We carried out a review of the data available to us about Country 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 Country Lodge Nursing Home, you can give feedback on this service.
People’s experience of using this service and what we found
People were safe living at Country Lodge Nursing Home. One person said, “The staff, and the food, are superb. We are being attended to by a group of ladies who will do anything for you”. Staffing levels were sufficient to meet people’s needs. Staff attended to people’s needs promptly when they used their call bells. People received their medicines as required.
People were complimentary about staff and a relative told us, “She loves them all. They are very attentive and treat everyone as an individual. They accommodate any meal requests people have. For example, my Mum had a marmalade sandwich for breakfast as this is something she can manage better than toast or cereal. Anything she wants, they will make it for her”. People had access to healthcare professionals as needed.
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.
The registered manager was sensitive and responsive to people’s needs. Residents’ meetings enabled people to make suggestions which were listened to. One person told us, “I suggested we choose a small, medium or large meal when we order our lunches to avoid unnecessary waste. They haven’t started it yet, but they did say they would do”. Audits had been implemented to monitor the quality of care and the home overall.
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 24 April 2020). At this inspection we found improvements had been made and the rating has improved to good.
Why we inspected
We undertook this inspection to see whether improvements had been made following the last inspection.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Country Lodge Nursing Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Country Lodge Nursing Home is a residential care home providing personal and nursing care up to 26 older people. At the time of our inspection visit there were 23 people living in the home. The home is an adapted house with some purpose built areas. There are lifts to enable people to access all areas of the home.
People’s experience of using this service and what we found
People had experienced care that was not monitored adequately, and this had resulted in some risks not being managed effectively. Current good practice that reduced risks to people and respected their legal rights was not embedded. The heightened risks had not had an impact on people, and they were happy with the care they received.
The registered manager and new owners of the home were extremely responsive in reviewing and addressing shortfalls identified. They put in place a robust plan of actions. We have not been able to assess the sustainability of this plan at the time of reporting.
People felt safe and spoke highly of the staff who supported them. The staff understood their responsibilities and how to protect people from abuse. There were enough staff to meet people’s needs and keep them safe.
There were organised activities, informal chats and entertainment which provided people with meaningful things to do with their time. People were supported to maintain contact with friends and family members.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not support this practice within the framework of the Mental Capacity Act. Staff respected people’s choices and preferences.
People were cared for by staff who knew them well and were kind and compassionate. Staff were committed to the home and wanted to provide the best care they could. People had built strong relationships with staff and appreciated the familiarity they had.
People were supported to eat and drink safely. Recording related to hydration was not adequate.
People received care and support in a way that met their personal needs and enabled them to live the way they chose to. The recording of some aspects of care was not up to date.
Rating at last inspection
The last rating for this service was good (published May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At the last inspection, the service was rated Good. At this inspection we found the service remained Good.
People and their relatives felt that Country Lodge Nursing Home provided safe care and that premises and equipment were well maintained. Staff responded to people’s needs promptly and had been trained to recognise the signs of potential abuse; they knew what action to take if they had any concerns. Risks to people were identified, assessed and managed safely by staff. Staffing levels were sufficient to meet people’s needs and safe recruitment practices were in place. Medicines were managed safely to ensure people received their medicines as prescribed.
People received effective care from staff who had completed extensive training in a range of areas. Registered nurses completed additional training. Staff had regular supervisions with their line managers and attended staff meetings. 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 were supported to have sufficient to eat and drink and had access to a range of healthcare professionals and services.
Positive, caring relationships had been developed between people and staff. Staff genuinely cared for people in a kind, friendly and sensitive manner. People and their relatives spoke highly of the care on offer. People were supported to express their views and to be involved in all aspects of their care. They were treated with dignity and respect.
Care plans provided detailed information to staff on how people wished to be supported. Activities were offered and minibus outings enabled people to access the community. Complaints were managed in line with the provider’s policy.
People and their relatives were involved in developing the service; their views were sought and acted upon. People, relatives and staff all spoke highly of the provider and the management team. Communication was good and staff felt valued. High quality care was evident and complimentary feedback was recorded from a range of people. Systems were in place to monitor and measure various aspects of the home and the service overall.
Further information is in the detailed findings below.
The inspection took place on 20 and 22 January 2015 and was unannounced.
