CQC report explained · a nursing home
What the CQC found at Ledbury Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing, fire safety and infection control were managed safely. They noted gaps in one person's repositioning chart, although the issue was identified and reminders were sent to staff.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff had suitable training, people received appropriate food and healthcare, and consent and best-interest processes were followed.
- Caring?
- Good
- The report does not give a separate rating or detailed findings under the Caring question.
- Responsive?
- Good
- The report does not give a separate rating or detailed findings under the Responsive question.
- Well-led?
- Good
- Inspectors found stronger management, quality checks and a positive, open culture. Staff described improved communication, teamwork and support.
What inspectors found, January 2022
Ledbury Nursing Home rated Good; inspectors found safer care, improved medicines management and stronger leadership, with a minor record-keeping gap.
Inspectors visited without warning on 15 December 2021. They observed care, spoke with staff, managers and relatives, and checked care records, medicines, staffing, safety records and quality audits. They also checked infection prevention and control arrangements.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found that risks were managed, medicines were recorded and checked more reliably, staffing was sufficient, and people received appropriate food, healthcare and support.
The home had improved from Requires Improvement at the previous inspection in January 2021. The earlier breaches relating to safe care and treatment and good governance had been addressed. Inspectors did find gaps in one person's repositioning records, but these were identified by the management team and staff were reminded.
Improved safety
The home had acted on problems found at the previous inspection. Inspectors found that risks to people's health and wellbeing were being managed more safely.
“The management team had made and sustained the improvements required following our previous inspection to support people's safety.” from the report
Medicines management
Medicines records were more up to date, and systems for storage, disposal and as-required medicines were in place.
“Improvements had been made in the management of people's medicines since our last inspection.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs. Recruitment checks, induction and ongoing training were in place.
“New staff members completed a structured introduction to their role and ongoing support.” from the report
Person-centred care
People's preferences, routines and individual needs were considered. Staff supported people to make choices and followed least restrictive approaches.
“People were encouraged to be involved in their care and staff took time to make sure people's choices and preferred routines were maintained.” from the report
Leadership and teamwork
The new manager and wider management team had strengthened quality checks and supported a more open culture.
“Things are getting much better here. The new manager has made a difference. Communication and team working are much improved.” from the report
Incomplete repositioning record
needs fixingOne person's repositioning chart had gaps, so it did not show that repositioning had happened as often as required. The quality improvement manager identified this and reminded staff.
“There were gaps in a person's repositioning chart which did not provide evidence that repositioning was being carried out at the frequency required.” from the report
- 01How do you now check that repositioning records are completed fully and at the required frequency?
- 02Has the manager's application to become registered with the CQC now been completed?
- 03How do you make sure the current staffing levels remain sufficient when staff are absent?
- 04How are relatives involved in decisions about their family member's care and preferred routines?
- 05What separate arrangements do you use to review people's experiences, complaints and individual activities?
This inspection assessed Safe, Effective and Well-led, including infection prevention and control; the report gives no separate ratings for Caring or Responsive. This explanation was written from the published report of 11 January 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, January 2021
Ledbury Nursing Home was rated Requires Improvement; inspectors found unsafe medicines management, incomplete care records and weak oversight.
This was a focused inspection on 4 and 6 November 2020. Inspectors looked at Safe, Effective and Well-led, after concerns about staffing, agency workers, training and medicines. They spoke with people, relatives, staff and professionals, observed care, and checked records.
The home was not always safe. Medicines were not always given or recorded as prescribed. Care plans, risk assessments and records of care were sometimes incomplete or inaccurate. Some people waited for help with meals, and some dietary needs were not met promptly.
The home was rated Requires Improvement overall. Safe, Effective and Well-led were each rated Requires Improvement. Caring and Responsive were not inspected during this visit, so their previous ratings were carried forward.
People felt safe
People told inspectors they felt safe living at the home. Staff understood their safeguarding responsibilities.
“People told us they felt safe living at the home.” from the report
Infection control
Inspectors were assured that the home used PPE safely, supported social distancing and had arrangements to prevent or manage infection outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Kind staff
Staff were seen supporting people with kindness and maintaining eye contact. One person described staff as friendly and attentive.
“Staff were seen to be kind and caring and for example lowered themselves down, so they were able to maintain eye contact with people.” from the report
Food choices
People generally liked the food and could choose their meals. Meals were presented well, with equipment available to support independence.
“Meals were seen to be well presented making them desirable to eat.” from the report
Medicines were not always safe
seriousPeople could miss prescribed medicines, and records did not always show what had been given. Inspectors also found problems with storage temperatures and missing instructions for medicines given when needed.
“Medicines were not always managed safely and recorded accurately.” from the report
Care records were incomplete
seriousCare plans, risk assessments and monitoring records were not always accurate or maintained. This meant the home could not always show that repositioning, wound care and other support had taken place.
“Monitoring records, care records and risk assessments to evidence the care and support provided were not always in place or were inconsistent.” from the report
Weak management checks
seriousAudits did not identify the problems inspectors found. Policies were not always followed, and some records were left where other people could see them.
“The provider had audit processes in place however, these had not identified the concerns we highlighted throughout the inspection.” from the report
Delays with meals and dietary needs
needs fixingTwo people waited 25 to 35 minutes for help with their midday meals. The report also says some dietary needs were not met promptly.
“After a period of 25-35 minutes both these people received assistance from staff to have their meal.” from the report
Consent records
needs fixingThe home could not provide written evidence of consultation with representatives about COVID-19 testing when people could not make the decision themselves.
“Written evidence of consultation with people's representatives under best interest decisions could not be found in relation to COVID-19 testing either during or following the inspection.” from the report
- 01What changes have you made to ensure every medicine is given, stored and recorded correctly?
- 02How do you now check that care plans, repositioning records and wound records are complete and accurate?
- 03How do you make sure there are enough staff when vacancies or sickness mean agency staff are needed?
- 04How do you record consent or best-interest decisions for COVID-19 tests and other treatments?
- 05What action has been taken following the CQC breaches, and what evidence can you show of improvement?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 20 January 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 Ledbury Nursing Home
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- January 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: Requires improvementEffective: GoodWell-led: Good
- July 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
11 live-in carers within about an hour of Herefordshire, County of
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.