The Lodge

Updated 1 February 2024

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.

Inspection team

The inspection team consisted of three inspectors and an Expert by Experience who spoke to people and their families. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. We inspected the service unannounced on two days.

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 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 a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last 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. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people and 6 relatives about their experience of the care provided. We spoke with 4 members of staff including the registered manager and provider. We spoke with 1 professional who was visiting the service.

We reviewed a range of records. This included care records, risk assessments and medicine records. We looked at 3 staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service and quality assurance arrangements.

Following the inspection

We had contact from 7 family members about their experience of the care provided. We continued to seek further information and clarification, from the registered manager, to validate evidence found.

Updated 1 February 2024

The Lodge is a residential care home providing the regulated activity of personal care. The service is registered to provide care and accommodation for up to 24 people, some of whom may be living with dementia. There were 20 people living at the service at the time of our inspection.

People’s experience of the service and what we found:

The registered manager and provider had not put in place effective systems to protect people from risk. Improvements were needed to formal systems throughout the service, particularly in the oversight of risk and people’s safety.

Information relating to people's individual risks was not always recorded or did not provide enough assurance that people were safe.

Systems were in place for accidents and incident recording however lessons were not learned, and improvements were not always made when things went wrong. People were not protected by the prevention and control of infection.

Staff had built positive relationships with people living in the service. However, not all care plans contained enough information to ensure staff knew the persons history and life story to deliver appropriate person-centred care.

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met.

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.

Staff were recruited in line with requirements and there was a consistent staff team. People had enough food and drink to meet their nutritional needs. The service worked with other organisations to ensure they delivered joined-up care and support and people had access to healthcare services when needed.

There was a homely and relaxed atmosphere between people and staff. People and their relatives told us they were treated with care and kindness. One family member said, “All the staff really care about the residents. There is lots of stimulating activities. Food is very good. It has a lovely warm and homely feel. As a family we are very happy with the level of care [relative] receives at The Lodge.” Another family member said, “My [relative] has been treated with kindness and compassion from the staff.”

Medicines were well managed, and staff received training to help ensure they were sufficiently skilled.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was Good when last inspected in March 2019. The report was published 4 April 2019.

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk and peoples safety of people. This inspection examined those risks. A decision was made for us to carry out a responsive inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Enforcement and Recommendations

At this inspection we have identified breaches in relation to safe care and treatment, need for consent and governance arrangements. Please see the action we have told the provider to take at the end of this report.

Follow up

We have requested 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.

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