CQC report explained · a nursing home
What the CQC found at Laverstock Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Rated Good; inspectors found safe, kind and personalised care, although some people reported waiting for the call bell at night.
This was an unannounced inspection on 3 and 4 December 2019. Inspectors spoke with people living at the home, relatives, staff and a visiting healthcare professional. They also observed care and checked care plans, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff during the visit, safe medicines systems, suitable risk assessments, trained staff, good food choices and timely healthcare support.
People were described as treated with kindness, dignity and respect. Care plans were personalised and reviewed regularly. Activities included group and one-to-one options. The home had improved from Requires Improvement at the previous inspection, published on 11 December 2018.
Safe medicines
Medicines were stored at safe temperatures, given as prescribed and recorded without gaps. Guidance was in place for medicines given only when needed.
“Medicines administration records had been completed in full with no gaps in recording.” from the report
Kind and dignified care
People and relatives described staff as kind and caring. Inspectors did not see the undignified care noted at the previous inspection.
“At this inspection we did not observe any undignified care and support.” from the report
Personalised support
Care plans gave staff detailed guidance about people's needs, preferences and communication. Monitoring charts were completed and checked by nursing staff.
“Care plans we reviewed were written positively with encouragement to promote independence woven through each plan.” from the report
Activities and social contact
The home offered varied activities, outings, clubs, religious services and one-to-one sessions for people who preferred or needed them.
“Activities staff also provided one to one activities to people who preferred or needed this type of engagement.” from the report
Improvement since the last inspection
The previous Requires Improvement ratings had improved to Good in all five areas. Inspectors found changes to medicines, risk management, training, dignity and leadership.
“At this inspection this key question has now improved to Good.” from the report
Waiting for help at night
needs fixingSome people said it took too long for staff to answer the call bell at night. The home had identified evenings as busy and was recruiting more staff.
“During the day time it is ok, but at night time it takes too long for the staff to answer the bell” from the report
One complaint was unresolved for the relative
needs fixingOne relative said their complaint had not been dealt with to their satisfaction. Inspectors shared this concern with the registered manager.
“One relative we spoke with told us their complaint had not been dealt with to their satisfaction.” from the report
Management handover
minorA new manager had started and was still completing an induction and handover with the registered manager. Families may want to check how this transition has developed.
“The provider had planned for the new manager to have an induction period where they did not have any operational responsibilities.” from the report
- 01How quickly are call bells answered at night now, and how are response times checked?
- 02Has recruitment for the busier evening period been completed, and what staffing levels are in place on each shift?
- 03How did the handover to the new manager progress, and who is currently responsible for day-to-day management?
- 04How are complaints followed up when a relative is not satisfied with the response?
- 05How will you make sure my relative's personalised care plan, food and fluid needs, activities and communication preferences are kept up to date?
This was an unannounced planned inspection based on the previous rating and assessed all five CQC questions; the provider was not asked to complete a provider information return before the inspection. This explanation was written from the published report of 28 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, December 2018
Rated Requires Improvement; inspectors found significant progress after an Inadequate rating, but safety, training, dignity, records and leadership still need work.
This was an unannounced inspection on 30 and 31 October 2018. Inspectors spoke with people living at the home, relatives, staff and healthcare professionals. They also reviewed care plans, risk assessments, medicines records, recruitment files and other records.
The home had improved significantly since the previous inspection in March 2018, when it was rated Inadequate in every area and placed in special measures. Cleaning, staffing, training support, care planning, activities and the culture among staff had improved. The home was no longer in special measures.
However, the improvements were not yet consistent. Inspectors found weaknesses in risk management, medicines storage and recording, staff training, dignity, oral care records and the use of feedback. All five areas were rated Requires Improvement, so further improvement was needed and the changes needed to become established.
Cleaner environment
The home was cleaner than at the previous inspection. Most areas and equipment appeared clean and in good working order.
“All areas of the home looked clean and there were no unpleasant odours.” from the report
Falls were reduced
Accidents and incidents were reviewed, with actions taken to reduce repeat risks. The report says falls reduced considerably between May and October 2018.
“Falls analysis reports demonstrated that incidents of falls had fallen significantly.” from the report
Kind interactions
Inspectors saw staff speaking warmly with people and using their interests and preferred ways of communicating.
“We saw caring interactions between staff and the people they were supporting.” from the report
Activities and choice
People were offered activities, outings, sensory sessions and opportunities linked to their interests. Staff also supported people to take part in festivals and religious activities.
“Activities took place and everyone living at the service was invited to attend.” from the report
Some risks were not properly managed
seriousSome staff did not know about a risk plan after an incident involving two people. Another person's risk of swallowing harmful substances was not fully considered outside the kitchen.
“This meant that the risk of a further incident had not been managed.” from the report
Medicines systems still had gaps
seriousSome creams and medicines were not stored securely. Fridge temperatures were outside the recommended range, opening dates were sometimes missing and some creams had been applied more often than prescribed.
“Medicines were stored in a locked treatment room; however, some medicated creams were kept insecurely in people's rooms” from the report
Staff training was incomplete
needs fixingSeveral staff had not completed training the provider considered mandatory. This included seven staff without manual handling training and 12 without food hygiene training.
“There were gaps in the training the provider considered to be mandatory for staff.” from the report
Dignity was not consistent
needs fixingMost people were treated with dignity, but inspectors saw a person left during a meal, another person without suitable cover over their legs and someone waiting more than an hour for help to move.
“However, we observed some practice that did not promote dignity.” from the report
Some care records were incomplete
needs fixingOral care charts did not show every attempt when care was declined, and did not always show what action staff took. Some useful information in daily notes had not been transferred into care plans.
“Charts demonstrated that for some people oral care was not being provided daily, but the record did not demonstrate what action had been taken.” from the report
Feedback was not always acted on
needs fixingThe home asked people for their views, but inspectors found that action plans had not been developed to respond to the feedback received.
“People's views were sought but action plans had not been developed to act on feedback given.” from the report
- 01How are you making sure staff know about and follow each person's risk management plan?
- 02How are medicines, medicated creams and medicine fridges stored and checked now?
- 03Which staff still need mandatory training, and how do you make sure they are safe to work while training is outstanding?
- 04How do you make sure people receive private, attentive care and are not left waiting for help?
- 05How do you record oral care and transfer important information from daily notes into each person's care plan?
This was an unannounced inspection covering all five key questions, including the care provided and the home environment; inspectors spoke with 10 people, two relatives, 11 staff and healthcare professionals, and reviewed records. This explanation was written from the published report of 11 December 2018 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Laverstock Care Centre
3 rated inspections over 2 years: the service has improved, from Inadequate to Good.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- August 2017
Registered with the Care Quality Commission on 9 August 2017.
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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