CQC report explained · a nursing home
What the CQC found at Lakeview Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from harm, risks were assessed and there were enough staff on the day. Medicines were given by trained nurses and infection control arrangements were in place.
- Effective?
- Good
- Consent and best-interest processes had improved and staff training was arranged around people's needs. People had access to food, drinks, healthcare and support from other professionals.
- Caring?
- Good
- People were treated with kindness, dignity and respect. They and their families were involved in care planning, and staff encouraged independence.
- Responsive?
- Good
- Care was personalised and included support for faith, interests, family contact and meaningful activities. People knew how to complain and the home tracked complaints and acted on them.
- Well-led?
- Good
- The home had a person-centred culture and a dedicated governance team. Audits, action plans, handovers and staff meetings were used to monitor and improve care.
What inspectors found, April 2019
Rated Good; inspectors found safe, kind and personalised care, with some care plans less person-centred than others.
This was an unannounced inspection on 14 March 2019. Inspectors reviewed the provider's information, notifications, care and staff records, medicines records, complaints, accidents, audits and quality checks. They spoke with people living at the home, visitors, staff and a visiting health professional.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable risk assessments, kind care, personalised activities and good systems for checking quality.
The inspection found that improvements had been made since the previous inspection, when the service was rated Requires Improvement. One minor area remained: some care plans were more person-centred than others, although inspectors said there was enough information overall to make sure people's views were heard.
Staffing and safety
Inspectors saw enough staff to support people without unnecessary waits. Recruitment, risk assessments and fire safety checks were also in place.
“On the day of inspection, we saw that there were sufficient numbers of staff in the building to ensure people were engaged in activities and they did not have to wait for support.” from the report
Kind and respectful care
Inspectors observed a positive, person-centred culture. People were supported with reassurance, privacy, dignity and independence.
“People were treated with kindness and respect and the atmosphere in the service remained positive throughout the day.” from the report
Activities and personal interests
People had access to activities linked to their interests, including activities for people with advanced dementia. Family contact was supported through a designated family space.
“We saw evidence of people being supported with past interests as well as being encouraged to try new things.” from the report
Quality monitoring
The provider used audits, action plans and a dedicated governance team to check care and follow up areas that needed improvement.
“Each unit in the service completed various audits throughout the year which were double checked and action plans were drawn up, with set completion dates.” from the report
Care plan consistency
minorSome care plans were more person-centred than others. Inspectors still found enough information overall, but families should check that their relative's preferences and changing needs are clearly recorded.
“We found that some care plans were more person centred than others but that overall there was sufficient information to ensure the person's voice was heard.” from the report
- 01How will you make sure my relative's care plan reflects their preferences and is updated when their needs change?
- 02How many staff would normally be available for my relative's unit, and how would you cover any staffing gaps?
- 03What training do staff supporting people with dementia or challenging behaviour receive?
- 04How would you record and follow my relative's end of life wishes, including any DNAR agreement?
- 05How would you respond if my family raised a complaint, and how would we be told what action was taken?
This was an unannounced inspection covering all five CQC questions; inspectors spoke with 12 people, 10 visitors and 10 staff, and reviewed nine care files and other service records. This explanation was written from the published report of 17 April 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.
What inspectors found, November 2017
Rated Requires Improvement; inspectors found safe, kind and responsive care, but improvements were needed in decision-making, health referrals and quality checks.
Inspectors visited unannounced on 3 October 2017. They observed care, spoke with people, relatives, staff and managers, and checked care records, staff files and quality records.
The home was rated Good for Safe, Caring and Responsive. People felt safe, medicines were managed safely, staff were kind, privacy and independence were respected, and activities and personalised care were available.
The home was rated Requires Improvement for Effective and Well-led. Mental capacity records were not always specific to each decision, one person did not receive a timely referral to a speech and language professional, and quality checks had not identified some problems. The overall rating of Requires Improvement means the home was not consistently meeting the expected standard, although inspectors found some improvements since October 2016.
People felt safe
People said they felt safe, risks were assessed, and staff knew how to respond to safeguarding concerns.
“People felt safe and staff understood when individuals were at risk.” from the report
Kind and respectful care
Inspectors saw staff supporting people in a kind and reassuring way. Privacy, dignity and independence were promoted.
“We observed people were supported in a kind and caring way in a relaxed and friendly manner.” from the report
Personalised support
Staff knew people well and care reflected personal preferences and cultural needs.
“We saw that staff knew people well and their cultural needs had been considered.” from the report
Activities and choice
People could take part in activities and pastimes they enjoyed, and they were supported to make choices about their day.
“People had the opportunity to participate in activities they enjoyed.” from the report
Decision-making records
needs fixingSome mental capacity assessments covered several decisions together instead of showing how each decision had been considered. Some best-interest decisions were also unclear.
“This meant these assessments were not decision specific as required.” from the report
Delayed health referral
seriousOne person had difficulty eating and drinking and was coughing severely. Inspectors found that a speech and language referral had not been made promptly.
“Although concerns had continued a referral to speech and language had not been made.” from the report
Quality checks missed problems
needs fixingAudits did not identify that one person's dressing was not always changed as planned. They also did not identify differences between medicines stock and electronic records.
“The provider's audits had not identified this concern.” from the report
Management registration
minorThere was no registered manager in post at the time of the inspection. The manager in post was in the process of registering with the CQC.
“The service did not have a registered manager in post.” from the report
- 01How do you now make sure mental capacity assessments are completed separately for each decision?
- 02How do you make sure relatives only make decisions on someone's behalf when they have the appropriate legal authority?
- 03What system now makes sure eating and drinking concerns are referred promptly to the right health professional?
- 04How have you changed the audits for pressure care and medicines stock checks?
- 05Is the manager now registered with the CQC, and who has overall responsibility for the home?
This was an unannounced inspection that covered all five key questions, using observations, discussions with people and staff, and checks of care and management records. This explanation was written from the published report of 3 November 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 Lakeview Care Home
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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