CQC report explained · a residential care home
What the CQC found at Lauren Court Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with repositioning, mattress settings, medicines, infection control and staffing support. Some people were left without the level of support set out in their care plans.
- Effective?
- Requires improvement
- Oral care was not consistently recorded, food and fluid records had gaps, some refresher training was overdue and the environment needed improvement. Mental capacity and best-interest processes had improved.
- Caring?
- Good
- Caring was not inspected during this focused inspection. The report says the rating for the key question not inspected was carried over from the last inspection.
- Responsive?
- Requires improvement
- Care records were task-focused and people were not always involved in care planning. People could not always have baths or showers when they wanted, although activities and communication plans were in place.
- Well-led?
- Requires improvement
- Management systems and records did not reliably identify, monitor or correct risks. The provider remained in breach of Regulation 17 because governance and record keeping were not effective enough.
What inspectors found, April 2023
Lauren Court Residential Care Home is rated Requires Improvement; inspectors found kind permanent staff but ongoing problems with staffing, medicines, care records and management oversight.
This was an unannounced focused inspection on 28 March 2023. Inspectors spoke with 12 people, one family member and five staff. They reviewed care records, medicines records and records about quality monitoring.
People generally said they felt safe and supported. Permanent staff were seen treating people with dignity and respect, and activities and meal choices were available. However, some people were left without their assessed support, and people said they could not always have a bath or shower when they wanted.
Inspectors found medicines were not always managed safely. There was no consistent evidence of oral care, care records had gaps, and infection control and cleanliness were not always good enough. The home’s systems did not identify or correct all these problems.
The overall rating remains Requires Improvement. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. The home had improved enough to no longer breach regulations 11 and 12, but it remained in breach of Regulation 17 on good governance.
Kind permanent staff
People spoke positively about permanent staff, who were seen to know people’s preferences and treat them with dignity and respect.
“People told us they felt safe and supported within the home and positive staff interaction was observed.” from the report
Choice and least restriction
The home had systems to support people’s choices and to make best-interest decisions where people could not decide for themselves.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Meals and activities
People were offered meal choices, including hot breakfast options, and inspectors saw activities taking place during the visit.
“A choice of main meals was provided and people's breakfast, including hot options, were made to order.” from the report
Medicines were not always safe
seriousOne person’s morning medicine had been left in their bedroom and had not been taken. Medicine records, storage temperatures, occasional medicines guidance and allergy information also needed improvement.
“Medicines were not always managed safely to ensure people had taken the medicines they needed.” from the report
People were left without support
seriousInspectors saw people left unsupported for periods that did not match their assessed needs. People also said staffing levels affected access to baths and showers.
“We observed instances where when people were left unsupported for periods of time which was not in line with their care needs.” from the report
Care records and oral care
needs fixingCare plans and risk assessments were not always followed. Records did not consistently show that people received oral care or the care they needed.
“There was no evidence people were consistency receiving oral care.” from the report
Weak management oversight
seriousAudits and checks did not identify all the shortfalls found by inspectors. Incomplete records meant risks were not always properly monitored or reduced.
“Systems and standards of record keeping had not been effective to sufficiently monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report
Cleanliness and infection control
needs fixingSoiled-product bags were left open in communal areas. Some areas were grubby and some bedrooms continued to smell unpleasant after cleaning.
“Some areas of the home were grubby, and some bedrooms continued to smell unpleasant even once they had been cleaned.” from the report
Person-centred care
needs fixingDaily notes lacked personal detail and some people were not involved in reviewing their care. Agency staff received mixed feedback about their skills and knowledge.
“Improvements were needed to demonstrate how the care being delivered was person centred.” from the report
- 01How will you make sure people are not left without the support set out in their care plans?
- 02How do you check that every medicine has been taken, and that occasional medicines, allergy information and storage temperatures are recorded correctly?
- 03What daily checks now show that people have received oral care and the support described in their care plans?
- 04How are you reducing reliance on agency staff and making sure agency workers understand each person’s needs?
