The Lodge

Updated 2 September 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 completed by 1 inspector 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 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. The Lodge is a care home with 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.

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 did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make.

During the inspection visits

We walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with 3 people who used the service and 6 family members and friends about their experience of the care provided. We spoke with 7 members of staff including the registered manager, care staff, maintenance staff and catering staff. We looked at a range of records. These included 5 people's records related to their care and support and a variety of people's medicine administration records.

We reviewed 3 recruitment records and a variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 2 September 2023

About the service

The Lodge is a residential care home providing accommodation and personal care for up to 20 people. At the time of our inspection there were 18 people living in the home.

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

Improvements were needed to the governance systems as they failed to bring about the required improvements to the service people received and drive improvements to the overall rating for the service. At the previous three inspections, the service has been rated requires improvement or inadequate.

Risks were not always monitored accurately, and some risks assessments were out of date or missing. These concerns were not systemic across the service, but this placed people at risk of receiving inappropriate care that didn't meet their needs safely. We have made a recommendation about this.

We identified issues of concern with infection prevention and control practices being followed within the kitchen area and the use of PPE. We have made a recommendation about this.

Medicines management had improved, and people had their medicines as prescribed. Staff had received training on administering medicines and their competence was regularly checked.

People and their relatives told us staff were kind and caring towards them and they felt safe living at the service. Staffing levels were good and appropriate to ensure people's needs were met in a safe, timely and consistent way.

Safety checks of the premises and fire safety checks were undertaken and there were plans in place in the event of an emergency evacuation. Staff had completed individual personal emergency evacuation plans for people to support with safe evacuation.

Staff were knowledgeable about people's health needs and the provider worked in partnership with other health professionals as a measure of providing the appropriate level of support.

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 17 December 2021) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, whilst some improvements have been made, the provider remains in breach of regulation. The service remains rated requires improvement. This service has been rated requires improvement or inadequate for the last three consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Enforcement and Recommendations

We have identified a breach in relation to good governance and oversight of the home.

We have made recommendations about the systems in place for monitoring risk, accurate recording of peoples diet and fluids, infection prevention and control measures.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.