CQC report explained · a residential care home
What the CQC found at Lily Close
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safeguarding procedures, risk assessments, enough staff and suitable recruitment checks. Medicines, infection control, and learning from accidents and incidents were also found to be managed safely.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff were trained and supervised, people were supported with food and healthcare, and the home was found to be working within the principles of the Mental Capacity Act.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors found that privacy, dignity, independence and involvement in decisions were promoted.
- Responsive?
- Good
- Care plans recorded people's needs, preferences and goals in detail. People were supported with communication, activities, relationships and complaints.
- Well-led?
- Good
- Inspectors found person-centred leadership, regular audits and involvement of people, relatives and staff. The home worked with other agencies and responded appropriately when things went wrong.
What inspectors found, October 2019
Lily Close was rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an unannounced planned inspection on 18 September 2019. One inspector spoke with two people living there, five staff members and two relatives. The inspector also reviewed care, medicines, recruitment and management records.
The home provided accommodation and care for people with learning disabilities and/or autism. Six people were living there, although the home could accommodate up to 10 people. Inspectors found enough staff, safe medicines arrangements, suitable staff recruitment and systems to protect people from abuse.
People were supported to make choices, stay healthy, keep relationships and develop independence. Inspectors found caring staff, detailed care plans, good links with health professionals and effective quality checks. All five CQC questions were rated Good, as they had been at the previous inspection published on 22 March 2017.
Safe staffing and medicines
Inspectors found enough staff and robust recruitment checks. Medicines were administered, recorded and audited safely.
“The service had robust recruitment practices. All staff had completed pre-employment checks to ensure their suitability for the roles.” from the report
Choice and independence
People were supported to make choices, take part in activities and develop their independence. Care was planned around their individual aims and preferences.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Kind and respectful care
People and relatives described staff as caring. Inspectors saw that privacy and dignity were respected and that staff encouraged people to do things for themselves.
“We observed staff encouraging people to do what they could at mealtimes.” from the report
Personalised support
Care plans included detailed information about people's needs, communication, preferences and goals. Staff worked to understand how each person wanted to be supported.
“People's care plans recorded their needs and preferences in detail.” from the report
Good management oversight
The provider used audits, staff observations, supervision and questionnaires to monitor and improve the service. People, relatives and staff were involved through meetings and feedback.
“The provider had quality assurance systems in place to ensure they provided high quality care and support and sought to continuously improve.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and update my relative's care plan, risks and communication needs after they move in?
- 02How do you make sure there are enough staff when a person's needs change?
- 03How would you support my relative to choose activities, maintain relationships and become more independent?
- 04How do you involve relatives in care reviews and decisions about treatment?
- 05How are medicines checked, recorded and audited?
This was an unannounced planned inspection that looked at the care provided and the premises, and rated all five CQC questions. This explanation was written from the published report of 25 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, March 2017
Lily Close was rated Good; inspectors found kind, personalised care, but the medicines audit was not effective.
This was an unannounced inspection on 6 February 2017. One inspector spoke with one person, a relative, two support workers and the manager. They also observed care and checked care files, staff records, medicines, audits and safety records.
The home was clean and spacious. Staff were described as patient, friendly and kind. Inspectors found enough staff, suitable training, personalised care plans, support with health appointments and activities, and good involvement of people and relatives.
There was one important medicines concern. A medicine was wrongly sent with a person staying away with family. The error was noticed by a relative, but inspectors said the medicines auditing system was not effective and recommended that it be improved.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The report says the shortfalls found at the previous inspection in 2015 had been addressed and improvements had been made.
Kind and respectful staff
Inspectors saw staff being polite and patient. People and relatives said staff were kind, helpful and attentive.
“Staff consistently treated people with respect, dignity and kindness.” from the report
Personalised care
Care plans described each person's needs, preferences and how they wanted to be supported. People and relatives were involved in reviews.
“The care plans were personalised and written in a first person format describing the person's needs and how they liked to be supported.” from the report
Staff training and support
Staff had training relevant to their roles and received supervision and appraisals. The report says the new manager had made improvements in this area.
“Staff were given time and support to complete a range of training programmes related to their roles.” from the report
Activities and independence
People were supported to do tasks themselves when possible, attend activities and use community facilities.
“Staff ensured people's human rights and worked within the principles of Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs).” from the report
Medicines checking
seriousOne medicine was wrongly sent with a person staying away with family. A relative noticed the error, but inspectors said the medicines audit was not effective and recommended stronger medicines management.
“Although the acting manager and staff told us, and records showed, that there was a medicine auditing system in place, people could be at risk because the system was not effective.” from the report
- 01What changes have been made to the medicines audit since the inspection, and how do you check that medicines are sent correctly when someone stays away?
- 02What is the current registration status of the manager who had applied to register with the CQC?
- 03How are people's care plans reviewed with them, their relatives and advocates?
- 04How do you make sure staff have completed the training, supervision and appraisals needed for their roles?
- 05How are people supported to choose activities, prepare food and do tasks independently?
This was an unannounced inspection covering all five CQC questions, based on conversations, observations and checks of care, staff, medicines, audit and safety records. This explanation was written from the published report of 22 March 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 Lily Close
3 rated inspections over 4 years: the service has held its Good rating throughout.
- October 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2014
Registered with the Care Quality Commission on 18 March 2014.
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 Havering
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Most charge £980 to £1,230 a week. 81 can care for a couple. 11 years' experience on average.
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