CQC report explained · a residential care home
What the CQC found at Liberty House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Environmental risks were not always assessed or managed, including shower water that could scald people and some household items that were not stored securely. Medicines were mostly administered safely, but guidance for 'when required' medicines was incomplete.
- Effective?
- Requires improvement
- Staff had relevant training and people were supported with food and healthcare. However, some health information was incorrect or missing, oral care guidance was absent, one exercise plan was not being followed, and out-of-date food was found.
- Caring?
- Requires improvement
- People said staff were kind, respectful and supportive of their privacy and independence. However, staff responses during challenging situations were inconsistent, and records showed language that could have affected how people felt.
- Responsive?
- Good
- People had choice over routines and activities, and care plans recorded their preferences. Staff supported relationships, community activities, communication needs and complaints.
- Well-led?
- Requires improvement
- Managers had systems for monitoring the home and involved people and staff in discussions. These systems were not effective enough to identify or prevent shortfalls in safety, medicines guidance, cleaning and support for behaviour that challenged.
What inspectors found, January 2020
Rated Requires Improvement; inspectors found kind and responsive care, but safety, choice, records and management needed significant improvement.
This was an unannounced inspection on 18 November 2019. Inspectors observed care, spoke with people, managers and staff, checked three care records and reviewed staffing, training, medicines and quality checks. They also gathered further information after the visit.
The home had enough staff and followed recruitment checks. People were supported with food, activities, health appointments and relationships. Inspectors found staff were generally kind, respected privacy and helped people build independence. The responsive rating was Good.
However, some environmental risks had not been identified, including unsafe shower water temperatures and insecure household items. Guidance for some medicines was incomplete. Staff practices could be restrictive or upsetting, and some care and health information was missing or inaccurate. Quality checks had not found these problems. The overall rating was Requires Improvement, down from Good at the previous inspection in July 2017.
Enough staff
Inspectors found staffing levels adequate and recruitment checks had been completed. People could receive individual support and staff sickness was usually covered.
“There were enough staff to ensure people's safety and safe recruitment practices were followed.” from the report
Kind and respectful support
People told inspectors staff helped them physically and emotionally. Staff promoted privacy, dignity and independence during personal care.
“People were supported by a staff team who were kind and caring and treated them in a considerate and respectful manner.” from the report
Choice and activities
People had choice over their daily routines, meals and activities. Staff supported outings, family relationships, social events and interests.
“People had choice and control over their routine and activities.” from the report
Relevant staff training
Staff received an induction, training linked to people's needs and supervision. Inspectors found training records were up to date.
“We viewed staff training records and could see training was up to date and relevant to people's roles.” from the report
Environmental safety risks
seriousSome risks had not been identified or reduced. Shower water was not regulated and could scald people, while some potentially harmful household items were not securely stored.
“The hot water in showers was not regulated, which meant people were at risk of being scalded.” from the report
Incomplete medicines guidance
seriousStaff did not always have clear written instructions for 'when required' medicines and homely remedies. This meant some staff might not know when or how to give and record them safely.
“There were limited protocols in place for people who were prescribed 'when required' medicines.” from the report
Restrictive or upsetting practice
seriousSome people had restrictions on personal technology. Records showed that, when a person objected, staff referred to the phone being 'confiscated', which managers agreed was inappropriate.
“We discussed this with the registered manager who agreed this was not appropriate and could make the person feel forced to comply.” from the report
Care information gaps
needs fixingSome records contained incorrect or missing health information. There was also no care plan explaining how staff should support oral hygiene.
“One person's Freedom centre care plan stated the person had epilepsy when they did not.” from the report
Food safety and care planning
needs fixingSome food was not dated after opening and out-of-date bread was found. One person's prescribed exercise regime was not being followed, with no record of attempts to encourage them.
“Some food was not labelled with open dates and there was out of date bread in the cupboard.” from the report
Weak quality checks
needs fixingThe home's audits did not identify several problems affecting people's safety and care. Cleaning and infection control guidance and audits were not detailed enough.
“However, there were shortfalls which affected the overall safety of people and staff in the home.” from the report
- 01What has been done to regulate shower water temperatures and secure household items that could cause harm?
- 02How are 'when required' medicines and homely remedies now explained to staff and checked?
- 03How do you make sure restrictions on phones or other technology are agreed, lawful, necessary and not presented as a threat?
- 04How have care plans been corrected, including health information, oral care and support with prescribed exercises?
- 05What new checks are in place to make sure cleaning, infection control, medicines and other safety problems are found promptly?
This was an unannounced inspection of the whole care home, including premises and care, and it assessed all five CQC questions; the previous Good rating was from July 2017. This explanation was written from the published report of 17 January 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, May 2017
Liberty House was rated Good; inspectors found safe, kind and personalised care with effective management.
Inspectors visited on 8 and 9 May 2017. They spent half a day at the home on each visit. They spoke with one person, three staff members and the registered manager. They reviewed both people's care plans and records about care, staff training, recruitment and service quality.
The home was supporting two people, although it was registered for up to seven. Inspectors found that care plans were current and followed, risks were managed, medicines were stored and given safely, and staff knew how to protect people from abuse.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was a new service, so the provider was not asked to complete a Provider Information Return before the inspection.
Managing risks
Staff used risk assessments and care plans to support safety while encouraging people to build confidence and independence.
“The emphasis of the risk assessment was to encourage people to live as independently as possible and to develop living skills.” from the report
Safe medicines
Inspectors found that medicines were stored and given safely, and records showed when they had been administered.
“People received their medicines as prescribed and accurate records were maintained of the medicines when they were administered.” from the report
Kind and respectful care
Staff promoted dignity, choice and independence, and supported people's family and friendship relationships.
“People were cared for by caring staff who were kind and compassionate.” from the report
Personalised support
Care plans reflected people's needs, wishes and personal histories. People were involved in planning their care and daily activities.
“Care plans were personalised to identify and meet people's needs and wishes.” from the report
Open management
The home had a clear management structure and quality checks. Staff said they could raise concerns and make suggestions.
“The provider had a quality assurance process in place.” from the report
Inspectors raised no specific concerns in this report.
- 01How are risk assessments and care plans reviewed now, particularly when someone's needs change?
- 02How are medicines audits carried out, and have any medicines errors or recording problems occurred since this inspection?
- 03How are people involved in menu planning and supported to maintain good nutrition?
- 04What current training and supervision do staff receive for supporting people with learning difficulties and behaviours that may be difficult to understand?
- 05How can residents and families raise complaints or suggestions, and how are these followed up?
This was a planned inspection of the overall service covering all five CQC questions; the home was new and inspectors did not observe meals. This explanation was written from the published report of 23 May 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.
Every inspection of Liberty House
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- January 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- May 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015
Registered with the Care Quality Commission on 17 March 2015.
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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