We carried out a review of the data available to us about The Old Lodge Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Old Lodge Nursing Home, you can give feedback on this service.
The Old Lodge Nursing Home provides support and nursing care for up to 47 older people, some of whom are living with dementia, have an acquired brain injury or neurological disorder. At the time of our inspection there were 39 people living in the home.
The service is provided over two floors. There is a lounge with a conservatory and dining room on the ground floor and a lounge on the first floor. Bedrooms and bathrooms are located on both floors. The home is located in a rural area on the outskirts of the village of Etwall.
People’s experience of using this service and what we found
The registered manager and staff team were committed to developing their knowledge and working with other agencies to improve the lives of the people they supported based on best practice. All professionals we spoke with gave positive feedback about the leadership and management of the home. There were quality assurance systems in place to identify and address any shortfalls and the staff team were passionate about continually striving to improve the service. People were encouraged to share their views to support the development of the service and share concerns. Staff were proud of the service and felt well supported by the registered manager and the provider.
The staff were committed to ensuring people experienced excellent care. Positive and caring relationships had been developed between people and the staff. People felt that staff were compassionate, and they had developed meaningful relationships with them. People were treated with dignity and respect by staff who understood the importance of this.
There was an emphasis on supporting people to lead full and interesting lives. People were encouraged to have fun and enjoy a broad range of social activities. The staff were motivated and committed to provide people with personalised experiences that exceeded their expectations. Staff valued people's differences and responded to each person's wishes. People’s diversity was fully recognised and promoted by the staff; people were supported to follow their religious beliefs and to maintain important family relationships.
The registered manager encouraged staff to provide care which recognised that people were at the heart of their service. People were central to deciding how care was planned and their care was reviewed with them to ensure it reflected their wishes. Staff recognised people’s individual preferences and organised care that reflected their individual cultural preferences. People felt well looked after and supported and had developed good relationships with staff who they felt were kind and caring and were dignified and respectful when providing their care. People were supported to express their views about the support they wanted during the end of their life. Staff ensured people received dignified personalised care towards the end of their life.
People’s care needs were identified and assessed before they moved into the home to enable staff to know and understand how they wanted to be supported. Risk management plans were in place to protect people from harm and to support them to remain independent. People were not restricted due to perceived risk and supported to try new and different experiences. There were enough staff working in the home and they understood how to recognise signs of abuse and people felt safe. Incidents and accidents were reviewed, to determine if lessons could be learnt. Medicines were well managed, stored in line with national guidance and people received them at the time they expected.
People made their own decisions and staff respected the choices they made. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People had a choice of meals and were happy with the quality of the food that was cooked. Where people need a specialist diet, this was prepared in consultation with people.
People benefitted from receiving a service from staff who were well trained to support people in line with best practice guidance. The staff had support to enable them to identify personal development opportunities and to raise any concerns they had. The staff worked in partnership with health care professionals to meet people’s health care and dental care needs were met. There was a culture within the organisation of striving for excellence and assisting people to reach their maximum potential.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good and outstanding in caring. (This report was published on 20 April 2017.)
Why we inspected
This was a planned inspection based on the previous rating.
People continued to receive safe care and there were enough staff to provide support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely. Staff had been suitably recruited to ensure they were able to work with people who used the service.
The care that people received continued to be effective. People made decisions about their care and staff sought people’s consent. Where people lacked capacity they were helped to make decisions. Where their liberty was restricted, this had been identified and action taken to ensure this was lawful. People received supported to stay well and had access to health care services and were able to choose what to eat. Staff received training to meet the specific needs of people who used the service.
The care people received remained outstanding. People were treated with dignity and staff were caring and kind. Staff helped people to make choices about their care and their views were respected. The care records detailed how people wished to be cared for and people could plan their future care and make advance decisions.
People were involved in the planning and review of their care and support and family members continued to play an important role. Where people had any concerns they were able to make a complaint and this was responded to.
The service continued to be well-led. Systems were in place to assess and monitor the quality of the service. People and staff were encouraged to raise any views about the service on how improvements could be made. The manager promoted an open culture which put people at the heart of the service.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This visit was unannounced, which meant the provider and staff did not know we were coming. At the last inspection in October 2013 the provider met all the requirements we looked at.
The Old Lodge Nursing Home is registered to provide accommodation and support for 42 adults who may have a physical, medical or dementia related condition. On the day of our visit, there were 39 people living in the home, one person was in hospital.
There was a registered manager in post. They were on annual leave on the day of our visit but visited the home whilst we were there. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People who used and visited the service were happy with the care provided and we observed staff treating people with care and compassionate. The staff were kind and respectful to people when providing support. We saw staff smiling and laughing with people and joining in activities in the home.
Visitors were welcomed and participated in daily events. People told us they could visit at any time and were always made to feel welcome.
People were dressed in their own style and if they needed support, staff helped people to take pride in their appearance. People were supported to have their personal care needs met.
People told us of ways they chose to spend their day. People were supported to participate in their hobbies and interests which included, attending religious services, going shopping and cake decorating.
People were protected from the risk of receiving unsuitable or unsafe care. Records were updated to inform and guide staff about changes to people’s care. Procedures to protect people from the risks associated with medicines were in place to ensure people received their medicines safely.
The registered manager had a training plan in place to ensure staff received the training they required to meet people’s individual needs. Staff received support from the management team to develop their skills and use their knowledge to enhance the lives of people who used the service. They did this by learning from previous situations and keeping up to date with best practice.
People knew who to speak to if they wanted to raise a concern and there were processes in place for responding to complaints. People we spoke with told us they were happy with the service provided and how staff provided their support.
The legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed. Some people who used the service did not have the ability to make decisions about some parts of their care, treatment and support. The Mental Capacity Act 2005 and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests, when they are unable to do this for themselves. Staff had an understanding of this and had received training on the systems in place to protect people who could not make decisions, and where restrictions had been placed upon people the necessary documentation for a DoLS authorisation was in place.
Healthcare professionals we spoke with told us the care and attention given to people who used the service was excellent. They all confirmed they would be happy for their relatives to live there.
The staff spoke well of the manager and the way the service was managed. They said they received the support , training and time they needed to deliver the necessary care and support to people.
There were suitable and sufficient systems in place to ensure the service was managed safely. People who used the service were at the heart of decision making and the care was centred around individual’s needs.
Records showed that we, the Care Quality Commission (CQC), had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.
The registered manager regularly assessed and monitored the quality of the care at the home. Appropriate and prompt action was taken to make improvements to the care when required.
Care plans were descriptive and easy to follow, and when we asked staff they were aware of people's needs and preferences. People received a varied diet and supplementary nutrition and fluids when required.
We observed staff talking with and assisting people throughout our visit, some of which were made indirectly and from a distance. Staff were seen to have undertaken tasks with peoples' privacy and dignity in mind and showed the staff were aware of their individual support needs.
We looked at how medicines are managed and found that this was well administered, with a well detailed policy and procedure for staff to follow.
We saw that the recruitment was secure so people could be assured that people employed were appropriate to work with vulnerable people. There are a number of quality assurance checks in place to ensure people remain safe at the home.
People confirmed that they felt safe using the service and all the relatives we spoke with told us they had no worries about the way care was provided. They praised the staff and one person said they were a 'good team'.