CQC report explained · a residential care home
What the CQC found at Lady Elsie Finney House Home for Older People
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments gave staff updated guidance, and medicines were managed by trained staff with detailed protocols. Inspectors found some missing pressure-area care plans, which were addressed during the inspection, and found cleanliness issues with some equipment.
- Effective?
- Good
- Staff training, supervision and appraisals were in place. People's nutrition, healthcare, consent and best-interest decisions were considered.
- Caring?
- Good
- Staff were kind, respectful and caring. Inspectors saw people being offered choices and having their privacy and dignity respected.
- Responsive?
- Good
- Care plans were person-centred, clear and regularly reviewed. The home had a complaints process, activities, and plans recording people's wishes for end of life care.
- Well-led?
- Good
- The management team carried out audits, acted on feedback and had clear responsibilities. Staff said managers were visible, supportive and available.
What inspectors found, August 2018
Lady Elsie Finney House Home for Older People was rated Good; inspectors found kind, safe and personalised care, with some cleanliness issues.
Inspectors visited on 19 and 20 July 2018. The first visit was unannounced and the second was announced. They spoke with residents, relatives and staff, checked care and medicines records, and looked around the home.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were assessed, medicines were managed safely, staff were trained, and people received care based on their needs and preferences.
Staff were described as kind and respectful. People were offered choices, supported to stay healthy, and helped to take part in activities. Care plans were reviewed and included people's wishes, including some end of life preferences.
Some carpets and dusty areas needed attention. Bath and shower chairs had ingrained dirt, but replacement equipment was sourced during the inspection and the audit process was changed. Issues from the previous inspection about risk plans, feedback, medicines records and training records had been improved.
Kind and respectful staff
Residents and relatives gave consistently positive views about the staff. Inspectors saw staff communicating respectfully and protecting people's dignity and privacy.
“We saw staff speaking with people who lived at the home in a respectful and dignified manner.” from the report
Personalised care
Care records included people's histories, beliefs, likes and wishes. Staff followed this guidance and supported people to make choices.
“We saw care records were written in a person-centred way and we observed staff followed the guidance in care records.” from the report
Improved risk and medicines management
Compared with the previous inspection, risk assessments and as-needed medicines protocols had improved. Audits gave managers oversight of medicines.
“These protocols were in depth and contained person-centred information to guide staff.” from the report
Supportive leadership
Managers sought feedback, reviewed the quality of care and acted on identified improvements. Staff said they felt supported and listened to.
“Staff told us they received constructive feedback on any areas for improvement from members of the management team, such as medicines procedures.” from the report
Cleanliness of some equipment
needs fixingAlthough the home was generally clean and tidy, inspectors found ingrained dirt on bath and shower chairs, as well as some dusty areas. Replacement equipment was sourced before the inspection ended and checks were strengthened.
“However, upon further inspection we found that bath and shower chairs had ingrained dirt on them.” from the report
A missing pressure-area plan
minorInspectors found missing plans for pressure-area care. The issue was addressed during the inspection, but families should ask how these plans are now checked and kept up to date.
“We did find missing plans around pressure area care, however this was addressed during the inspection.” from the report
- 01How do you now check bath and shower chairs, carpets and dusty areas, and how often are these checks reviewed?
- 02How are pressure-area care plans checked to make sure they are complete and updated when people's needs change?
- 03How do you check that medicines administration records match the instructions for as-needed and variable-dose medicines?
- 04How will you involve my relative and our family in care planning, including any end of life wishes?
- 05What activities are available, and how do you adapt them to each person's interests and abilities?
This was a planned inspection covering all five key questions, with an unannounced visit on 19 July and an announced follow-up visit on 20 July 2018. This explanation was written from the published report of 15 August 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 2017
Rated Requires Improvement; inspectors found kind, responsive care, but safety records and management checks were not reliable enough.
The inspection took place on 20 and 21 July 2017. The first day was unannounced. An inspector and an expert by experience spoke with people, relatives, staff and managers. They observed care, checked the building and reviewed care plans, medicines, training and management records.
People were generally treated kindly and had personalised care, food choices, activities and access to healthcare. Staffing levels had improved since the previous inspection, and staff were not seen rushing. However, some care plans did not explain how to manage important risks. Medicines instructions were not always consistent, and thickening powder was left where people could reach it on the first day.
The home was rated Good for Effective, Caring and Responsive. It was rated Requires Improvement for Safe and Well-led, giving an overall rating of Requires Improvement. The provider breached regulations about safe care and treatment and good governance.
Improved staffing
Staffing levels had been reviewed and increased since the previous inspection. Inspectors found staff had time to respond safely and did not appear rushed.
“We noted staff were not rushing and had time to respond to people in a safe and timely manner.” from the report
Kind care
Inspectors saw warm and respectful interactions. Staff spent time listening and supported people at their own pace.
“We observed people being supported by staff with kindness and compassion in their day-to-day care.” from the report
Personalised support
Care plans included people's histories, likes, dislikes and preferred support. Staff used this information to build relationships and adapt care.
“This showed the provider had gathered personalised information to guide staff to deliver support that was responsive to their needs.” from the report
Activities and social life
People had access to group and individual activities, including music, quizzes, visits and pet therapy.
“This showed the provider recognised activities were essential and provided a varied timetable to stimulate and maintain people's social health.” from the report
Food and healthcare
People were offered choices and regular drinks and snacks. Staff responded promptly to health problems and involved healthcare professionals.
“This showed people were supported to have sufficient to eat, drink, and maintain a balanced diet.” from the report
Important risks were not clearly recorded
seriousSome care plans did not explain how staff should manage risks linked to diabetes, behaviour or mobility. This could leave staff without clear guidance when people needed help.
“This meant documentation did not reflect the person's needs and did not offer strategies to manage the risk and keep them safe.” from the report
Medicine instructions conflicted
seriousSome records did not clearly state the dose for medicines given when needed. The report said this created a risk that people could receive more or fewer tablets than necessary.
“This meant people were at risk of receiving more or less tablets than were necessary.” from the report
Thickening powder was accessible
seriousPowder used to thicken drinks was within people's reach on the first inspection day, despite a known choking risk. It was stored securely on the second day after inspectors raised the concern.
“On the first day of our inspection, we observed powder used to thicken drinks was accessible to people who lived at the home.” from the report
Feedback was not followed through
needs fixingSome survey responses said people were afraid to ask staff or felt staff did not listen. The home could not show that it had properly discussed these concerns with the people who raised them or taken suitable action.
“They were unable to show evidence they had responded appropriately to the feedback and that any action had been taken.” from the report
Training records were inaccurate
minorStaff spoke positively about training, but the records did not always accurately show who had completed it. The manager said processes would be reviewed.
“Some of our information is inaccurate.” from the report
- 01How have you updated care plans so staff have clear instructions for diabetes, behaviour and mobility risks?
- 02How do you now check that as-needed medicine records give the correct dose and match the medication administration records?
- 03How are thickening powders and other items with a choking risk stored safely and checked?
- 04What action did you take in response to the survey comments from people who felt afraid to ask staff or were not listened to?
- 05How do you now keep training records accurate and make sure refresher training is completed?
This was a comprehensive inspection covering all five CQC questions, with the first day unannounced; the report also compares staffing with the previous inspection on 14 November 2014. This explanation was written from the published report of 20 September 2017 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 Elsie Finney House Home for Older People
3 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Lady Elsie Finney House Home for Older People →
- September 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Lady Elsie Finney House Home for Older People →
- January 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 2 February 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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85 live-in carers within about an hour of Lancashire
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. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.