managed. One member of staff told us, “A lot has improved, with some renovations and equipment being put together for a better and enabling environment for the service users.”

The environment had improved since our last inspection. Improvements to the premises had been made, and risks we had identified during our last visit had been addressed.

Further and sustained improvements to the environment were needed, and the registered manager had plans to do this. Required servicing and testing certificates were in place to ensure the premises and equipment were safe to use. Plans were in place to support people in emergencies.

People gave us mixed feedback on staffing levels. One person told us, “There’s not enough staff.” Another person we spoke with said, “I don’t think we need any more staff.” However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such as staff training.

Staff told us there were enough staff at the service. Comments from staff included, “There is more than enough staff around the home" and, "At Bowland lodge we have enough staff, well trained and hardworking. Both for day and night shift.” However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such as staff training.

Staff were a visible presence around the service. People received support in a calm, unhurried way, and staff had the time to have meaningful conversations with them. One person told us, “They respond in a timely manner.” However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such as staff training.

Staff had not always received required training, including training to support autistic people and people with a learning disability. The registered manager said this would be arranged. The registered manager monitored staffing levels to ensure they were sufficient for people to receive safe support. Staff were safely recruited into the service, and a range of pre-employment checks were carried out.

People we spoke with did not give us feedback on the cleanliness of the home. However, further and sustained improvement was needed in some areas of the home to ensure effective cleaning could take place.

Staff said the service had improved under the leadership of the registered manager. One member of staff said, “The home has made so [many] changes.” However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such the renovation and condition of some areas of the building.

Communal areas were generally clean and tidy. Some areas were in need of renovation to allow effective cleaning, for example the dining room and the laundry room flooring, and work was underway to address this.

The provider had an infection prevention and control (IPC) policy. Staff received IPC training as part of the Care Certificate and also from IPC external professionals. IPC practices had improved, and staff now used disposable personal protective equipment. However, our assessment found the provider’s governance processes did not meet expected standards, which impacted on areas such the renovation and condition of some areas of the building.

People told us they received their medicines when needed. One person said, “My medicines are always on time and they stay with me and help me take them.” However, we identified ongoing issues with medicines management.

Senior management informed us they were continuing to work on addressing issues raised at previous inspections. Whilst there had been improvements there was further work to be implemented in relation to the documentation associated with medicines management. We were told a new medicines policy had been implemented in May 2024, however we found this did not always correlate to the processes taking place in the home. For example, the policy referred to paper records for administration of topical medicines however the service had an electronic system for this.

Medicines were stored securely and safely, including controlled drugs. However, there continued to be issues with temperature monitoring of the medicines fridge. Records show continuous high temperatures without any actions. This placed people at risk of receiving unsafe medicines. We saw some improvements in the quality of the medicines records, however we still found issues relating to transcribing of medicines with warning labels and inconsistent allergy recording. Processes were still not robust for the management of topical medicines and records continued to not provide assurance that people were receiving their topical medicines. We saw the same error for the same person which had been raised at the last four consecutive inspection. Guidance to support staff in the safe administration of when required medicines continued to require further development to ensure records were person-specific. Care plans had improved, however we did find some lacked information for staff to be able follow. For example, some we looked at did not contain any guidance for staff to follow in relation to elimination needs. For another service user we found inconsistencies about how this person communicated. Internal audits were taking place and some audits we looked at showed 100% compliance, however issues identified during the course of the inspection demonstrated these governance processes were not always effective. External auditors employed by the provider had also failed to identify the issues we found.