CQC report explained · a nursing home
What the CQC found at Lindau Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Lindau Residential Home was rated Requires Improvement; inspectors found kind care but gaps in safety, care planning and management oversight.
This was an unannounced focused inspection on 24 January 2023. Three inspectors spoke with people, a relative and staff. They observed care and checked care, medicine, staffing and management records.
The home had enough staff during the inspection and people said staff were kind and caring. Medicines were mostly managed safely, people received health support, and meals met people's dietary needs.
However, some risks had not been properly assessed or reduced. Some people did not have complete care plans, staff lacked epilepsy training, some areas were not clean, and quality checks had missed important problems.
The overall rating changed from Good at the previous inspection in 2017 to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive were not assessed in this focused inspection, so their previous ratings were not used to calculate the overall rating.
Kind and respectful staff
People said staff were kind, listened to them and respected their dignity and privacy.
“It is brilliant here. The staff are lovely, they listen to what you want and say, they are always there” from the report
Safeguarding and staffing
Staff understood how to recognise and report abuse. Inspectors saw suitable staffing levels during the inspection and call bells were answered quickly.
“We observed there were suitable numbers of staff to provide the care and support people were assessed as needing at the time of the inspection.” from the report
Health support
People were supported to attend health appointments and had access to GPs, community nurses and other professionals when needed.
“People had access to health services when they needed it.” from the report
Food and hydration
People were offered meal choices and more food if wanted. The home provided meals for different dietary needs and monitored people's weight and fluid intake.
“We observed mealtimes to be relaxed and people were offered choices of meals and offered more if they wanted it.” from the report
Some prompt action
The manager acted during or after the inspection to lock rooms containing harmful items, move hoists and improve some records and cleaning arrangements.
“The registered manager took timely action to address the concerns relating to the service and addressed the most serious of the concerns immediately.” from the report
Unmanaged safety risks
seriousRisks from hot pipes, harmful items, fire escape routes and some people's health needs had not been properly assessed or reduced. Inspectors said this placed people at risk of harm.
“The failure to provide safe care and treatment by reducing risks to people's health and safety is a breach of Regulation 12” from the report
Incomplete care plans
seriousSome people did not have care plans or enough information for staff to meet their needs. People with learning disabilities did not always have clear goals or plans to maintain and develop skills.
“One person had lived at the service for 3 weeks and had no care plan in place.” from the report
Epilepsy training and guidance
seriousThere were no epilepsy risk assessments, and some staff did not know a person had epilepsy. Some care staff had not received epilepsy training.
“There were no risk assessments in place relating to people living with epilepsy.” from the report
Weak management checks
seriousAudits had missed problems with risk assessments, fire safety, infection control and MCA and DoLS. Provider visits were not supported by clear records of what had been checked.
“The systems to review and check the quality of the service were not always robust or sufficient to alert registered persons of concerns and issues within the service.” from the report
Infection control and cleanliness
needs fixingSome areas were not clean, and there were no COVID-19 risk assessments for people, including those at higher risk of becoming acutely unwell.
“Some areas of the service were not clean.” from the report
PRN medicine guidance
needs fixingSome as-needed medicines did not have clear protocols explaining when or how staff should give them or when to seek further advice.
“People prescribed 'as and when required' (PRN) medicines did not always have the appropriate protocols in place” from the report
- 01What has been done to assess and reduce the risks from hot pipes, the boiler, harmful items and restricted fire escape routes?
- 02Have all residents, especially people with epilepsy or specialist equipment, got complete and up-to-date risk assessments and care plans?
- 03What epilepsy training have staff completed, and how do you check that staff know how to respond safely?
- 04How are PRN medicines now supported by clear protocols, and how are medicine errors or concerns reviewed?
- 05How are management audits now checking care plans, risk assessments, infection control, fire safety and DoLS notifications?
This was a focused inspection of Safe, Effective and Well-led only, following concerns about medicines, mental health needs and infection control; Caring and Responsive were not inspected and their previous ratings were carried over. This explanation was written from the published report of 17 March 2023 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 2017
Rated Good; inspectors found safe, kind and responsive care, with a small number of improvements still needed.
This was an unannounced inspection on 26 and 27 July 2017. The inspectors spoke with people living in the home, relatives, visitors, staff and a healthcare professional. They looked at care records, medicines, staff checks, training, accidents, complaints and quality audits.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines processes, suitable health support and respectful care. People had personalised care plans, choices about food and activities, and complaints were investigated.
The previous inspection in June 2016 had rated the home Requires Improvement and found three breaches. The report says these problems had been resolved. A new issue was found because the latest CQC rating was not displayed on the home's website, although it was displayed at the premises.
Medicines were safer
The medicines problems found at the previous inspection had been addressed. Medicines were stored securely, checked and recorded, with guidance for occasional medicines.
“Medicines that required special storage and extra checks were checked daily by two nurses at each shift and recorded in a book to follow good practice.” from the report
Kind and respectful care
Inspectors saw staff speaking kindly, protecting privacy and reassuring people when they were anxious or needed help.
“People were treated with dignity and respect and there was good humour and rapport between people and staff.” from the report
Personalised care and activities
Care plans included people's preferences, communication needs and support with decisions. People could choose from activities such as crafts, walks, music, gardening and outings.
“Care plans were individual and personalised to reflect people's needs.” from the report
Good oversight
The manager used a wide range of audits and action plans. Feedback from people was collected and used to identify improvements.
“The registered manager conducted numerous audits and analyses to maintain good oversight of the service and safety of the people using it.” from the report
Website rating was missing
needs fixingThe latest CQC rating was displayed at the premises but not on the website. Inspectors said this was a legal requirement and asked the provider to put it right.
“Although the provider had displayed their latest rating at the premises as required, they had failed to display their latest CQC inspection report rating on their website which is a legal requirement.” from the report
Staff supervision was not always regular
needs fixingStaff had day-to-day support, but formal supervision had not always happened as often as managers wanted. The deputy manager identified this as an area for improvement.
“Although they had day to day contact with all staff formal supervisions had not always been conducted as often as they would like.” from the report
Two weights needed correction
minorTwo people's converted weights had been calculated incorrectly for their specialist air mattresses. The manager corrected this immediately, and inspectors found no harm had occurred.
“Two people's converted weight had not been calculated correctly using the formula.” from the report
More choking-response training was suggested
needs fixingSome staff said further training on responding to choking would be useful. Inspectors said some staff answers about what to do could be improved.
“Although staff have received training in first aid some commented further training particularly in regards to responding to people choking would be beneficial.” from the report
- 01How often are staff now given formal supervision, and how is this recorded?
- 02What further training have staff had on responding to choking?
- 03How do you check that specialist air mattresses are set to the correct weight?
- 04How have you maintained the improvements to medicines management found since the previous inspection?
- 05What activities are available for someone with my relative's interests, abilities and health needs?
This was an unannounced inspection of the overall service and considered all five CQC questions, including records, medicines, staffing, care, activities, complaints and management systems. This explanation was written from the published report of 19 September 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 Lindau Residential Home
3 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.