CQC report explained · a residential care home
What the CQC found at Lilliput House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found personalised risk assessments, regular reviews and safe moving and handling arrangements. Infection prevention and control measures were also found to be effective.
- Effective?
- Good
- Staff had completed the required training and received induction, supervision and checks of their work.
- Caring?
- Good
- This area was not assessed during this targeted inspection.
- Responsive?
- Good
- This area was not assessed during this targeted inspection.
- Well-led?
- Good
- Inspectors found effective quality checks, clear management roles and confidence in the management team.
What inspectors found, July 2021
Inspected but not rated; inspectors found good risk management, staff training, infection control and leadership during this targeted visit.
This was an unannounced targeted inspection on 22 June 2021. It checked concerns about staff skills, training, risk management and infection control. One inspector spoke with people, relatives and staff, observed care and checked records.
Inspectors found that people's risks were identified and reviewed. Staff understood how to support people safely. Staff training was up to date, and their work was checked by senior staff. Infection control measures, including the use of PPE, were also found to be effective.
The management team was established and staff had confidence in it. Quality checks were carried out regularly. The service was not given a new rating because this inspection did not cover the whole service. The previous overall rating was Good, published on 29 November 2019, and remained unchanged.
Personalised risk planning
Risk assessments gave staff clear instructions and were reviewed regularly. Staff knew people's risks and how to support them safely.
“Risk assessments included clear instructions for staff on how to minimise risks for people.” from the report
Staff training
Staff had induction, regular supervision and the training needed for their roles. Training records showed that staff were up to date.
“Staff training records showed that staff were up to date with all training required.” from the report
Infection control
Inspectors found suitable arrangements for PPE, testing, visiting, cleaning and managing possible outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Management and checks
The management team had clear roles, and the home used regular audits and monitoring to check standards.
“Quality assurance systems in place were effective and robust.” from the report
Inspectors raised no specific concerns in this report.
- 01What has changed since the targeted inspection about staff skills, training and risk management?
- 02When was the last full inspection, and when is the next comprehensive inspection expected?
- 03How often are each person's risk assessments reviewed, and how are staff told about changes?
- 04How do you check that staff continue to use moving and handling equipment safely?
- 05How are infection control arrangements and PPE use monitored now?
This was a targeted inspection of specific parts of Safe, Effective and Well-led, including infection control; it did not assess the whole service, and Caring and Responsive were not rated. This explanation was written from the published report of 22 July 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.
What inspectors found, December 2019
Lilliput House was rated Good; inspectors found kind, personalised care, with some records and staffing checks needing improvement.
This was an unannounced inspection on 7 and 8 November 2019. Inspectors spoke with people, relatives, staff and visiting professionals. They observed care and reviewed care plans, medicine records, staff files and management records.
The home was supporting 42 people and could care for up to 54. People said they felt safe and well cared for. Inspectors found suitable training, personalised care, respectful staff and a varied activity programme. Relatives felt involved and listened to.
The inspection was partly prompted by concerns about staffing, staff attitudes, moving and handling, continence care and response times. Inspectors found no evidence that people were at risk of harm from these concerns. They did find some weaknesses in staffing assessments, food and fluid records, medicine security and incident records. All five areas were rated Good, the same as at the previous inspection.
Kind and respectful care
People and relatives described staff as kind and helpful. Inspectors saw respectful interactions and found that privacy, dignity and independence were supported.
“People were supported by staff who were kind, caring and patient.” from the report
Personalised support
Care records described people's needs, abilities, life histories and preferences. Staff knew people well and reviewed their care monthly.
“People received personalised care. Their needs, abilities, life history, and preferences were documented, known and supported by staff.” from the report
Activities and relationships
People could choose from activities in the home and local community. The home also supported contact with relatives, friends and other residents.
“People had the opportunity to engage in a varied range of activities both in the home and local community.” from the report
Staff training
Staff received induction, practical checks, supervision and training linked to their roles and people's needs.
“Staff received mandatory and role specific training in areas such as equality and diversity, food hygiene, promoting continence, nutrition and manual handling.” from the report
Open management
Staff said they felt supported and listened to. Regular meetings, surveys and audits helped the management identify and act on improvements.
“A range of team meetings were held monthly to help ensure all staff felt supported and had opportunity to reflect on team performance.” from the report
Staffing checks
needs fixingInspectors found enough staff during the inspection, but dependency scores used to help decide staffing levels had not been reviewed. The manager introduced a new staffing tool during the inspection.
“Although there were adequate numbers of staff to meet people's needs, we received mixed views about staffing levels at the home.” from the report
Call bell waits
needs fixingThe manager audited call bell response times and inspectors saw timely responses. However, some people said they sometimes waited longer than expected.
“Although the manager carried out weekly audits of call bell response times, and we observed staff responding in a timely way, some people said they had to wait longer than they expected.” from the report
Food and fluid records
needs fixingSome records did not give a clear total of food and drink intake. It was also unclear whether low intake had been reported. The manager changed the monitoring process during the inspection.
“However, the records were not always totalled to provide an overview and it was not clear whether lower intake had been reported.” from the report
Medicine storage
needs fixingOne cabinet for medicines needing extra security was fixed to an internal wall, making it more vulnerable to being removed. The manager arranged for it to be fixed to an external wall during the inspection.
“Some medicines requiring additional security were not held as securely as they should be.” from the report
Incident records
minorAccidents and incidents were recorded appropriately, but the manager agreed that the forms needed more detail.
“Staff recorded accidents and incidents appropriately although the manager agreed the forms needed more detailed information.” from the report
- 01How do you now review people's dependency scores and use them to decide staffing levels?
- 02What are the current call bell response times, and how do you follow up reports of longer waits?
- 03How do you check that food and fluid records are totalled and that low intake is acted on?
- 04How are medicines needing extra security stored and checked now?
- 05What changes have been made to ensure accident and incident forms contain enough detail?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided, and it was partly prompted by concerns about staffing, moving and handling, continence care and response times. This explanation was written from the published report of 3 December 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.
Every inspection of Lilliput House
2 rated inspections over 2 years: the service has held its Good rating throughout.
- July 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- December 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2018GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016
Registered with the Care Quality Commission on 1 December 2016.
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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