Country Lodge Nursing Home is a care home with nursing. The people living there are mostly older people with a range of physical and mental health needs such as Parkinson’s disease, multiple sclerosis or stroke. Some people at the service are living with dementia. The home is part of an old Sussex barn dating back to around 1805 and is located within the South Downs National Park. It has been converted to offer accommodation for up to 25 people; at the time of our visit there were 21 people living at the home. There is a large communal sitting room and dining room , landscaped gardens and many bedrooms have ensuite facilities.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe and staff had been trained and knew what to do if they suspected abuse was taking place. Risks to people were assessed appropriately and were reviewed monthly to ensure care was delivered safely. People at risk of pressure ulcers had been assessed and advice sought from healthcare professionals such as a tissue viability nurse. Accidents and incidents were recorded and action taken to address any concerns. Plans were in place so that people were supported in the event of an emergency. Staffing levels were sufficient and there were more care staff on duty in the mornings so that people’s needs could be met appropriately. The service followed safe recruitment procedures and new staff were vetted to ensure they were safe to work with people. Medicines were ordered, administered and stored securely. MAR (Medicine Administration Records) charts were completed by staff appropriately and registered nurses trained to administer medicines.
People had sufficient to eat and drink and spoke highly of the meals at Country Lodge. They had been assessed against the risk of malnutrition and were weighed at least monthly. Special diets were catered for and the advice of a healthcare professional was sought where required. People had access to healthcare professionals and services. Staff received essential training and were encouraged to take additional qualifications. Nursing staff received additional, specialised training. Staff had regular supervision meetings with their manager and team meetings were also in place for staff to discuss any issues or concerns. Staff had a good understanding of the Mental Capacity Act (MCA) 2005 and the registered manager was organising some dedicated training on this topic. No-one at the service had their freedom restricted and no-one was subject to the requirements of the Deprivation of Liberty Safeguards (DoLS).
Caring relationships had been developed between people and staff. Staff were friendly and engaged with people throughout the day and they knew people well. People’s spiritual needs were catered for and clergy would visit the service in line with people’s personal preferences. People were encouraged to be involved in decisions about their care. Where people had difficulty in communicating verbally, the service had made arrangements to meet their particular needs. Relatives and friends could visit at any time and could stay for a meal if they wanted. People’s privacy and dignity were promoted and staff demonstrated how they would care for people in a sensitive and caring way. Nursing and care staff knew how to care for people as they reached the end of life and in line with people’s wishes. The registered manager had sought advice and organised special training on end of life care for nursing staff.
People felt they were listened to by staff and were encouraged to be independent as much as possible. Care plans contained detailed information for staff on people’s daily care needs. Information had been recorded in risk assessments and in daily records so that care was planned holistically and delivered to ensure people’s safety and welfare. People were encouraged to participate in a range of daily social activities and the service organised a summer garden party and Christmas event every year. The service dealt with complaints promptly and in line with the provider’s policy.
People were involved in developing the service and residents’ meetings were held twice a year. When potential new staff were shown round the service, people could meet with them and have a chat. Questionnaires were sent to people and their relatives to ask for their views about the service, any concerns and any suggestions they wanted to make. Staff were supported to question practice and were happy in their work. Staff meetings were held every three to six months and staff felt the owner was fully involved in all aspects of the service. The registered manager felt supported by the owner and had helped to develop a positive, open culture and high quality care that was delivered in a homely environment. There were systems in place to audit the quality of the service and regular audits had been undertaken.
Staff told us that before people received any care and treatment they were routinely asked for their consent. This was confirmed during our discussion with the people we spoke with. Staff were aware of people's rights to consent for treatment. People told us that they were treated with respect and felt well cared for by staff.
The visitors told us a number of positive comments about the care being provided to their relative. They said that they were involved in their care planning and that they had a good rapport with the manager and staff.
The good level of hygiene and cleanliness at the home was quite prominent at the time of our visit. The premises looked clean and fresh, it was evident that there was a good regime of cleaning and infection control in place. Visitors commented on the level of cleanliness too.
The complaint procedure was displayed in the reception area together with a comment book for visitors. People spoken with were aware of their rights to raise concerns and be listened to.
The records sampled were up to date, securely stored and only accessible to designated members of staff.
People said that the staff were kind and they felt well cared for. People told us they knew about their care files and their care had been discussed with them. People said the routines in the home were relaxed and flexible. They told us that they were offered choices about what they wished to wear and choice of menus. This was evidenced in the care plans. We spoke to staff and they demonstrated that they were aware of care needs of people they supported.
People said that they felt safe and staff were able to demonstrate that they had sufficient knowledge about protecting people from abuse.
Staff confirmed that they were supported by the management team. We saw that people cared for by staff were supported to provide care and treatment safely and to an appropriate standard.
We spoke to staff and the management team and they demonstrated that the home had a quality system to manage risk and assure the health, welfare and safety of people who received care.
We spoke to four care staff who were on duty. They told us about the level of care they provide to people.