CQC report explained · a residential care home
What the CQC found at Libury Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks, safeguarding concerns, accidents, fire safety and medicines were managed appropriately. Inspectors found enough staff and safe recruitment practices.
- Effective?
- Good
- Staff had relevant training and people received coordinated support from health and social care professionals. People's food, drink, capacity and independence needs were assessed and managed.
- Caring?
- Good
- People said staff were kind, compassionate and respectful. Staff supported people's dignity, independence, choices and personal preferences.
- Responsive?
- Outstanding
- Staff provided exceptionally personalised support. They helped people follow interests, develop relationships, communicate their wishes and avoid social isolation and loneliness.
- Well-led?
- Good
- Managers were visible, approachable and respected. Quality checks, action plans, feedback and partnership working supported the running of the home.
What inspectors found, October 2019
Rated Good overall; inspectors found exceptionally personalised care, with the responsive rating Outstanding and only a minor concern about the dining area.
This was an unannounced inspection of the care home. One inspector spoke with six people, two relatives, the manager and four staff. They also observed care and reviewed care, medicine and management records.
The home was rated Good for Safe, Effective, Caring and Well-led. People were protected from avoidable harm, received their medicines safely, and were supported by kind staff with suitable training. Care plans were well maintained and managers used audits and feedback to improve the service.
Responsive care was rated Outstanding. Inspectors found that staff understood people's histories, interests and communication needs, and helped people build relationships, take part in activities and avoid loneliness. The overall Good rating was unchanged from the previous inspection, while Well-led improved from Requires Improvement and Responsive improved from Good.
Personalised support
Staff went beyond basic care to understand people's past interests and support activities that improved their confidence, mood and wellbeing.
“People received exceptional person-centred care. Their care and support not only met their health and support needs, but staff regularly went the extra mile” from the report
Relationships and activities
People were supported to build relationships, join activities and take part in community events that mattered to them.
“This provided excellent outcomes for people in reducing social isolation, loneliness and low mood.” from the report
Kind and respectful staff
People described staff as kind and caring. Staff supported people to remain independent and respected their choices and dignity.
“People we spoke with were positive about the staff and care they received. They told us they were treated with kindness, compassion and respect.” from the report
Safe care and medicines
Inspectors found that risks were assessed, staff followed safety plans and medicines were administered as prescribed. Medicine reviews helped reduce the risk of over-medication.
“People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed.” from the report
Improved leadership
The management team was described as visible and supportive. Audits and action plans were used to monitor quality and make improvements.
“There continued to be a quality assurance system in place to ensure that staff gave high-quality care.” from the report
Dining area
minorAlthough meals were enjoyed and nutrition was managed well, inspectors found the dining room felt institutional and cold. The manager said there were plans to redecorate it.
“The dining area felt institutional and cold.” from the report
- 01What changes have been made, or are planned, to make the dining area feel less institutional and cold?
- 02How will you make sure my relative's past interests, relationships and preferred activities are included in their care plan?
- 03How often will my relative's medicines be reviewed, especially if medicines affect mood or behaviour?
- 04How will you support my relative to communicate choices if they cannot communicate verbally?
- 05How can relatives raise concerns, and how will we be told what action has been taken?
This was an unannounced inspection covering all five CQC questions, with the home and the care provided both looked at; the previous overall rating was Good. This explanation was written from the published report of 8 October 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, January 2017
Libury Hall is rated Good overall, but inspectors found that management systems and care records still needed improvement.
Inspectors visited without notice on 22 November 2016 and met the registered manager on 7 December 2016. They spoke with people living there, relatives, staff and health professionals. They also observed care and checked care records, medicines records, training records and quality checks.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safer risk management, safe medicines practice, suitable training, kind staff and care that reflected people's individual needs. People were supported with food, healthcare, activities, independence and complaints.
The well-led rating was Requires Improvement. Some care records were inaccurate, and the improvement plan did not cover every issue with clear timescales. Inspectors also found that some suspected safeguarding concerns had not been reported promptly to the appropriate authorities.
Managing risks
Inspectors found substantial improvement in risk assessments and care plans. Staff supported people to make choices and manage risks while promoting independence.
“Care records we looked at demonstrated that staff identified and responded to risk positively, and that they encouraged people to manage and mitigate the risks for themselves.” from the report
Medicines
Medicines were administered as prescribed. Staff training, regular reviews, audits and stock checks helped support safe medicines management.
“People's medicines were reviewed regularly by either a GP or specialist mental health professional, and adjusted accordingly” from the report
Kind and respectful care
Staff knew people well and treated them with dignity. Inspectors saw warm, respectful relationships and people said staff listened to them.
“Staff spoke with people in a kind, patient and friendly way and respected people's dignity.” from the report
Individual support
Care plans had become more detailed and personal. They included people's interests, social aims, health information and ways to support them.
“People had individual and detailed care plans that reflected a holistic approach noting interests, educational and social aspirations as well as health information.” from the report
Care records were not always accurate
needs fixingSome summary records did not match the main care plans after people's needs changed. Inspectors said this created a risk that staff could provide care that was not current or appropriate.
“Some records were consistently inaccurate, particularly where information was transferred from the main care plan to a short summary section.” from the report
Safeguarding reporting
needs fixingThe home took action to reduce risks, but some suspected harm or abuse was not reported promptly to the appropriate authorities.
“The registered manager had not always reported the concern to the appropriate body.” from the report
Improvement planning
needs fixingThe manager had identified several issues, but the improvement plan did not include all areas needing attention or clear timescales for completing the work.
“These were not incorporated into the management plans with clear timescales for achievement” from the report
- 01How do you make sure the one-page care summaries always match people's current care plans?
- 02What training do key workers receive to complete and update care plans?
- 03How are suspected safeguarding concerns reported now, and who checks that reports are made promptly?
- 04What actions are currently on the service improvement plan, and what are the completion dates?
- 05How are activities maintained when activity staff are absent?
This was an unannounced inspection covering all five key questions and checking improvements after the previous inspection. This explanation was written from the published report of 11 January 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 Libury Hall
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2013
Registered with the Care Quality Commission on 6 December 2013.
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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