CQC report explained · a residential care home
What the CQC found at Landemere Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk monitoring and staffing had improved, but care plans did not always reflect current risks or changes. Medicines improvements were still being implemented and monitored.
- Effective?
- Good
- People received suitable healthcare support, enough food and drink, and care from staff who were generally trained and supported. First aid training was not yet complete for all care staff.
- Caring?
- Good
- People's privacy, dignity, independence, views and preferences were respected. Staff knew people well and supported them to be involved in their care.
- Responsive?
- Good
- Care was personalised and adapted to people's needs. Complaints were investigated, communication needs were assessed, and people were supported with relationships and activities.
- Well-led?
- Requires improvement
- Audits and monitoring had improved, but governance was not yet consistently embedded or sustained. Care plans and records did not always keep pace with changes in people's needs.
What inspectors found, May 2023
Landemere Residential Care Home was rated Requires Improvement; care was kind and responsive, but safety records and management oversight were not yet reliable enough.
This was an unannounced follow-up inspection after the previous Requires Improvement rating. Inspectors visited on 21 and 22 March 2023, spoke with people, relatives, staff and managers, and reviewed care plans, medicines records, audits, training records and recruitment files.
The home had improved since the last inspection. There were enough staff, people said they felt safe, medicines checks were being strengthened, and infection control was satisfactory. Inspectors also found good care, food, activities, communication and support for people's dignity and choices.
However, some care plans did not contain up-to-date information about risks and changing needs. Some restrictions, such as lap belts, were not supported by recorded best-interest decisions. The home was still working to make improvements consistent and lasting, so the overall rating remained Requires Improvement.
Enough staff
Inspectors found enough staff to meet people's needs, with staff responding quickly to call bells and keeping oversight of people.
“There were enough staff to meet people's needs.” from the report
Kind and respectful care
People were treated with dignity and respect. Staff supported independence and knew people's preferences.
“During our inspection we saw staff acted in ways to promote people's dignity and privacy.” from the report
Personalised support
Staff knew people well and provided care around their routines, preferences and communication needs.
“People received personalised care as staff knew them well.” from the report
Activities and relationships
People were supported to maintain relationships, socialise and take part in activities linked to their interests.
“People were supported to follow their interests and enjoy activities.” from the report
Improved complaints handling
Complaints were investigated and reviewed for patterns and lessons that could improve people's care.
“All complaints were investigated and analysed for trends and lessons learnt.” from the report
Care plans not always up to date
needs fixingSome care plans did not record important risks, changes in health or the actions staff should take. In one case, a weight change increased the risk of malnutrition but the plan was not updated and no dietician referral had been made until inspectors raised it.
“Care plans did not always reflect relevant information about people's care needs and changes to these.” from the report
First aid training incomplete
needs fixingThe provider was still working to ensure all care staff completed first aid training. A risk assessment was used so that a first-aid-trained staff member was present on every shift.
“The provider told us the numbers of staff who had completed this training remained low due to staff turnover and cancelled training.” from the report
Medicines improvements still ongoing
needs fixingThe provider had identified medicines errors shortly before the inspection. New checks and actions were in progress, so families should ask how these changes are being sustained.
“Shortly before our inspection, the provider had identified some medicines errors and had taken action to improve medicines safety.” from the report
No registered manager in post
minorThere was no registered manager at the time of the inspection. The current manager had applied to register, and the application was being processed.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01How do you make sure care plans are updated promptly when a person's risks, weight, mobility or health needs change?
- 02What checks are now in place after the medicines errors identified shortly before the inspection?
- 03How do you record best-interest decisions for lap belts and any other restrictions?
- 04How many care staff have now completed first aid training, and what is the plan for those who have not?
- 05Has the current manager's application to become registered been approved?
This was an unannounced follow-up inspection covering all five rating areas, with infection prevention and control also reviewed; inspectors visited the home on 21 and 22 March 2023. This explanation was written from the published report of 11 May 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
Landemere Residential Care Home was rated Requires Improvement; inspectors found risks, staffing and personalised care were not managed consistently.
Inspectors visited on 13 and 14 June 2022. The first visit was unannounced and began in the evening. They spoke with people, a relative, staff and a healthcare professional, and reviewed care records, medicines records, staff files and management records.
The inspection found problems with risk management, staffing levels, call bell response, pressure sore prevention and keeping care records up to date. People did not always receive care that matched their preferences. Some complaints were not recorded, so the home could not properly identify patterns or lessons.
There were also positive findings. Medicines were managed safely, people generally liked the staff, meals were enjoyed, families could visit freely and activities helped reduce isolation. However, all five areas were rated Requires Improvement. Safe remained at this rating, while Effective, Caring, Responsive and Well-led fell from Good at the previous inspection.
Medicines
Inspectors found that medicines were given safely and at the times people needed them. Records reviewed were complete, and staff had regular competency checks.
“People received their medicines at the times they needed them and in a safe way.” from the report
Meals and choices
People enjoyed the food and were offered choices of meals and drinks. Staff helped people who needed support to eat.
“The food is very, very good, we can have biscuits and cake and drinks anytime.” from the report
Activities and visitors
People could see family and friends freely and take part in activities such as gardening, chair exercises, bingo and a choir.
“These activities helped to reduce social isolation, helped people follow their interests and hobbies and build relationships together.” from the report
Risk management
seriousFalls and pressure sore risks were not always reflected accurately in care plans or reduced through suitable action. One catheter bag had not been changed for three weeks despite a weekly schedule.
“The provider had failed to assess risks and adequately monitor and manage people's safety.” from the report
Staffing and call bells
seriousStaff were not always deployed according to identified risks. Inspectors found that call bells could not always be answered quickly, and staffing calculations did not fully reflect the building layout.
“The provider had failed to ensure people received safe care by deploying sufficient staff to meet their needs.” from the report
Personalised care
seriousPeople did not always receive support suited to their needs and preferences. This included emotional support, shower frequency and activities for some people living with dementia.
“The provider had failed to ensure people received care that was appropriate, met their needs and reflected their preferences.” from the report
Privacy of records
needs fixingCare plans and personal records were left unsecured in communal areas. This meant confidential information was not always protected.
“Care plans and people's care records were left un-secured in communal areas.” from the report
Learning from complaints
needs fixingNot all complaints were entered in the complaints log. This meant the home could not show how they were investigated, answered or used to improve care.
“We found complaints that had not been included in the complaints log.” from the report
- 01What has changed to make sure there are enough staff on each shift, and how quickly are call bells now answered?
- 02How are falls, pressure sores and catheter care risks now assessed, recorded and reviewed?
- 03How will you make sure each person's shower preferences and emotional needs are recorded and followed?
- 04How are complaints now logged, investigated and used to identify lessons or patterns?
- 05What action has been taken in response to the Warning Notice, and what evidence can you show that the problems have been fixed?
This was a full inspection covering all five key questions and infection prevention and control; the previous overall rating was Good, with Safe previously Requires Improvement and the other four key questions previously Good. This explanation was written from the published report of 14 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 Landemere Residential Care Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Landemere Residential Care Home →
- July 2022Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Landemere Residential Care Home →
- May 2022Inspected but not ratedSafe: Inspected but not rated
- February 2019Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 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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