- 05What action has been taken to improve governance, record keeping, cleanliness and the condition of the environment?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and the report says the rating for the uninspected key question was carried over from the last inspection. This explanation was written from the published report of 29 April 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, June 2022
Requires Improvement; inspectors found kind care, but important gaps in risk management, consent records and oversight.
Inspectors visited without notice on 20 and 21 April 2022. They spoke with five people living in the home, nine relatives and six staff. They also checked care records, medicines records, recruitment files and management records.
People were treated with kindness and respect. Inspectors saw warm interactions between staff and residents. Food and drink choices were available, relatives were supported to stay in touch, and health professionals were contacted when needed.
However, some risks were not properly assessed or managed. Care plans did not always contain enough information about health needs. Checks on the building and equipment were not kept up to date. Records about consent, mental capacity and applications to restrict liberty were also incomplete or unclear.
The overall rating was Requires Improvement. Safe, effective, responsive and well-led were rated Requires Improvement. Caring was rated Good. The provider was required to send an action plan, and CQC said it would monitor progress.
Kind and respectful care
People and relatives described staff as caring and respectful. Inspectors also saw staff engaging with people in a warm way.
“We observed staff engaging with people during the inspection, in a caring and warm manner.” from the report
Food and dietary support
People's nutritional risks were assessed and kitchen staff knew about specialist diets and preferences. People said they had enough to eat and drink and had choices.
“People received sufficient food and drinks and most people told us they enjoyed the food available and they always had choices.” from the report
Staff training
Staff received regular training, supervision and appraisals. Relatives told inspectors that staff had the skills to meet people's needs.
“Training records showed that staff were provided with regular updates on courses deemed necessary to ensure they had the knowledge and skills to support people safely.” from the report
Family contact
People were supported to keep in touch with relatives, including during the COVID-19 pandemic. Relatives were also kept informed about changes and incidents.
“People were supported to maintain relationships with friends and family, including during the COVID-19 pandemic when there were times relatives were unable to visit.” from the report
Risks and safety checks
seriousSome health needs and risks were not recorded in enough detail. Checks on the building and equipment had not been maintained for several months.
“Regular checks on the building and equipment were not maintained to ensure safety.” from the report
Consent and liberty safeguards
seriousThe home did not always assess or record people's ability to consent properly. Records of applications to restrict liberty were incomplete, and best interest decisions were not always recorded accurately.
“Systems in place to monitor DoLS were not effective.” from the report
Care plans not always current
needs fixingSome care plans did not reflect people's current needs or give staff enough detail about medical conditions, mobility, nutrition and risks.
“However, some plans did not reflect people's current needs and required updating.” from the report
Weak management checks
seriousAudits and provider oversight did not find all the problems identified during the inspection. Several types of records needed further improvement.
“The systems in place to monitor the quality and safety of the service were not fully effective.” from the report
Staffing and recruitment
needs fixingFeedback about staffing levels was mixed. The home was recruiting more staff, and recruitment records were missing some information for two staff members.
“Although dependency assessments were completed for everyone, no completed dependency tool was provided to establish if staffing levels met people's assessed needs.” from the report
- 01What has been done to make sure every resident has up-to-date risk assessments and care plans for conditions such as diabetes, seizures, smoking and nutrition?
- 02How do you now check the building, equipment and water safety, and when were these checks last completed?
- 03How are mental capacity assessments, consent records, best interest decisions and Deprivation of Liberty Safeguards applications now checked?
- 04What staffing levels are planned for day and night shifts, and how do you show they match residents' assessed needs?
- 05What action has been taken in response to the three breaches, and can you explain how progress is being monitored?
This was an unannounced comprehensive inspection of the home, including infection prevention and control; it was the first inspection of this newly registered service under the current provider. This explanation was written from the published report of 10 June 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.
Every inspection of Lauren Court Residential Care Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Lauren Court Residential Care Home →
- June 2022Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Lauren Court Residential Care Home →
- January 2021Inspected but not ratedSafe: Inspected but not rated
- May 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021
Registered with the Care Quality Commission on 27 August 2021.
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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84 live-in carers within about an hour of Cheshire West and Chester
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Most charge £980 to £1,260 a week. 76 can care for a couple. 10 years' experience on average.
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