CQC report explained · a nursing home
What the CQC found at Larchwood Nursing and Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2021
Larchwood Nursing and Residential Home is Rated Requires Improvement; inspectors found safe, well-led care but some medicines records needed improvement.
This was an unannounced focused inspection on 8 and 25 June 2021. One inspector spoke with people living in the home, relatives, staff and a health professional. Records about care, medicines, incidents, audits and infection control were also checked.
The home was rated Good for Safe and Well-led. Inspectors found that risks were managed, staff understood safeguarding, recruitment checks were completed, infection control was satisfactory and lessons were learnt when things went wrong. Medicines were mostly managed safely, but there were a couple of recording mistakes.
The overall rating remained Requires Improvement. This was because the inspection only assessed Safe and Well-led, while the ratings for the other areas were carried forward from the previous comprehensive inspection. The home had improved and was no longer breaching regulations, but it had been rated Requires Improvement or Inadequate for the last four inspections.
Positive experiences
People and relatives spoken to were generally positive about the care and support. Relatives said staff were kind and reassuring.
“People we spoke with were very happy living at Larchwood.” from the report
Risk management
Care records included assessments and guidance for known risks, such as falls and poor skin condition. Staff could explain people's risks and how to support them.
“Risk assessments were in place for people's known risks.” from the report
Infection control
Inspectors were assured about the home's infection prevention arrangements, including personal protective equipment, testing, visiting and outbreak management.
“We were assured that the provider was using PPE effectively and safely.” from the report
Open management
People, relatives and staff could raise concerns. The manager acted on feedback and kept people informed when mistakes happened.
“The manager and staff encouraged feedback and acted on it to improve the service.” from the report
Medicines records
needs fixingMedicines were mainly managed safely, but inspectors saw a couple of recording mistakes. Management said this would be followed up through staff supervision and later provided evidence that this had happened.
“During our observations we found a couple of mistakes with recording.” from the report
Waiting for staff
needs fixingPeople's basic needs were being met, but staff and relatives gave mixed views about staffing levels. Some people sometimes had to wait a short while for support.
“There was a mixed view on staffing levels, but everyone agreed that people's basic needs were being met, although staff mentioned, sometimes people had to wait a short while.” from the report
- 01What steps were taken after the medicines recording mistakes, and how are records checked now?
- 02How many staff are usually on duty during each shift, and how do you prevent people waiting for support?
- 03What were the home's previous ratings for Effective, Caring and Responsive, and when will these areas next be assessed?
- 04How are incidents, accidents and audit findings shared with staff and used to improve care?
- 05Who is managing the home while the registered manager is away, and how can relatives raise concerns?
This was a focused inspection of Safe and Well-led, including infection control; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 14 July 2021 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 2019
Rated Requires Improvement; inspectors found kind care and clear progress, but medicines and some clinical care were not consistently safe.
This was an unannounced, comprehensive inspection over two days. Inspectors spoke with people living at the home, relatives, staff and health professionals. They reviewed medicines records, care plans and management documents.
The home had improved since its previous inspection, when it was rated Inadequate and placed in Special Measures. People were treated kindly, their privacy was respected, staffing levels were generally enough, and the home was clean. Food, activities, the environment and staff culture had also improved.
However, some people missed prescribed medicines during one morning round. Inspectors also found problems with insulin records, wound care, diabetes care, staff clinical training and some Mental Capacity Act records. The home remained in breach of Regulation 12, although it was no longer in Special Measures.
Kind and respectful staff
Inspectors saw warm and respectful interactions. People’s privacy and dignity were maintained, and relatives described staff as kind and compassionate.
“During our inspection we saw that all staff interacted warmly with people and showed them respect and patience.” from the report
Improved nutrition
The home had improved how it assessed and supported people’s nutritional needs. People had choices, and staff provided assistance where needed.
“Since our inspection in November 2018, the service had made improvements in supporting people with their nutritional needs which we concluded were being met.” from the report
Improved environment and cleanliness
The home was visibly clean, with improvements to its environment since the previous inspection. People had access to personalised rooms and an enclosed courtyard.
“The home and equipment was consistently visibly clean throughout with no malodours present.” from the report
Improved staff culture
Inspectors found better morale, engagement and teamwork than at the previous inspection. The quality monitoring system and action plan had helped drive improvements.
“Since our last inspection in November 2018, we saw improvements in staff morale, culture and engagement.” from the report
Missed medicines
seriousSome people did not receive prescribed medicines during one morning round. Records did not always explain missed doses, and inspectors found discrepancies in one person’s insulin administration.
“On 29 March 2019 some people did not receive their morning medicines as intended by prescribers.” from the report
Clinical care and training
seriousCare was not always delivered as planned for people with diabetes or wounds. Nursing staff needed up-to-date clinical training and competency checks.
“For another person with a wound, we saw that the care was not always delivered as planned and required.” from the report
Mental Capacity Act records
needs fixingSome people’s capacity had not always been assessed properly. Staff understanding of the practical requirements was also inconsistent.
“Some people's capacity to make decisions had not always been assessed as required and care plans were variable in the quality of the related recorded information.” from the report
No registered manager
needs fixingThe registered manager was no longer in post, and recruitment was underway. A regional support manager was managing the home temporarily.
“The service, as required by its registration with CQC, is required to have a registered manager in post.” from the report
- 01What changes have been made to prevent medicines, including insulin, being missed or recorded incorrectly?
- 02How do you now check that staff are competent to provide wound care and diabetes care?
- 03Which staff have completed the planned clinical training, and how are their skills assessed?
- 04How do you assess mental capacity and record best-interest decisions for people who cannot decide for themselves?
- 05When will a permanent registered manager be in post, and how will families be kept informed about management changes?
This was a planned comprehensive inspection covering all five key questions, following the previous Inadequate rating and Special Measures status. This explanation was written from the published report of 2 May 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.
Every inspection of Larchwood Nursing and Residential Home
7 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- July 2021Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Larchwood Nursing and Residential Home →
- May 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Larchwood Nursing and Residential Home →
- November 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- November 2013
Registered with the Care Quality Commission on 4 November 2013.
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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13 live-in carers within about an hour of Norfolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.