CQC report explained · a residential care home
What the CQC found at Larkswood
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found safe staffing and caring support, but weaknesses in safety checks, infection control and management oversight.
This was an unannounced inspection on 13 December 2022. One inspector spoke with people, relatives, staff and a health professional. They reviewed care plans, medicines records, recruitment files and management records.
People generally received personalised care. Staff understood people's needs, medicines were given safely and staffing levels were enough to meet needs. People and relatives said they felt safe and well supported. The home also used audits and gathered people's views.
The inspectors found problems with consent for sensor mats, staff checks, mask use and notifications to CQC. The overall rating changed from Good to Requires Improvement. Safe was rated Requires Improvement, and Well-led remained Requires Improvement. The other questions were not inspected and their previous ratings were carried forward.
Enough staff
The inspectors found enough trained staff to meet people's needs. Rotas supported this finding.
“There were sufficient numbers of trained staff on duty to meet people's needs.” from the report
Medicines and risk management
People's risks were assessed and medicines were administered and recorded safely during the inspection.
“People received their prescribed medicines as required. People's risks had been identified and assessed as needed.” from the report
Personalised communication
The home adapted communication for a person whose first language was not English and arranged an interpreter when needed.
“Staff had developed signs to communicate with them and brought in an interpreter when a specific situation needed to be discussed.” from the report
Audits and feedback
The home had audits covering several areas and used residents' meetings to gather people's views.
“A robust system of audits monitored and measured the service and were used to drive improvements.” from the report
Consent for sensor mats
needs fixingSensor mats had been placed beside every person's bed without first obtaining their agreement. The management team said this would be corrected after the inspection.
“Sensor mats restrict people's freedom of movement, and consent for these to be used unreservedly should have been obtained from people before being put into use.” from the report
Recruitment checks
needs fixingTwo staff who returned to the home after working elsewhere did not have new DBS checks. The inspectors said this was an area needing improvement.
“However, a new Disclosure and Barring Service (DBS) check had not been completed for either staff member.” from the report
Mask use
needs fixingStaff were not wearing disposable masks as required by the government guidance that applied at the time of the inspection. They were reminded during the visit.
“Staff did not wear disposable masks and were under the impression these were no longer required.” from the report
Missed notifications
needs fixingRequired notifications about a death and a serious injury had not been sent to CQC. Notifications were submitted retrospectively after the inspection.
“The previous manager had not always notified CQC when a person died, either at the home or in hospital.” from the report
- 01Have all people now agreed to the use of sensor mats, and how is that consent recorded?
- 02Have new DBS checks been completed for the two staff who returned after working elsewhere?
- 03What is the current process for sending CQC notifications about deaths, serious injuries and other incidents?
- 04How are medicine stock checks now formally recorded and audited?
- 05Has the lapsed DoLS authorisation been renewed, and how are future renewals tracked?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key-question ratings were carried over from the previous inspection. This explanation was written from the published report of 31 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, August 2019
Rated Good; inspectors found safe, kind and personalised care, but frequent management changes and incomplete records meant well-led was Requires Improvement.
This was an unannounced inspection on 13 August 2019. Inspectors spoke with people living in the home, relatives, a visitor, healthcare professionals, staff and the provider. They also checked care records, medicines records, staff files and management documents.
The home was rated Good overall. Safe, Effective, Caring and Responsive were all rated Good. Inspectors found enough staff, safe medicines arrangements, suitable care planning, kind staff and good support for people's choices, health, relationships and activities.
Well-led was rated Requires Improvement. The home had no registered manager, and there had been frequent changes in management. Staff supervision and team meetings were not recorded regularly, complaints records were not always kept as required, and improvements needed more time to become firmly established.
The overall rating improved from Requires Improvement at the previous inspection. The four previous breaches had been addressed, and the provider was no longer in breach of regulations at this inspection.
Safe care and medicines
Inspectors found reliable arrangements for ordering, giving, recording and disposing of medicines. Risks such as falls, skin damage and poor nutrition were assessed and reviewed.
“There were reliable arrangements for ordering, administering and disposing of medicines.” from the report
Kind and respectful staff
People were treated warmly and respectfully. Staff knew people's preferences and supported privacy, dignity and independence.
“We observed people were treated with kindness and care by staff.” from the report
Personalised support
Care plans included people's preferences, backgrounds, health needs and daily choices. Staff were observed supporting people to make decisions about their care and routines.
“Care plans were personalised and included up to date information for staff on how best to support them with their assessed needs.” from the report
Good food and healthcare support
People spoke positively about the food and had choices, including support for special diets. Staff arranged healthcare promptly and shared information with other services.
“People were provided with the support they required to reduce the risk of malnutrition and dehydration.” from the report
Frequent management changes
needs fixingThere was no registered manager at the time of inspection, and three managers had left since January 2019. People, relatives and staff said this caused worry and unsettlement.
“Since the service registered in January 2011, there has been a continual change of management.” from the report
Staff supervision and meetings
needs fixingStaff did not receive formal supervision as often as the home's policy required. Team meetings were also infrequent, and informal support was not recorded.
“We reviewed all of the supervision records for 2018 and 2019 which indicated staff had each received one formal supervision in this timeframe.” from the report
Complaint records
needs fixingComplaints were investigated and resolved, but records were not always kept in line with the home's policy. Some information was written on separate, undated pieces of paper.
“The information was not in one record, but noted on pieces of paper, undated.” from the report
Improvements not yet embedded
minorGovernance and care records had improved, but inspectors wanted more time to see whether these changes would be sustained and become part of the home's usual practice.
“The improvements made, needed more time to be sustained, maintained and fully embedded into the culture of the service.” from the report
- 01Who is the registered manager now, and how long have they been in post?
- 02How are staff supervision sessions and team meetings now scheduled and recorded?
- 03How are complaints recorded, investigated and checked to make sure the home's complaints policy is followed?
- 04What evidence can you show that the improved care records and audit systems have been sustained?
- 05How will relatives and residents be kept informed about management changes?
This was an unannounced planned inspection covering all five CQC questions, including the care provided and the care home premises. This explanation was written from the published report of 29 August 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 Larkswood
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2019Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2015
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 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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