CQC report explained · a nursing home
What the CQC found at Lincoln House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer recruitment, good safeguarding systems, reviewed risk assessments and secure medicines. Damaged corridor surfaces remained an infection control risk.
- Effective?
- Good
- People had detailed assessments and care plans, staff training was in place, consent was sought, and staff worked with health professionals. Improvements had also been made to the building and courtyard.
- Caring?
- Good
- People were treated with dignity and respect, involved in care plan reviews and supported to make choices. Staff were observed spending time talking with people.
- Responsive?
- Good
- Care plans reflected people's preferences, interests and communication needs. People and families said they felt able to raise concerns, and end of life wishes were recorded.
- Well-led?
- Good
- Audits and management oversight had improved, covering medicines, care plans, daily records, risks and staff knowledge. There was no registered manager in post during the inspection, but a new manager had been appointed and was waiting to start.
What inspectors found, June 2022
Rated Good; the home improved from Inadequate and has left Special Measures, but damaged communal surfaces remained an infection risk.
Inspectors visited without notice on 26 April 2022. They spoke with people, relatives and staff, reviewed care and medicines records, and checked training, rotas and quality records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found better care plans, safer staffing, secure medicines, respectful care and stronger checks on quality.
The home had previously been rated Inadequate and placed in Special Measures. Inspectors found that the provider had made enough improvements and was no longer breaking the regulations listed at the previous inspection.
There was still a problem with damaged surfaces in communal corridors. The provider said it would put this right and source new handrails. There was also no registered manager in post at the time of the inspection, although a new manager had been appointed and was waiting to start.
Improved safety
Staffing, safeguarding, risk management and building security had improved since the previous inspection. Inspectors found that earlier breaches in these areas had been resolved.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations” from the report
Medicines management
Medicines were stored securely and records and stock were checked. Staff received training and regular competency checks.
“Medicines were well audited to ensure people received their medicines as prescribed.” from the report
Personalised care
Care plans recorded people's needs, choices and preferences. People and their relatives were involved in planning and reviewing support.
“People were involved in planning and reviewing their support needs. Care plans were shaped around people's preferences.” from the report
Kind and respectful staff
People spoke positively about the staff. Inspectors observed staff talking with people and providing care with dignity.
“Staff were observed supporting people in a meaningful way during the inspection.” from the report
Stronger oversight
The home had introduced regular audits at different management levels. These covered care records, medicines, environmental risks and staff understanding of their roles.
“Audits had now been fully embedded at the service which ensured stronger oversight had been established.” from the report
Damaged communal surfaces
needs fixingInspectors found damaged surfaces in corridors. They considered this an infection control risk, and the provider said repairs and replacement handrails would be arranged.
“We identified surfaces in corridors that had become damaged.” from the report
No registered manager in post
minorThere was no registered manager when inspectors visited. A new manager had been appointed and was waiting to start, with a phased handover planned.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Have the damaged corridor surfaces been repaired, and have the replacement handrails been fitted?
- 02Is there now a registered manager in post, and have they completed the planned registration process?
- 03How often are audits of medicines, care plans, daily records and environmental risks now completed?
- 04What staffing levels and training checks are currently in place on each shift?
- 05How are you checking that the improvements made after the previous Inadequate rating have been sustained?
This was an unannounced follow-up inspection covering all five CQC questions, after the previous Inadequate rating and Special Measures status. This explanation was written from the published report of 21 June 2022 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, September 2021
Lincoln House Care Home was rated Inadequate and placed in special measures; inspectors found serious risks, staffing shortfalls and poor oversight.
This was an unannounced comprehensive inspection in June and July 2021. Inspectors spoke with people using the service, staff and managers. They reviewed care plans, medicines records, staff files and other safety and quality records.
The home was not safe. Risks in the building and in people's care were not always assessed or controlled. There were not always enough skilled staff on the residential unit. Safeguarding incidents were not properly reported or investigated, and some consent and DoLS records were not lawful or up to date.
Staff were generally kind and patient, and infection control, complaints handling and end of life care were positive. However, people sometimes waited too long for help, their preferences were not always followed, and food and fluid monitoring on the residential unit was poor.
The overall rating fell from Requires Improvement at the previous inspection in June 2019 to Inadequate. Safe and Well-led also fell to Inadequate. The home was placed in special measures and CQC said it would monitor progress and re-inspect.
Kind and patient staff
People and inspectors described staff as caring and dedicated. Staff were seen treating people respectfully and supporting independence.
“We observed staff treating people with patience, kindness and respect and having a joke with them.” from the report
Infection control
Inspectors were assured about most infection prevention arrangements, including PPE, testing, admissions and visiting. The home also appeared clean.
“The service appeared clean and there were no odours. A cleaning schedule was in place for communal areas and for each person's individual room.” from the report
End of life care
People's wishes for end of life care were clearly recorded. Staff arranged anticipatory medicines and kept relatives informed.
“People's end of life wishes for their care were clearly recorded in their care plan.” from the report
Complaints handling
Inspectors reviewed nine complaints and found that written and verbal complaints were recorded and managed in line with the home's procedure.
“Written and verbal complaints were recorded and well managed in line with the provider's policy.” from the report
Unsafe environment and risk controls
seriousInspectors found hazards including unsecured external doors, a poor courtyard, a hot drinks machine and accessible items that could pose choking or ingestion risks. Some immediate safety actions were taken during or after the inspection.
“Systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Poor food and fluid monitoring
needs fixingOn the residential unit, fluid targets were unclear and records were not always completed. Action was not always recorded when people had not eaten or drunk enough.
“We could not be assured all the people who used the service were fully protected from the risk of not eating or drinking enough.” from the report
Weak management oversight
seriousAudits did not identify important safety and care problems. The provider had not made enough improvement since the previous inspection and remained in breach of governance requirements.
“Systems designed to monitor the safety and quality of the service and take action to mitigate risk, were not robust.” from the report
- 01How many permanent and agency staff are now working on the residential unit on each shift, and how do you check that agency staff have the right skills?
- 02What has changed to prevent people leaving the home when it is unsafe, and how are safeguarding incidents now reported and reviewed?
- 03How are food and fluid targets recorded and checked each day, and what happens when someone does not eat or drink enough?
- 04How do you now check that mental capacity assessments, best interest decisions, consent records and DoLS applications are current and legally correct?
- 05What evidence can you show that the new audits and service development plan have identified and fixed the problems found in this inspection?
This was an unannounced comprehensive inspection covering all five key questions and infection prevention and control; the inspection was prompted partly by a specific incident, but CQC did not examine the circumstances of that incident. This explanation was written from the published report of 4 September 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.
Every inspection of Lincoln House Care Home
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2021Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 22 March 2011.
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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