Enter and view: Catherine Lodge Care Home

Healthwatch Barnet carried out an Enter and View visit to Catherine Lodge on 5 December 2019 to assess the quality of care provided to older residents. The home accommodated 39 residents, many of whom had lived there for several years, and some were living with dementia. During the visit, Healthwatch spoke with staff, residents and relatives. 

Overall, the report found that Catherine Lodge was a clean, well-maintained and well-run care home that provided high-quality care. Residents and relatives consistently reported being happy with the care received, describing the environment as warm, caring and supportive. Staff were observed to be respectful, approachable and dedicated, and staff turnover was low, which helped maintain continuity of care. 

The home was found to have strong management arrangements and sufficient staffing levels. Staff received regular supervision and training, and management carried out quality assurance monitoring. However, Healthwatch expressed concerns about some training being completed through e-learning in staff members’ own time and questioned how effectively learning outcomes were monitored, particularly for staff whose first language was not English.

Residents benefited from robust healthcare support, including regular visits from a dedicated GP, opticians, chiropodists and district nurses. Catherine Lodge held Gold Standards Framework accreditation for end-of-life care and was praised for its close partnership working with healthcare professionals. Care plans were comprehensive, regularly reviewed and developed with input from residents and relatives. 

Healthwatch highlighted significant concerns about delays in obtaining Deprivation of Liberty Safeguards (DoLS) assessments. At the time of the visit, 11 applications were awaiting approval, some of which had been pending since early 2018. The report noted concerns about the lack of communication and lengthy waiting times from Barnet Adult Social Care Services.

The report also identified concerns about hospital admissions and discharges. Management reported difficulties obtaining timely responses from NHS 111 and 999 services and raised concerns about residents being discharged late in the day and, in many cases, without discharge letters. This created challenges for ensuring continuity of care and medication management. 

Residents enjoyed a wide range of activities, including exercise classes, quizzes, bingo, art, music, dancing, reminiscence sessions, visits from schoolchildren and birthday celebrations. Residents and relatives spoke positively about the activities programme and valued the opportunities for social engagement. 

While the home catered for residents living with dementia, Healthwatch felt it could become more dementia-friendly. The team noted that signage and décor did not reflect dementia-friendly design principles, as there was little colour differentiation between doors and walls and limited visual cues to help orientation. Healthwatch also suggested expanding dementia-specific activities and creating a sensory area for residents. 

Residents were generally satisfied with food quality and meal arrangements. The home offered varied menus, specialist diets and close monitoring of nutritional needs. Healthwatch recommended the introduction of food moulds to improve the presentation of pureed meals for residents who had swallowing difficulties. 

Feedback from residents and relatives was overwhelmingly positive. Residents reported feeling safe, respected and well cared for, while relatives described the home as a genuine, caring environment where staff were committed to residents’ wellbeing. No complaints were raised during the visit and all residents and relatives said they would recommend the home. 

Healthwatch concluded that Catherine Lodge provided high-quality residential care and made recommendations to improve dementia-friendly design, expand dementia-focused activities, introduce food moulds, and review the effectiveness of staff e-learning. It also recommended raising concerns with Barnet Council and the local Clinical Commissioning Group about DoLS delays, hospital discharge practices, and reported problems with NHS 111 and 999 responses. 

In its response, Catherine Lodge welcomed the positive findings and agreed to introduce food moulds and review training arrangements. However, the home did not fully support all dementia-related recommendations, arguing that its small, family-style environment meant some of the suggested environmental adaptations were unnecessary, although it agreed to further consider sensory activities for residents.