CQC report explained · a nursing home
What the CQC found at Lanercost House - Carlyle Suite
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, April 2019
Rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
This was an unannounced inspection over three days. Inspectors reviewed care plans, staff files, training and management information. They observed care and spoke with relatives, staff and health and social care professionals.
The home cared for 13 people, with space for up to 15. Inspectors found that people were safe, received their medicines as prescribed and lived in a clean home. Staff understood people's dementia-related needs and there were enough staff to provide care.
Relatives were very positive about the care. People were treated with kindness and dignity, and their care plans reflected their preferences. They were supported to take part in activities, go out into the community and access health services.
All five areas were rated Good. This means the inspectors found the home met the relevant standards at the time of this inspection. The previous inspection had rated the home Requires Improvement, but the report says the home was no longer in breach of regulations.
Kind and respectful care
Relatives consistently described staff as warm and caring. Inspectors saw staff helping people feel at ease and protecting their dignity.
“People were treated with kindness, compassion and dignity.” from the report
Improved safety
The home had improved how it assessed and communicated risks. Staff followed care plans and responded calmly when people became anxious or distressed.
“Improvements had been made to the way risks were managed.” from the report
Personalised support
Care plans recorded people's histories, likes, dislikes and care preferences. Staff supported people to make choices and remain as independent as possible.
“Care plans which described how staff should care for people were specific and detailed.” from the report
Activities and trips
People took part in activities linked to their interests and were supported to go for walks, attend local events and take trips in the community.
“People could take part in a range of activities inside and outside of the home.” from the report
Care qualifications
minorOnly two care staff had completed a care qualification at the time of inspection. The provider had recognised this as an area for development.
“At the time of the inspection, only two members of care staff had completed a care qualification.” from the report
Bedroom signs
minorAfter renovation, some bedroom doors had not yet been personalised. Staff said they would work with people and families to add meaningful visual signs.
“After a recent renovation some bedroom doors had not been personalised.” from the report
Feedback collected across two homes
minorThe latest survey combined feedback from this home with another service on the same site. Inspectors said this could dilute feedback specific to this home.
“The survey had been sent to people and families of both of the homes and collated.” from the report
- 01What progress has been made in helping more care staff complete a care qualification?
- 02How are risks and changes in a person's behaviour recorded and shared with all staff?
- 03How will you make bedroom doors meaningful and recognisable for each person?
- 04How do you collect and review feedback that relates specifically to this home rather than the other home on the site?
- 05How will you involve our family member in decisions if they cannot make a particular decision themselves?
This was an unannounced inspection of the overall service, including both the premises and care, and all five CQC question areas were rated. This explanation was written from the published report of 18 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, September 2018
Rated Requires Improvement; inspectors found unsafe gaps in risk planning and staff training, although medicines and emergency arrangements were managed well.
This was an unannounced inspection on 18 July 2018. It was prompted partly by concerns about moving and handling, personal care and pressure care. The inspection did not examine the circumstances of an incident because it was subject to a criminal investigation.
Inspectors looked at whether the home was safe and well-led. They reviewed five care records and three staff files, spoke with people living there, relatives, staff and professionals, and observed care. They found that risk assessments and care plans were not always followed or updated correctly.
Some staff had not completed the training needed for important safety measures. Repositioning records were also incomplete. Medicines, equipment checks, staffing on the day, cleanliness and emergency evacuation plans were satisfactory.
The overall rating was Requires Improvement. Safe and well-led were both rated Requires Improvement. The other three areas were not inspected and their previous ratings were used in the overall rating. This was the second time the home had been rated Requires Improvement.
Medicines managed safely
Inspectors found medicines were stored, administered and recorded appropriately. Staff administering medicines had training and their competence was checked.
“We carried out spot checks on medicine administration records and found them to be correct.” from the report
Emergency planning
Each person had a detailed personal evacuation plan. The home also had a business continuity plan for events such as fire or loss of power.
“We found personal emergency evacuation plans (PEEPs) in place for each person.” from the report
Staff understood safeguarding
Staff could describe different types of abuse and knew how to report concerns. A whistleblowing policy was also available.
“This meant staff knew how to identify and report abuse.” from the report
Open management
The manager and staff worked openly with inspectors. Records were provided promptly and incidents and complaints were reviewed.
“During the inspection, the registered manager and their team were keen to work with us in an open and transparent way.” from the report
Care plans were not always followed
seriousA moving and handling assessment from an occupational therapist had not been transferred properly into the care plan. Staff were therefore not always using the safest method when transferring one person.
“Subsequently staff were not following best and safe practice when using a hoist to help transfer the person from their bed to a chair.” from the report
Training gaps
seriousFor a care approach involving restraint during distress, only four of 15 staff had the correct training. Four had no training and seven had training that had expired.
“This indicated the majority of staff had experience in supporting people in this way but had not met training requirements highlighted in the assessment and care plan.” from the report
Quality checks needed more development
needs fixingThe manager had increased audits and introduced new checks, but CQC recommended that the home continued to improve its quality assurance systems.
“We recommended the service continued to improve its quality assurance systems and we will continue to monitor this.” from the report
- 01Have all staff who support moving, handling, personal care or restraint completed the correct and current training?
- 02How do you make sure occupational therapist advice is transferred into each person's care plan and followed by every shift?
- 03How are repositioning charts checked each day, and what happens if a record is missing?
- 04What action have you taken in response to the Regulation 12 breach, and has CQC checked the improvements?
- 05What were the results of the additional audits and management checks introduced after this inspection?
This was an unannounced focused inspection of Safe and Well-led only; the other three ratings were not inspected and carried over from the previous comprehensive inspection. This explanation was written from the published report of 28 September 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.
Every inspection of Lanercost House - Carlyle Suite
5 rated inspections over 3 years: the service has improved, from Inadequate to Good.
- April 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Lanercost House - Carlyle Suite →
- September 2018Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Lanercost House - Carlyle Suite →
- January 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: InadequateWell-led: Inadequate
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 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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