CQC report explained · a residential care home
What the CQC found at Larchwood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Larchwood Care Home was rated Good overall, but Safe was Requires Improvement because medicines, staffing and some risk records were not always managed safely.
Inspectors made an unannounced visit on 7 November 2019. They spoke with people living in the home, relatives, staff and a visiting professional. They also checked care plans, medicines records, recruitment files, staffing rotas and quality checks.
People generally said they were happy and that staff were kind and caring. Inspectors found good care, effective support, personalised activities and helpful involvement from health professionals. However, staff said there were not always enough of them, and inspectors saw poor moving and handling practice while staff were busy.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement because medicines were missed, some risk records were incomplete and safety systems were not always followed. The Safe rating had fallen from Good at the previous inspection.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff treating people with kindness, dignity and respect.
“People told us that they were happy living in the service and staff were kind and caring.” from the report
Personalised care
Care plans included people's preferences, communication needs and what might cause anxiety or stress. Staff knew people well.
“Care plans were in place to guide staff and were detailed and informative.” from the report
Food and choice
Meals were attractive and people could choose what they wanted. Specialist diets were available and staff supported people at an appropriate pace.
“Meals looked appetising and staff supported people to make choices by showing them the meals which were available.” from the report
Activities and social contact
People had access to different activities and events, helping them stay involved and avoid social isolation.
“People were supported to access a range of stimulating activities.” from the report
Staffing and moving people safely
seriousStaff said there were not always enough staff, particularly when several people needed two staff members. Inspectors observed poor moving and handling practice while staff were rushing people to lunch.
“Staff were observed to be busy and as they were rushing to move people to the dining room for lunch, we observed some poor moving and handling practice” from the report
Missed medicines
seriousOne person did not receive prescribed medicines for seven days, and the refusal was not escalated as required. Records for creams and lotions were also incomplete.
“We observed that one person had not received their prescribed medicines for a period of seven days, but the system had not been followed” from the report
Catheter monitoring
seriousSome people's catheter records did not show that bag changes had taken place when required. The manager said the recording and review system was changed.
“Some people had catheters in place but there were gaps in the documentation and we could not see that catheter bag changes had taken place as required.” from the report
Quality checks did not find every problem
needs fixingThe home's audits covered areas such as medicines, care plans and the environment, but they had not detected all the inconsistencies found by inspectors.
“However, these audits had not identified some of the inconsistencies in practice we found in areas such as medicines and catheter care.” from the report
Some end of life plans lacked detail
needs fixingEnd of life plans identified what mattered to people, but some did not contain enough information about what should happen if someone became suddenly ill.
“Some plans would benefit from further information to ensure that there were clear arrangements in place in the event of a sudden illness.” from the report
- 01What changes have been made to staffing levels since the inspection, and how are staffing needs now calculated?
- 02How do you make sure medicine refusals are escalated promptly and that creams and lotions are recorded correctly?
- 03What new system is being used to record and review catheter care, including required bag changes?
- 04How are people monitored after a head injury caused by a fall?
- 05How do your current audits identify problems with medicines, catheter care and moving and handling before they affect people?
This was an unannounced planned inspection covering all five questions, including the care and premises, and the previous overall rating was Good, published on 9 May 2017. This explanation was written from the published report of 7 December 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, May 2017
Larchwood Care Home was rated Good overall; inspectors found safe, kind care, but activities and some care records needed improvement.
The inspection was unannounced and took place on 25 and 26 January 2017. Inspectors spoke with people living there, staff and visiting professionals. They observed care and reviewed care records, medicines, staffing, recruitment and quality checks.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff, safe medicine arrangements, suitable training, good access to healthcare and respectful relationships between staff and residents. People were involved in their care and could make everyday choices.
Responsive was rated Requires Improvement. People wanted more activities. Some care records did not give enough detail about diabetes, wounds, hospital information and patterns of behaviour. The overall rating was Good, but these areas needed attention.
Safe staffing
Inspectors found enough staff to meet people's needs. Recruitment checks were completed before staff started work.
“There were sufficient numbers of staff on duty in order to meet the needs of people using the service.” from the report
Safe medicines
People received their medicines as prescribed. Inspectors found no discrepancies in the medicine records they checked.
“People received their medications as prescribed and management of medicines procedures were in place.” from the report
Kind and respectful care
Staff knew people well and supported their choices, privacy and independence. Inspectors observed calm, polite and compassionate care.
“People were treated with dignity and respect. We saw staff communicating with people in various ways including hand gestures as well as talking to people in a polite and empathic manner.” from the report
Quality monitoring
The home collected views from residents, relatives, staff and other people involved in care. It used audits and action plans to identify improvements.
“This meant that the provider gathered information about the quality of the service from a variety of sources and had systems in place to promote continuous improvement.” from the report
Not enough activities
needs fixingPeople enjoyed the activities but said they wanted more. One of the two activities coordinators was away and their hours were not covered.
“People told us they liked the activities but would have liked more.” from the report
Diabetes information was incomplete
needs fixingA care plan recorded that a person had diabetes but did not explain what staff should do if blood glucose levels were too high or too low.
“However we found information about how to manage people's needs in relation to diabetes was poorly documented.” from the report
Wound monitoring records
needs fixingOne body map did not explain how a wound had happened. There was also no clear record of monitoring its progress or when further specialist advice might be needed.
“However, they did not record how the wound had occurred and following the initial assessment there was no evidence that the staff were monitoring the progress of the wound” from the report
Weight gain was not acted on
needs fixingInspectors found that appropriate action had not been taken for someone whose weight had increased significantly. The manager said this would be discussed with the person and family.
“However, we also saw that staff had not taken the appropriate action to support people whose weight had significantly increased.” from the report
Staffing shortfall covered by agency workers
minorThe home was recruiting and had a shortfall of about 150 staff hours each week. Inspectors found enough staff because the gap was being covered by agency workers.
“They had a staffing deficit of approximately 150 hours a week but were filling the shortfall by using agency staff.” from the report
- 01How many activities are now provided each week, and how are they covered when an activities coordinator is away?
- 02How do you record and monitor support for residents with diabetes, including what staff should do when blood glucose levels are too high or too low?
- 03How are wounds and other skin problems recorded, checked and followed up until they have healed?
- 04Do residents now have hospital passports or equivalent information prepared before an emergency admission?
- 05How many staff vacancies remain, and how often are agency workers being used?
This was an unannounced inspection covering all five key questions, with inspectors observing care, speaking with people, staff and professionals, and reviewing records and management systems. This explanation was written from the published report of 9 May 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 Larchwood Care Home
4 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 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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