CQC report explained · a residential care home
What the CQC found at Lympne Place (High Trees and The Beeches)
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2018
HF Trust - Lympne Place was rated Good overall; inspectors found safe, kind and responsive care, but some records and financial decisions needed improvement.
This was an unannounced inspection on 30 November 2017. Inspectors spoke with the registered manager and six staff. They reviewed five care plans, risk assessments, staff records, rotas, training records, complaints, surveys and audits.
The home supported 12 people with learning disabilities and other complex needs. Inspectors found enough staff, safe medicines management, clear risk guidance and good support with health needs. People were treated with kindness and respect, supported to make choices and encouraged to be independent.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Effective was rated Requires Improvement because financial best-interest decisions were not always recorded and staff did not consistently record people's goals, activities or achievements.
Safer medicines
Medicines were stored in locked cabinets in people's rooms. Records were complete and regular checks had been introduced after problems at the previous inspection.
“Medicines were now managed safely and stored in people's individual rooms.” from the report
Kind, respectful support
Inspectors saw strong relationships between people and staff. Staff adapted their communication and support to each person's needs.
“Staff treated people with dignity and respect. People told us that staff were kind and caring.” from the report
Choice and independence
People were supported to choose meals, activities and daily routines. They could help with household tasks, go out and, for some people, work or volunteer.
“People took part in a range of activities both inside and outside of the service.” from the report
Management oversight
The registered manager used audits, feedback and action plans to identify and address problems. The previous breaches had been met.
“The registered manager completed regular checks and audits and any issues were identified and rectified.” from the report
Financial decisions were not recorded
seriousThe home had not recorded the required agreements or best-interest decisions when people's money was used to pay for staff meals. Inspectors identified a risk of financial abuse. Money was refunded after the inspection and meetings were planned.
“People had not agreed to this arrangement and it was not clearly documented.” from the report
Goals and achievements were missed
needs fixingStaff did not consistently record people's goals, daily activities or achievements. Inspectors said this could affect whether staff supported people consistently to reach their hopes and wishes.
“Staff had not kept consistent records of people's achievements or set goals for them to achieve, in line with best practice when supporting people with learning disabilities.” from the report
Staff were unclear about meal payments
needs fixingStaff gave different answers about when people should pay for a staff member's meal while eating out. The registered manager reviewed the policy and clarified it with staff after the inspection.
“There was confusion among the staff so we checked the local policy.” from the report
- 01How are people's goals, daily activities and achievements recorded now, including if the online system is unavailable?
- 02Have best-interest decisions about people's finances now been recorded in each person's support plan?
- 03How are staff told when people can or cannot pay for a staff member's meal when eating out?
- 04Have all refunds linked to staff meal payments been completed and checked?
- 05How are medicines audits and medicine administration records checked when senior staff are absent?
This was an unannounced inspection covering all five CQC questions, including the premises, care plans, risk assessments, staffing, training, medicines and management records. This explanation was written from the published report of 16 January 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2016
HF Trust - Lympne Place (High Trees and The Beeches) was rated Requires Improvement because medicines and management checks were not consistently safe.
This was an unannounced inspection on 12 and 16 August 2016. Two inspectors observed care, checked records and medicines, and spoke with people, staff, relatives and social care professionals.
The home was rated Good for Effective, Caring and Responsive. Inspectors found kind and respectful staff, personalised care, good support with health needs, and activities that reflected people's choices.
The home was rated Requires Improvement for Safe and Well-led. Medicines were not always managed safely at The Beeches. Some required notifications had not been sent to the CQC, and management support and checks were not strong enough.
The report says three legal regulations were breached. The previous inspection in January 2014 found no concerns. The provider was asked to send the CQC a report explaining what it would do.
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. Staffing was adjusted around activities and appointments.
“There were enough staff on duty to meet people's needs and keep them safe.” from the report
Kind and respectful care
Staff took time to listen and communicate in ways suited to each person. Inspectors saw people being treated with dignity and compassion.
“Staff took the time to listen and interact with people so that they received the individual support they needed.” from the report
Health support
People were supported to attend health appointments and staff monitored their health needs. Care plans included guidance about conditions and warning signs.
“People's health was monitored and when it was necessary health care professionals were involved to make sure people were supported to remain as healthy as possible.” from the report
Personalised activities
People had flexible activity timetables and were supported to take part in activities at home and in the community, including work, college and trips out.
“People were supported to take part in activities and staff supported people to undertake a choice of leisure activities within the service and in the community.” from the report
Medicine safety
seriousAt The Beeches, the medicines cabinet key was left in the lock, some records were inaccurate or incomplete, and some medicines did not match the recorded day. The home could not assure inspectors that medicines were always given as intended.
“We reviewed Medication Administration Record Sheets (MARS), some gaps were identified and the tablets taken from some of the dispensed dosage systems did not correlate with the correct day” from the report
Missed notifications
seriousThe home had not told the CQC about the outcomes of some Deprivation of Liberty Safeguards applications at The Beeches. The manager corrected this after the inspection.
“They had not notified us of the outcomes of Deprivation of liberty applications at The Beeches.” from the report
Limited management oversight
seriousRestructured staffing left the registered manager with insufficient senior or deputy manager support across both homes. Inspectors linked this to gaps in monitoring, including medicines checks.
“Shortfalls and gaps in quality monitoring identified at The Beeches during the inspection indicated that people and services would benefit from increased management support” from the report
Hard-to-follow records
minorCare records were maintained but included repeated information. Inspectors said this could make it harder for staff to find and follow the most up-to-date guidance.
“Although the risk to people not receiving the appropriate support was minimal, it could mean that staff may not read through the entire contents or may miss some important guidance” from the report
- 01What changes have been made to medicines storage, administration records and weekly medicine checks at The Beeches?
- 02How do you now check that medicines taken from dispensing systems match the correct day and are recorded accurately?
- 03What additional senior or deputy management support is now in place across High Trees and The Beeches?
- 04How do you make sure all Deprivation of Liberty Safeguards applications and outcomes are notified to the CQC on time?
- 05How have the support files been simplified so staff can find the most up-to-date guidance easily?
This was an unannounced comprehensive inspection of both registered homes, covering all five key questions, with visits on 12 and 16 August 2016. This explanation was written from the published report of 10 September 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Lympne Place (High Trees and The Beeches)
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- January 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Lympne Place (High Trees and The Beeches) →
- September 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Lympne Place (High Trees and The Beeches) →
- March 2014
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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