CQC report explained · a residential care home
What the CQC found at Lady Dane Farmhouse
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, March 2021
Rated Good; inspectors found safer care and stronger management, with this inspection focused only on Safe and Well-led.
This was an unannounced, focused inspection on 4 March 2021. Two inspectors spoke with two people and six staff, checked medicines, care plans, training and rota records, and reviewed further records after the visit. They also sought feedback from relatives.
The home had improved its arrangements for assessing risks and managing medicines. Risk assessments contained the information staff needed, medicines were checked using new electronic technology, and staff were trained to identify abuse. Inspectors were also assured about infection control measures during the COVID-19 pandemic.
The home was rated Good overall, improving from Requires Improvement at the previous inspection published on 25 November 2019. Safe and Well-led were both rated Good. This visit did not inspect Effective, Caring or Responsive, so earlier ratings for those areas were carried forward.
Risk management
Risks had been identified, assessed and reviewed. Staff had clear instructions about what to do if risks occurred.
“At this inspection we found the registered manager had made improvements and were no longer in breach of regulation 12, risks were safely assessed and mitigated.” from the report
Safe medicines
New electronic dispensing technology and regular audits had addressed the previous problems with medicines.
“We looked at specific medicines, and all medicines tallied with medicine records.” from the report
Person-centred support
The report says support was personalised and aimed to give people choice, independence and opportunities to develop skills.
“People received care and support that was personalised to their individual needs.” from the report
Management and communication
Staff understood their roles and relatives said they felt listened to. The home used audits, newsletters and feedback to improve its work.
“Relatives said they felt listened to.” from the report
Outstanding vacancies
minorThe report says there were enough staff at the inspection, but vacancies remained and recruitment was under way.
“The registered manager had identified staff vacancies within the home and recruitment was underway to fill these posts.” from the report
Size of the home
minorThe home was larger than recommended by best practice guidance. Inspectors said the building design helped reduce any negative impact on people.
“The service is larger than recommended by best practice guidance.” from the report
- 01How many staff vacancies are there now, and how are shifts covered while recruitment continues?
- 02How are risks and care plans reviewed on the electronic system, and how are families told when needs change?
- 03How does the electronic medicines system work in practice, and what do the latest medicines audits show?
- 04What were the previous ratings for Effective, Caring and Responsive, and when will these areas next be inspected?
- 05How does the building design reduce the possible impact of the home's larger-than-recommended size on residents?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 27 March 2021 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, November 2019
Rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines management and incomplete risk guidance.
This was an unannounced inspection on 2 October 2019. One inspector spoke with people, staff and managers, observed care, and reviewed care, medicines, staff and quality records. Staff files were checked at the provider's main office.
The home was caring, effective and responsive. People were treated with kindness and respect, supported to make choices, and helped to take part in activities and maintain relationships. Staff understood people's needs and worked with health professionals when support needs changed.
Safety and management needed improvement. Some risk assessments lacked clear instructions, including for diabetes and choking. Medicines records were not always accurate and guidance for 'as and when' medicines was limited. Quality checks had not found these problems. The home was in breach of Regulation 12, and CQC required an action plan and planned to monitor progress.
Kind and respectful care
People felt valued and staff were patient, warm and caring. Staff knew people's preferences and supported dignity and equality.
“Staff were compassionate and caring and people felt respected and valued as a result.” from the report
Choice and independence
People were supported to make daily decisions and develop their skills. Staff used pictures, laptops and other approaches to help people communicate choices.
“People were supported to make choices about their care on a daily basis and there was a culture that promoted dignity and independence.” from the report
Activities and relationships
People had activities in the home and community, including holidays, college courses, cooking and music. Families and friends were encouraged to stay involved.
“People had access to a range of activities both in the service and the wider community to prevent isolation.” from the report
Staffing and training
Inspectors found enough staff to support people without rushing them. Recruitment checks were completed and staff had ongoing training and supervision.
“Staff said that overall there were enough staff to give people the support and care they needed.” from the report
Risk guidance was incomplete
seriousSome risk assessments did not explain clearly enough what staff should do. This included risks linked to diabetes, choking and skin damage.
“Potential risks to people's health and welfare had not been consistently assessed and there was not always guidance to mitigate the risk.” from the report
Medicines records and guidance
seriousRecords showed medicines had sometimes been signed for before they were given or on the wrong day. Guidance for medicines given when needed was limited.
“Medicines records had not always been completed accurately when medicines had been given.” from the report
Quality checks missed problems
needs fixingThe home had daily, weekly and monthly checks, but these did not find the safety and medicines issues identified by inspectors.
“Checks and audits had been completed on the quality of the service. However, these had not been effective at identifying the shortfalls found at this inspection” from the report
- 01What has been changed to make sure medicines are recorded only after they are given?
- 02What written guidance is now available for 'as and when' medicines, including when they should be given?
- 03How do staff recognise and respond to high or low blood sugar levels?
- 04What instructions do staff follow if someone starts to choke?
- 05How do your quality checks now identify risks and medicines problems before they affect people?
This was an unannounced inspection of the care home covering all five CQC questions, including the premises and care provided; no person was receiving respite care at the time. This explanation was written from the published report of 26 November 2019 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 Lady Dane Farmhouse
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- March 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- October 2018
Registered with the Care Quality Commission on 2 October 2018.
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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39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.