CQC report explained · a nursing home
What the CQC found at Lakeview
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Lakeview rated Requires Improvement; inspectors found generally safe care but weaknesses in risk records, medicines records and checks on quality.
This was an unannounced focused inspection. Inspectors visited on four dates and spoke with people, relatives, staff and other professionals. They reviewed care records, medicines records, staffing information, accident reports and audits.
The home was rated Requires Improvement overall. Safe and well-led were both rated Requires Improvement. Inspectors found that risks were generally managed in practice, staffing levels were sufficient and medicines were usually given safely, but some records and storage arrangements were not reliable.
The home had many audits and checks, but these had not always found the problems inspectors identified. The provider made some changes during the inspection, including daily checks of cream records and reorganising cream storage.
The inspection only directly assessed Safe and Well-led. The other areas were not inspected and their previous ratings were used in calculating the overall rating.
Staffing and recruitment
Staffing levels were sufficient to meet people's needs safely. Recruitment included checks such as references and DBS checks.
“Staffing levels were sufficient and staff received training enabling them to meet people's needs effectively.” from the report
Safeguarding
Staff understood how to recognise abuse and raise concerns. The provider worked with safeguarding professionals when incidents occurred.
“The provider had a robust safeguarding policy in place and staff had a good understanding of what abuse to be aware of and how to raise a safeguarding alert if needed.” from the report
Person-centred support
Inspectors saw positive interactions. Staff understood that support should be adapted to each person's wishes and needs.
“We observed positive interactions between staff and people and found staff to have a good understanding of how to adjust their approach depending on who they were supporting.” from the report
Working with other professionals
The home worked with health and social care professionals and shared relevant updates and concerns.
“The provider worked proactively with external professionals.” from the report
Visiting
The home encouraged visits and relatives said there was a clear system for visiting during an infection outbreak.
“The provider encouraged visiting wherever possible.” from the report
Inconsistent risk records
needs fixingSome care plans and risk assessments did not match. One moving and handling assessment had been updated, but related assessments had not been changed.
“However, in some instances we found inconsistencies within people's support plans and risk assessments.” from the report
Falls response
seriousA minority of relatives reported delays when people fell and said follow-up safety measures were not always put in place effectively.
“A minority of relatives we spoke with told us they had observed poor management of falls within the home.” from the report
Medicines records and storage
needs fixingTopical creams were not always stored correctly. Records for applying creams and transdermal patches were not always completed correctly.
“However, we identified topical creams were not always stored correctly.” from the report
Audits did not find problems
needs fixingThe home had many audits, but they had not identified the record problems found by inspectors. The provider was asked to use audits more effectively.
“However, audits and checks had failed to identify inconsistencies within records including electronic body maps, transdermal patch charts and risk assessments.” from the report
Communication after incidents
needs fixingMost relatives felt informed, but a minority said not all staff understood their responsibility to tell families about falls or other incidents.
“However, a minority of relatives felt not all staff understood their responsibilities in reporting to families when people had falls or incidents had occurred.” from the report
- 01How are you making sure every person's risk assessment and support plan contains the same, up-to-date information?
- 02What has changed in the way falls are responded to, recorded and followed up?
- 03How do you now check that creams and transdermal patches are stored safely and recorded correctly?
- 04How can you show that your audits are finding and correcting the problems inspectors identified?
- 05How are families told promptly and consistently when there is a fall or other incident?
This was an unannounced focused inspection of Safe and Well-led, with infection prevention and control also considered; the other ratings carried over from the previous inspection. This explanation was written from the published report of 25 January 2023 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, July 2022
Rated Good; inspectors found safe, well-managed care, but medicines records and staffing levels needed attention.
The inspection activity ran from 24 June to 7 July 2022, with a visit on 24 June. One inspector spoke with people, relatives and staff, and checked care records, medicines records, staffing information, incidents and management audits.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, safeguarding systems were in place, staffing was sufficient for safety, and medicines were generally given safely. Infection prevention and control arrangements were also found to be effective.
There were two points to watch. Some medicines records did not match stock levels, although the manager acted straight away and provided evidence of weekly checks. Some staff said they regularly worked at the minimum staffing level, which could affect how quickly people were supported.
Safeguarding and risk management
Staff understood how to report safeguarding concerns. People's risks were assessed, reviewed and explained clearly to staff.
“Risks associated with the provision of people's care were clearly identified; risk assessments provided staff with clear guidance” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including COVID-19.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Person-centred care
Inspectors found that people's preferences, wishes and dislikes were considered. People were supported to have control over their care.
“Evidence gathered from observations of people's care, a review of records and feedback from people, relatives and staff evidenced a person centred culture throughout the home.” from the report
Quality management
Audits and governance systems identified improvements and helped the provider act on problems. Staff were encouraged to share ideas and reflect on incidents.
“Audits and governance systems were robust.” from the report
Working with others
The provider worked with relatives, staff and external professionals to understand and meet people's wider health and care needs.
“The provider worked in collaboration with people, relatives, staff and external professionals such as dieticians, physiotherapists and GP's to provide a holistic experience of care for people” from the report
Medicines records
needs fixingSome medicine stock levels did not match the records. The manager said this had been addressed and provided evidence of improved weekly checks after the inspection.
“Stock of some people's medicines did not always tally with the stock recorded in medication administration records (MAR).” from the report
Minimum staffing levels
needs fixingSome staff said they regularly worked with only the minimum number of staff required. They said this could make it harder to respond to people, especially during breaks.
“However, some staff identified they worked to the minimum amount of staff required regularly.” from the report
- 01How do you now check that medicine stock matches the medication administration records?
- 02How often is the home staffed at the minimum level, and how do you cover breaks and one-to-one care?
- 03What action is taken if staffing falls below the targeted level needed for social support?
- 04How are changes to people's risks and care plans shared with every member of staff?
- 05How can relatives receive updates or raise concerns if something goes wrong?
This was a focused inspection that rated Safe and Well-led; Caring, Effective and Responsive were not assessed and no new ratings were given for them. This explanation was written from the published report of 15 July 2022 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
4 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Goodstayed GoodSafe: GoodWell-led: Good
- June 2021Goodup from Requires improvementSafe: GoodWell-led: Good
- September 2019Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2018
Registered with the Care Quality Commission on 24 July 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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