Updated 13 March 2026
Date of Inspection: 20 March to 21 April 2026. Bowland Lodge is a residential care home providing personal care for up to 36 people. The service provides support for older people, people living with dementia, people with mental health needs and people who experience addictions to substances. At the time of our inspection there were 28 people using the service. The inspection was undertaken in response to ongoing concerns about the quality and safety of care, leadership stability, and governance arrangements.
The service was previously in breach of the legal regulation in relation to good governance. Improvements were not found at this inspection, and the provider remained in breach of this regulation.
On 9 April 2026 during the inspection, we were informed by one of the partners that in 2017 the other partner had passed away. No action was taken at the time to notify us or cancel the registration of the partnership nor apply to register a new legal entity. This meant for 9 years Bowland Lodge had been operated by an unregistered provider. We were introduced to a person who suggested they were the owner of Bowland Lodge, but we established they were Mr Darshen Kumar Malhotra’s son, and they had no legal standing to operate the service.
The evidence indicates, following the death of a registered partner in February 2017, the service was not operating within a lawful provider framework. As a result, there was no legal entity registered to operate Bowland Lodge.
At Bowland Lodge we found serious and widespread concerns. These included significant risks to people’s safety, ineffective systems to manage care and treatment, lack of staff, potential financial difficulties, lack of training for staff, poor risk management and medicine management and a lack of effective leadership and governance. We have been working with the local authority to ensure people are kept safe.
People were not consistently safe. The environment was in a poor state of repair, with ongoing concerns relating to fire safety, water safety and maintenance. We identified risks associated with fire safety; however, appropriate risk assessments and management plans were not in place. There were prolonged issues with hot water availability, unresolved water leaks that posed electrical and fire risks, and a lack of assurance that effective remedial action had been taken. Medicines were poorly managed, including unsafe storage, incomplete records, at times there were not enough staff to complete checks, and staff not following prescribed guidance for people on alcohol maintenance programmes. Safeguarding concerns were not always recognised or reported appropriately, including incidents where staff were assaulted and people went missing.
Care and treatment were not effective. Assessments, care plans and risk assessments did not clearly guide staff on how to meet people’s needs. Staff lacked understanding of the Mental Capacity Act and were using restrictive practices without appropriate legal frameworks, capacity assessments or bestinterest decisions. Although some people were believed to have a learning disability or be autistic, records did not clearly reflect this, and staff had not received appropriate training, including the mandatory training around supporting people with a learning disability or autism which meets Oliver McGowan standards.
We expect services for people with a learning disability or autism to meet the statutory guidance Right support, Right care, Right culture (RSRCRC). Meeting RSRCRC guidance means that people receive care that is person‑centred, promotes their independence and choice, and is delivered by staff and leaders whose values, attitudes and behaviours ensure people are treated with dignity, respect and compassion. The service did not meet the principles of RSRCRC.
Despite these concerns, people told us staff were kind, caring and respectful. We observed staff interacting with people in a compassionate and unhurried way, and people felt their dignity was respected. Staff had built positive relationships and were committed to providing good care. However, this was undermined by staffing shortages, lack of training, absence of meaningful activities and poor management support and the lack of a manager.
The service was not consistently responsive to people’s needs. While some staff worked in person‑centred ways and professionals described collaborative working, care records did not support consistent delivery of care. Frequent changes in management led to inconsistencies, and future planning for people was not in place.
The service was not well-led. There was no registered manager in post, high turnover of interim managers, and a lack of effective governance systems. Audits failed to identify known risks, notifications to CQC had not been made, and there were concerns about the financial viability of the service, including non‑payment of staff wages, pensions and training fees. Staff did not feel supported or able to speak up, although they remained committed to delivering good outcomes for people.