CQC report explained · a nursing home
What the CQC found at Latimer Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm, medicines were generally managed safely, risks were reviewed and infection control procedures were followed. They identified that pharmacist advice had not been recorded in some protocols for covert medicines, but the protocols were sent to the pharmacy and signed after the inspection.
- Effective?
- Good
- This question was not inspected during this focused visit, so the report does not give a new rating for it.
- Caring?
- Good
- This question was not inspected during this focused visit, so the report does not give a new rating for it.
- Responsive?
- Good
- This question was not inspected during this focused visit, so the report does not give a new rating for it.
- Well-led?
- Good
- Inspectors found effective audits, regular staff meetings and an approachable manager. Relatives and staff said communication and support had improved.
What inspectors found, October 2022
Latimer Court was rated Good; inspectors found improvements in medicines, safeguarding and management, with a minor medicines process gap identified during the visit.
This was an unannounced focused inspection on 15 August 2022. Inspectors looked at Safe and Well-led because of concerns about staffing and to check whether earlier legal requirements had been met. They reviewed care and medicines records, recruitment files and management information, and spoke with relatives and staff.
The home was rated Good overall. Inspectors found that medicines were being given as prescribed, risks were reviewed, safeguarding systems were in place and infection control measures were effective. Staffing arrangements were judged to meet people's needs, although one relative said staff deployment sometimes needed to improve.
There had been improvements since the previous inspection, which had rated the service Requires Improvement and found breaches of regulation. The provider was no longer in breach at this inspection. The overall rating included ratings from the previous inspection for areas that were not examined during this focused visit.
Medicines improved
Records showed people received their medicines as prescribed. Staff who administered medicines had been trained and their competence had been checked.
“People's medication records confirmed they received their medicines as prescribed.” from the report
Safeguarding
The home had systems to record and report possible abuse. Staff understood their safeguarding responsibilities and concerns were reported appropriately.
“Staff had received training on safeguarding and understood their responsibility to record and report any concerns.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely, managed infection risks and kept its infection control policy up to date.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Management and oversight
The home used regular audits and action plans to identify and address improvements. Staff had daily meetings to discuss important issues and responsibilities.
“There were effective quality assurance systems in place which ensured all aspects of the service were regularly audited.” from the report
Covert medicines process
needs fixingSome protocols for medicines given covertly did not show that a pharmacist had been consulted about safe administration. The protocols were sent to the pharmacy and signed after the inspection.
“However, the protocol did not evidence a pharmacist had been consulted on safe administration method.” from the report
Staff deployment
needs fixingThe inspection found staffing arrangements met people's needs, but one relative said staff deployment did not always respond to individual needs quickly enough.
“A relative told us at times the deployment of staff needed to be improved to ensure people's individual needs were responded to at all times.” from the report
- 01How do you make sure staff deployment responds to each person's needs at all times?
- 02How are current staff vacancies being covered, and how often are agency staff used?
- 03For anyone given medicines covertly, how is pharmacist advice recorded and reviewed?
- 04What action plans from your audits are currently open, and how do you check that they have been completed?
- 05How would you manage an infection outbreak while continuing to support family visits?
This was an unannounced focused inspection of Safe and Well-led, including infection control; the other key-question ratings were not reassessed and the overall rating used ratings from the previous inspection. This explanation was written from the published report of 5 October 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.
What inspectors found, September 2021
Rated Requires Improvement; inspectors found people were put at risk by medicines recording and management checks.
This was a focused inspection after concerns about staffing and management. Inspectors visited on 15 and 16 July 2021, spoke with people, relatives and staff, observed care, and checked care records, medicines records, audits and management systems.
The main concern was medicines. Records did not show that eight people had received their prescribed medicines on one evening. Some medicine patch records were incomplete, and there were no daily checks to confirm patches were still in place. The home took action during and after the inspection.
Inspectors found that risks were assessed, staff understood safeguarding procedures, recruitment checks were safe, and infection control arrangements were suitable. Relatives generally said people were safe and well cared for.
The overall rating fell from Good to Requires Improvement. Only Safe and Well-led were inspected at this visit. The other ratings were carried forward from the previous comprehensive inspection.
Risk planning
People's risks had been assessed and reviewed. Staff understood people's care and health needs, although some repositioning support was not recorded consistently.
“All risk assessments included evidence of risk planning and review.” from the report
Safeguarding
Staff knew how to recognise and respond to abuse, and safeguarding training and policies were in place.
“Staff had undertaken safeguarding training and there were safeguarding policies in place.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Safe recruitment
New staff had pre-employment checks to assess whether they were suitable to work at the home.
“New members of staff were subject to pre-employment checks to ensure they were suitable to work with people who lived at the home.” from the report
Medicines not reliably recorded
seriousRecords did not show that eight people had received their medicines as prescribed on the evening of 13 July 2021. Conflicting and blank entries were not identified or escalated by other staff.
“We found staff practices did not support eight people to receive their prescribed medicines safely.” from the report
Medicine patch checks
needs fixingCharts for two people did not consistently show where and when patches were applied or removed. There were no daily records confirming that patches remained in place.
“There was no record of daily checks to confirm people's medicines via a patch remained in place.” from the report
Management checks
needs fixingQuality checks did not reliably identify the medicines recording problems or ensure that concerns were escalated to management.
“The provider and management team had quality assurance systems and processes in place designed to enable them to monitor and drive improvement in the safety and quality of people's care.” from the report
No registered manager
needs fixingThere was no registered manager when inspectors visited. A manager had been appointed and their application was progressing.
“There was no registered manager in place at the time of our inspection.” from the report
- 01What changes have been made to make sure every medicine dose is given and recorded correctly?
- 02How do you now check that pain patches are applied, removed and still in place each day?
- 03How are missed or refused medicines identified and escalated to a manager and healthcare professionals?
- 04Is there now a registered manager, and how are quality checks reviewed by senior management?
- 05What was the outcome of CQC's follow-up after the breach of Regulation 12?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 2 September 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.
Every inspection of Latimer Court
7 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- October 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- November 2017Requires improvementup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Inadequatedown from Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016InadequateSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- June 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- February 2013
Registered with the Care Quality Commission on 18 February 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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