All inspections: The Lodge - Care Quality Commission

During this inspection we assessed the hospital's management of medicines. Whilst there was pharmacist involvement in monitoring and auditing medicine safety at the hospital we noted some delays in administering medicines prescribed by GPs, some gaps in records that are needed to provide assurance that medicines are being administered safely and as intended by prescribers. For one person, we noted a lack of information about their prescribed medicines.

We did not need to speak to people during this inspection, which was focussed on the fitness and quality of the records held about people using the service. However, we could see from people's records that they were involved in developing their treatment and support plans and that they had one to one time with staff, during which they could express any concerns they may have about their records.

We found that the quality of records, including those relating to detention under the Mental Health Act 1983, was consistent and that people's records were fit for purpose. The information recorded about individuals clearly supported staff to deliver effective care and treatment to people using the service.

At our December 2012 inspection we found that the provider was non-compliant because the care and treatment did not take account of changes in individuals' condition or circumstances. Records did not provide assurance that patients were receiving individual support that upheld their rights. The provider sent us an action plan that set out how they intended to make improvements. At this inspection we found that improvements were being made but were not yet complete. New records were due to be introduced. However, at the time of our inspection the original format of care records were in place and we found gaps in these records that made it difficult to be certain whether key documents had been reviewed in a timely way. Whilst patients were receiving appropriate care and their welfare was being protected, there was a risk that staff would rely on incorrect information when planning and delivering care and support.

During our inspection we spoke briefly with three patients receiving care and treatment at The Lodge. They told us that staff supported them well and understood their needs. One patient told us they felt safe at The Lodge and that staff supported them effectively with their medication, and by listening to them. Another individual expressed concerns about how their belongings were managed. We followed this up and found evidence that these concerns had been investigated on more than one occasion and that staff were supporting the individual appropriately.

At the time of our visit 13 people were using the service, 11 of whom were detained under the Mental Health Act (MHA) 1983. The remaining two were informal patients. Three patients were receiving one to one observation from staff. Whilst we spoke briefly to three people, they all declined to speak with us in detail. However, during our visit we spoke with staff, observed how people were supported, and how staff interacted with them. We also looked at the records for five of the people accommodated at The Lodge and tracked their care, treatment and support.

Patients were treated with dignity and respect, they were supported to influence how they lived and to maintain their independence. We found that individuals were enabled to express any views and concerns they may have, or to make a complaint. Patients were involved in meaningful activities, although staff told us that this was sometimes difficult to achieve.

Most patients received care and treatment that met their needs, however we identified some concerns about individualised assessment, search practices and the timeliness of assessment and care plan reviews.

All the areas we visited were clean and saw that the provider had arrangements in place to prevent and control infection.

We found that there were appropriate numbers of staff, of the correct seniority and skills to meet the needs of patients during our visit. Staffing levels were monitored and arrangements were in place to cover staff absence.

Because of people's apparent anxiety in the presence of strangers, we were not able to speak for long with people using the service. This meant we were unable to gather much information about their experiences of the service.

One person told us they had been making Christmas decorations and they had these displayed near their room. They did not wish to speak to us any further. Another told us that staff had helped them to arrange for repairs to a bicycle and that they were going out during the afternoon.

One person with whom we spoke told us that they were happy at The Lodge. They said they liked the staff and were able to go out and ride their bicycle.

We observed a number of people interacting positively with the staff on duty.

Archived: The Lodge

All Inspections

26 February 2014

During an inspection in response to concerns

23 July 2013

During an inspection looking at part of the service

1 May 2013

During an inspection looking at part of the service

19 December 2012

During a routine inspection

8 December 2011

During an inspection looking at part of the service

6 September 2011

During an inspection in response to concerns