CQC report explained · a residential care home
What the CQC found at Lawrence Mews
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were not always protected from infection risks. Inspectors also found food hygiene lapses, black mould, unsafe storage of some equipment and environmental safety issues, although medicines, staffing and safeguarding were managed well.
- Effective?
- Good
- People received support that met their needs. Staff had suitable training and support, people's diets and health needs were monitored, and staff worked with healthcare services.
- Caring?
- Good
- Staff were kind and compassionate. People were involved in decisions, supported to express their views, and treated with privacy, dignity and respect.
- Responsive?
- Good
- Care plans were personalised and updated when people's needs changed. People were supported with communication, activities, friendships, family relationships and complaints.
- Well-led?
- Requires improvement
- The registered manager provided supportive leadership, but the provider's quality checks and maintenance systems had not identified or managed important risks.
What inspectors found, April 2020
Lawrence Mews was rated Requires Improvement; inspectors found kind, person-centred care but infection control and management checks were not reliable.
The inspection took place on 13 February 2020 and was announced 24 hours in advance. One inspector spoke with a resident and six staff, observed care, checked care and medicines records, and reviewed staff and management records. Further information was gathered after the visit.
The home provided personalised care for up to five people with learning disabilities, autism or mental health support needs. People were treated kindly, involved in decisions, supported to communicate, and helped to build independence and relationships.
The main problems were infection control, food hygiene, cleaning and maintenance. Inspectors found black mould, missing Legionella risk arrangements, unsafe food-handling practices, damaged surfaces and some safety defects. The provider acted immediately on some issues, but its checks had not found them sooner.
The overall rating fell from Outstanding at the previous inspection to Requires Improvement. Effective, caring and responsive care were rated Good. Safe and well-led were rated Requires Improvement.
Kind, respectful care
Staff were compassionate and supported people's dignity, privacy and choices. People were involved in decisions about their care and even in choosing new staff.
“Staff were compassionate and kind towards the people they cared for.” from the report
Personalised support
Care plans gave staff detailed guidance about people's needs, preferences and communication. Staff supported people to gain skills, try new activities and become more independent.
“People received care and support which met their individual needs.” from the report
Safe medicines practice
People received medicines as prescribed. Staff were trained and assessed before administering medicines, and audits were carried out.
“Medicines were managed safely. People received their medicines as prescribed; and the provider had safe medicine procedures in place.” from the report
Infection risks
seriousPeople were not always protected from potential infection. Inspectors found black mould, no suitable home-specific Legionella risk assessment, missing handwashing supplies and equipment exposed to possible contamination.
“People were not always protected from the risk of infection.” from the report
Food hygiene
seriousFood was carried through the laundry room and outside before reaching the dining room. Staff also sometimes prepared food without washing their hands, creating a risk of cross-contamination.
“There were lapses in good food hygiene practice.” from the report
Cleaning and repairs
needs fixingSome areas could not be cleaned properly because paintwork and surfaces were damaged. Inspectors also found a loose handrail, a broken toilet seat and defects in two fire doors.
“Some areas of the care home had not been effectively cleaned.” from the report
Weak management checks
needs fixingThe provider's quality monitoring had not identified the safety problems before the inspection. Maintenance records were incomplete and some repairs were not recorded or actioned.
“The provider's quality assurance governance was not always effective.” from the report
- 01What has been done to remove the black mould, and how is the home checking that it does not return?
- 02Has the home completed the Lawrence Mews-specific Legionella risk assessment, and are all required safety checks now recorded?
- 03How are food, laundry and handwashing practices separated and checked to prevent cross-contamination?
- 04Have the loose handrail, broken toilet seat, damaged surfaces and fire-door defects all been repaired?
- 05What changes have been made to the provider's quality monitoring and maintenance records since the inspection?
This was a planned inspection covering all five CQC questions, including the premises and care provided; the previous overall rating was Outstanding, published on 2 July 2017. This explanation was written from the published report of 18 April 2020 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, July 2017
Rated Outstanding; inspectors found exceptionally caring, responsive and well-led support, with one recording shortfall about food and fluid amounts.
This was an announced inspection on 12 May 2017. One inspector spoke with people living at the home, relatives, staff, managers and health and social care professionals. Records for all five people were reviewed, along with medicines and staff records.
The home was rated Outstanding overall. Safe and Effective were rated Good. Caring, Responsive and Well-led were rated Outstanding.
Inspectors found enough trained staff, safe medicine arrangements, suitable risk assessments and good support for people's health. They also found very kind and respectful care, strong involvement in decisions, personalised activities and a clear focus on helping people lead independent and meaningful lives.
One shortfall was identified. For people at risk of poor nutrition or dehydration, the total amount of food and drink consumed was not always recorded each day. The manager said this process would be reviewed.
Kind and respectful care
Staff were described as genuinely caring and showed warmth, empathy and respect. Inspectors saw staff respond calmly and effectively when someone became distressed.
“People had excellent, meaningful relationships with the staff.” from the report
Personal choice and communication
The home used individual communication methods, including signs, symbols and pictures, so people could express their wishes and help make decisions about their care.
“It was evident that decisions were made with people and not for them.” from the report
Meaningful lives
People were supported to follow their interests, build independence and take part in local activities. Support was adjusted to give people as much or as little help as they wanted.
“People received the highest quality care and support to lead meaningful lives.” from the report
Strong leadership
The manager and provider promoted staff development, listened to people's views and used quality checks to improve the service.
“There was a culture of excellence at this home, driven by inspirational management from the top down.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs, safe recruitment and appropriate checks on medicine administration, storage and staff competence.
“People's medicines were managed safely.” from the report
Food and fluid records
needs fixingFor people at risk of malnutrition or dehydration, the total amount eaten and drunk was not always recorded each day. The manager said the process would be reviewed.
“However we did note that the total amount consumed each day was not always recorded.” from the report
- 01How do you now make sure the total amount of food and drink is recorded each day for people at risk of malnutrition or dehydration?
- 02How would you communicate with my relative if they could not communicate their wishes verbally?
- 03How are people involved in reviewing their care plans and setting personal goals?
- 04How do you adjust staffing when a person's needs or activities change?
- 05How do you support people to maintain relationships with family and take part in local community activities?
This was a planned inspection of the whole service, covering all five CQC questions and the overall rating; five people lived at the home at the time. This explanation was written from the published report of 21 July 2017 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 Lawrence Mews
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- April 2020Requires improvementcurrent ratingdown from OutstandingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2017Outstandingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 17 November 2010.
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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