CQC report explained · a residential care home
What the CQC found at Lester Hall Apartments
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and risks were assessed, monitored and reviewed more effectively. Staff had more training, incidents had reduced, safeguarding practice had improved and medicines were managed safely.
- Effective?
- Requires improvement
- This area was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Requires improvement
- This area was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- Care was more personalised and based on people's routines and preferences. More activities, community opportunities and communication support were available.
- Well-led?
- Good
- Leadership, management oversight and quality checks had improved. The home had clearer systems for monitoring risks, learning from incidents and involving people, relatives and staff.
What inspectors found, December 2022
Rated Good after major improvements; inspectors found safer, more personalised care, better activities and stronger leadership.
This was an unannounced, focused inspection on 6 and 7 December 2022. One inspector spoke with people, staff and visiting health professionals, observed care, and checked care files, medicines records, recruitment files, complaints, training and audits.
The home was rated Good for Safe, Responsive and Well-led. Inspectors found better risk management, safer medicines practice, more permanent staff, improved care planning and more activities. People were described as feeling safe, respected and supported by staff who knew them well.
The previous inspection had found serious problems, including breaches relating to safe care, safeguarding, staffing, person-centred care and governance. Inspectors found the home was no longer in breach of those regulations. The overall rating changed from Requires Improvement to Good, but Effective and Caring were not inspected during this visit and their previous ratings were carried forward.
Staff who knew people well
People received more consistent support from permanent staff, with less reliance on agency workers. Staff had extra training and support to build their skills and confidence.
“People received consistency and continuity from staff who knew them well and were competent and skilled.” from the report
Safer medicines
Inspectors found that medicines were ordered, stored, given and returned safely. Staff training and competency checks were up to date.
“The ordering, storage, administration and returns of medicines followed best practice guidance.” from the report
Personalised activities
People were supported to follow their interests, spend time in the community and avoid isolation. A new sensory room gave people another place for activities and family celebrations.
“The development of the sensory activity room was a good addition and increased choice and opportunities for people.” from the report
Stronger oversight
New management roles and improved audits helped the home monitor risks and quality. Inspectors found staff were more positive, engaged and informed about people's needs.
“New and improved systems and processes had been implemented to assess, monitor and mitigate risks and improve the quality of care and support people received.” from the report
Serious problems at the previous inspection
seriousThe home had recently failed to meet requirements in several important areas, including risk management, safeguarding, staffing, person-centred care and governance. The current inspection found improvements, but families may want to check that they have been sustained.
“Breaches of legal requirements were found in safe care and treatment, safeguarding, staffing, person centred care and governance.” from the report
- 01How have you kept the improvements in staffing and reduced use of agency workers since this inspection?
- 02How are risks, incidents and emotional or behavioural needs assessed and reviewed for my relative?
- 03What activities and community opportunities would be available for my relative, based on their interests and preferences?
- 04How will you support my relative's communication needs, including access to easy-read information?
- 05What checks are made to ensure medicines are given safely and at the right times?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 20 December 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, August 2022
Lester Hall Apartments was rated Requires Improvement overall, with Safe rated Inadequate and inspectors finding people at risk from poor risk management, staffing and inconsistent care.
Inspectors visited without notice on 4 and 5 July 2022. They spoke with people, relatives, staff and managers, and checked care files, medicines records, staff records, complaints, staffing information and audits.
The most serious findings were about safety. Risks were not always properly assessed or managed. Some staff did not have the skills or experience needed, agency staff were heavily used, and some people said they did not feel safe. Inspectors were also concerned about physical interventions and restrictions on one person.
Care was not consistently personalised, respectful or dignified. Staff did not always follow support plans, involve people in decisions, encourage independence or provide activities and community opportunities. People also gave negative feedback about the choice and quality of meals.
There were some positive areas. Medicines were managed safely, health professionals were involved, infection control had improved and new audits and action plans had been introduced. However, improvements were not yet fully embedded. The home remained rated Requires Improvement, as it had been at the previous three inspections.
Healthcare support
People were supported to use health services, including specialist services. Staff shared information with external professionals and acted on their recommendations.
“Records confirmed how staff sought support from external professionals and implemented any recommendations made.” from the report
Infection control
The home had improved its infection prevention and control arrangements. Inspectors were assured about cleaning, visiting, testing and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Complaints
There was a complaints procedure, including an easy-read version. Records showed that concerns were investigated and action was taken where needed.
“The complaints log confirmed actions had been taken to investigate concerns and make improvements where required.” from the report
Unmanaged risks
seriousKnown risks were not always clearly assessed or managed. Inspectors were concerned about the frequency and type of physical intervention used with one person.
“The provider had failed to ensure known risks had been sufficiently assessed, monitored and mitigated.” from the report
People did not always feel safe
seriousThree people did not consistently feel safe. Inspectors were concerned that some people were at increased risk of abuse or avoidable harm.
“The provider had failed to ensure people were sufficiently protected from abuse and avoidable harm.” from the report
Staffing and skills
seriousThe home relied heavily on agency staff, and not all staff had the training, skills or experience needed for people's complex needs. Staff deployment and supervision were also inconsistent.
“The provider had failed to ensure people received consistent care and support from staff who were suitably trained, skilled, experienced and supported.” from the report
Inconsistent personal care
seriousStaff did not consistently follow people's support plans, routines and preferences. This affected people's wellbeing and could lead to distress.
“The provider had failed to ensure people received care and support based on their individual needs, preferences and routines.” from the report
Meals
needs fixingPeople were unhappy with the choice and quality of meals. Kitchen dietary records were also not up to date when inspectors checked them.
“Negative feedback was received from people about the choice and quality of meals.” from the report
Weak oversight
seriousManagement systems did not consistently identify and reduce risks or keep accurate records. Improvements had been started but were not yet sustained.
“The provider had failed to consistently assess, monitor and mitigate risks and to maintain accurate records.” from the report
- 01What immediate changes have been made to assess and manage the risks identified in this report?
- 02How do you check that agency staff have the right training and experience before supporting each resident?
- 03How do you make sure staff follow each person's support plan, routines and positive behavioural support guidance?
- 04What evidence can you show that staffing levels, staff deployment and management oversight have improved?
- 05What has changed about meal choice and quality since the inspection, and how are residents' views recorded?
This was an unannounced inspection prompted by concerns about staff deployment and competence, with infection prevention and control also reviewed; all five key questions were rated. This explanation was written from the published report of 3 August 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 Lester Hall Apartments
7 rated inspections over 6 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- August 2022Requires improvementstayed Requires improvementSafe: InadequateResponsive: Requires improvementWell-led: Requires improvement
- November 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not ratedResponsive: Inspected but not rated
- February 2021Inspected but not ratedSafe: Inspected but not rated
- October 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2015Inspected but not ratedSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 2011.
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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What to check when you visit
At least 100 live-in carers within about an hour of Leicester
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 £980 to £1,270 a week. 83 can care for a couple. 12 years' experience on average.
“If you bump into her in the night on her way to the bathroom she will still inquire how you are and if everything is alright.”
“Tino was the most wonderfully rounded, empathetic and intuitive person. He not only developed a great relationship with Neville but also had a great working relationship with our existing carer.”
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.