CQC report explained · a nursing home
What the CQC found at Lillington House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2019
Lillington House was rated Good overall; inspectors found caring, safe and well-organised support, with a few records and food arrangements needing attention.
This was an unannounced, planned inspection on 20 June 2019. Inspectors reviewed records, medicines, staffing, training and quality checks. They spoke with people, relatives, staff and a healthcare professional, and observed care.
The home provides nursing and rehabilitation for up to 57 people with neurological disabilities, including people with highly complex medical needs. Inspectors found enough suitably trained staff, safe medicines arrangements, detailed care plans and good teamwork with therapy and healthcare professionals.
People were treated with kindness, dignity and respect. Staff supported choice, communication, nutrition, activities and therapy. Inspectors found some improvements were still needed, including access to food after 8pm, recording equipment checks and the detail supporting covert medicines decisions.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. The previous overall rating was also Good, but leadership had previously needed improvement. Inspectors found that leadership improvements had been made.
Safe staffing
Inspectors found enough clinical and care staff, with staffing adjusted for people with particularly complex needs. Recruitment checks were completed before staff started work.
“There were enough clinical and care staff to meet people's needs and provide safe care.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw warm interactions and found that staff supported dignity, choice and independence.
“People received compassionate care from staff who prioritised their needs and worked as a team to ensure people achieved good outcomes.” from the report
Specialist rehabilitation
Therapy was tailored to individual needs, with goals reviewed as people made progress. The home used physiotherapy, occupational therapy and hydrotherapy.
“Therapies, such as hydrotherapy, physiotherapy and occupational therapy were tailored to meet each person's individual needs.” from the report
Learning and oversight
The home had systems to monitor quality and acted on learning from incidents and feedback. Inspectors found that leadership had improved since the previous inspection.
“There was a clear quality assurance system in place and the provider took learning from situations to improve outcomes for people.” from the report
Food after 8pm
needs fixingStaff told inspectors that there was no general access to food after 8pm until the following morning. The manager said immediate action would be taken to offer food to anyone who wanted it.
“after 8pm there was no access to food until the following morning.” from the report
Equipment checks
needs fixingClinical equipment was clean and ready to use, but checks were not always recorded. This could make it harder to show that checks had been completed.
“Clinical equipment was clean and ready to use, but the checks were not always recorded.” from the report
- 01What food and drink are now available to people who want something after 8pm?
- 02How are checks on clinical equipment recorded, and how do you make sure records are complete?
- 03How are decisions about giving medicines covertly assessed, agreed and recorded?
- 04What changes were made after the previous inspection to improve leadership and communication?
- 05How are each person's therapy goals reviewed and updated as their abilities change?
This was an unannounced, planned inspection covering all five key questions, including the care, nursing and premises provided by the home. This explanation was written from the published report of 11 July 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, December 2016
Castel Froma was rated Good overall; inspectors found safe, kind and personalised care, but the home was not consistently well-led.
Inspectors visited without warning on 9 and 10 November 2016. They spoke with people living there, relatives and staff. They observed care, reviewed care plans and medicine records, and checked training, recruitment and quality monitoring.
The home supported up to 57 people with neurological disabilities and complex medical needs. Inspectors found enough skilled staff, safe medicines, suitable risk assessments and good support from nurses, therapists and other health professionals. People were treated with kindness, dignity and respect.
Care plans were personalised and people and relatives were involved in decisions. The overall rating was Good, as were Safe, Effective, Caring and Responsive. Well-led was rated Requires Improvement because communication, support and supervision were not consistent for all care staff.
Kind and respectful care
Staff took time to understand people's communication, preferences and personal histories. Inspectors saw thoughtful interactions and people were treated with dignity.
“Staff were compassionate and thoughtful and communicated effectively with people.” from the report
Improved medicines management
The home had acted after the previous inspection found medicines were not always managed safely. At this inspection, storage, administration, records and stock checks were generally safe.
“At this inspection we found improvements had been made.” from the report
Personalised rehabilitation and activities
People were supported to work towards individual goals and take part in activities. Staff also helped families manage risks when taking people out of the home.
“People were supported to achieve personal goals through rehabilitative input from physiotherapists and occupational therapists.” from the report
Communication with care staff
needs fixingSome care staff said managers did not always understand the demands of their work. They reported inconsistent instructions and were not confident that concerns would be listened to or acted on.
“This demonstrated that communication between managers and care staff was not always effective in the home.” from the report
Limited feedback information
minorThe 2016 survey had few responses and combined results from another service, so it was not clear which feedback related to this home. Some people also did not know how to raise serious concerns.
“Some people we spoke with were not aware of how to share more serious concerns through the provider's complaints procedure.” from the report
Incomplete medicine audit trail
minorThe quantity of medicines received was recorded, but the actual date of receipt was not. The clinical lead said this would be recorded in future.
“Although there was a record for the quantity of medicines received from the pharmacy, the actual date of receipt was not recorded.” from the report
- 01What has been done to improve communication between managers, nurses and care staff?
- 02How often will care staff now receive supervision, and how can they raise concerns if they feel unsupported?
- 03How do you check that all medicine records include the date medicines were received from the pharmacy?
- 04How can residents and relatives raise a formal complaint, and who will help them understand the process?
- 05How do you make sure feedback from residents and relatives is clearly separated from feedback about any other service?
This was an unannounced inspection of all five key areas, including care, staffing, medicines, records, complaints, management and quality monitoring. This explanation was written from the published report of 21 December 2016 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 Lillington House
4 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015Goodstayed GoodSafe: Requires improvement
- January 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 30 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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At least 100 live-in carers within about an hour of Warwickshire
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Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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