Source · CQC inspection

Gledhow Lodge

Type Social Care Org Region Yorkshire & Humberside Last inspected 19 Feb 2020

Overall rating: Inadequate  View full CQC report

Domain ratings

Five CQC key questions
Safe
Inadequate
Effective
Inadequate
Caring
Good
Responsive
Requires Improvement
Well-led
Inadequate

Earlier inspection findings

pre-2024 framework · 6 must-do 1 should-do

Must-do actions (6)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 6
Must do
Responsive
Care plans did not evidence people received regular personal care and care plans were not always accurate and contemporaneous records of people's needs.
Regulation: Regulation 9 HSCA RA Regulations 2014 Person-centred care
⚠ Care plans did not evidence people received regular personal care and care plans were not always accurate and contemporaneous records of people's needs.
Must-do action 2 of 6
Must do
Effective
The provider was not operating within the principles of the Mental Capacity Act 2005 and systems around assessing people's capacity and making decisions in people's best interests were not robust.
Regulation: Regulation 11 HSCA RA Regulations 2014 Need for consent
⚠ The provider was not operating within the principles of the Mental Capacity Act 2005 and systems around assessing people's capacity and making decisions in people's best interests were not robust.
Must-do action 3 of 6
Must do
Safe
Systems and processes around health and safety were not in place or were not followed adequately to ensure the building and equipment were safe. People did not always receive their medicines as prescribed and systems around monitoring medicines administration and records were not robust.
Regulation: Regulation 12 HSCA RA Regulations 2014 Safe care and treatment
⚠ Systems and processes around health and safety were not in place or were not followed adequately to ensure the building and equipment were safe. People did not always receive their medicines as prescribed and systems around monitoring medicines administration and records were not robust.
Must-do action 4 of 6
Must do
Safe
Systems and processes around safeguarding vulnerable adults were not robust.
Regulation: Regulation 13 HSCA RA Regulations 2014 Safeguarding service users from abuse and improper treatment
⚠ Systems and processes around safeguarding vulnerable adults were not robust.
Must-do action 5 of 6
Must do
Well-led
Management and leadership of the service was inadequate in ensuring there was effective oversight of the service. Governance systems were absent or ineffective in identifying areas of improvement and ensuring improvements were made.
Regulation: Regulation 17 HSCA RA Regulations 2014 Good governance
⚠ Management and leadership of the service was inadequate in ensuring there was effective oversight of the service. Governance systems were absent or ineffective in identifying areas of improvement and ensuring improvements were made.
Must-do action 6 of 6
Must do
Effective
Staff did not receive adequate training and supervision to ensure they were competent in meeting people's needs.
Regulation: Regulation 18 HSCA RA Regulations 2014 Staffing
⚠ Staff did not receive adequate training and supervision to ensure they were competent in meeting people's needs.

Should-do actions (1)

Recommended improvements to enhance service quality.

Should-do action 1 of 1
Should do
Effective
We recommend the provider consider best practice guidance around meeting people's nutritional needs and monitoring their health and wellbeing.

Previous inspection

9 February 2019
RatingRequires Improvement
TypeComprehensive inspection
Actions 2 must-do 3 should-do
1 resolved 4 repeated

Location details

CQC ID: 1-108939262
Local authority: Leeds
Region: Yorkshire & Humberside

Inspection report

Type: Comprehensive inspection
Date: 19 February 2020
Rating: Inadequate
Actions: 6 must-do 1 should-do
AI-extracted 17 Feb 2026