CQC report explained · a nursing home
What the CQC found at Lindisfarne Crawcrook
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Rated Requires Improvement; inspectors found better medicines management but ongoing problems with staffing, safety, meals and oversight.
This was an unannounced focused inspection on 7 August 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicines, staff and management records.
The home had improved its medicines management and records since the previous inspection. Staff recruitment was safe. People were supported in line with mental capacity law, and staff worked with other health professionals.
However, staffing levels and deployment were not enough to provide safe, timely and person-centred care. Inspectors found risks linked to distress, the environment, mealtimes and a lack of engagement. The home's checks had not found or acted on these problems quickly enough.
The overall rating remains Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. The home has had this rating for the last three inspections and remained in breach of regulations.
Medicines records improved
Medicines were managed more safely than at the previous inspection. The provider was no longer in breach for this aspect of medicines record keeping.
“Improvements had been made to the safe management of medicines with more robust records now in place.” from the report
Safe recruitment
Inspectors found that recruitment processes were in place and had been followed correctly.
“The provider had processes in place to ensure the safe recruitment of staff and these had been correctly followed.” from the report
Working with professionals
Staff made referrals when needed and worked with several health and care professionals to support people's needs.
“Staff worked with a range of other professionals, including GPs, district nurses, speech and language therapy and the mental health team.” from the report
Mental capacity processes
Records showed that capacity assessments and best-interest decisions were documented appropriately. The report said the home was working within the principles of the Mental Capacity Act.
“The provider was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Insufficient staffing
seriousStaff were not always available to supervise people or provide timely, meaningful support. Care was often task-centred, and some people were left disengaged for much of the day.
“There were insufficient staff and they were not appropriately deployed to support people in a safe, timely and person-centred way.” from the report
Safety risks
seriousInspectors found unsafe items left accessible in an area used by people living with dementia. Support for people who were distressed or agitated was also not always effective.
“Hot tea pots were left unprotected on the drinks trolley, which posed a risk to people's safety, as some people were walking around the trolley, on the unit where people lived with dementia.” from the report
Poor mealtime experience
needs fixingPeople were not always given choices, encouragement or alternatives at mealtimes. Staff did not consistently check whether people needed help to eat.
“People were not offered an alternative if they did not want their meal.” from the report
Environment not suited to dementia
needs fixingThe refurbishment programme had not progressed enough. The environment offered too little visual and sensory stimulation to help people stay oriented and engaged.
“There was little visual and sensory stimulation to help maintain the involvement and orientation of people who lived with a dementia, as they moved around.” from the report
Weak quality monitoring
seriousAudits were being completed, but they had not identified or dealt with important problems quickly enough. The provider remained in breach of the governance regulation.
“The audit and governance processes had either failed to identify or they had not been actioned in a timely way.” from the report
- 01How many staff are planned for each unit, and how will you make sure people receive supervision and timely care?
- 02What specific changes have been made to support people who become distressed or agitated, and what refresher training have staff completed?
- 03What has changed at mealtimes so people are offered choices, encouragement and alternatives when needed?
- 04What is the timetable for making the environment more suitable for people living with dementia?
- 05What actions are being taken to address the three breaches, and how will you show that the changes are working?
This was a focused inspection of Safe, Effective and Well-led, with the scope widened to Effective; Caring and Responsive were not inspected during this visit and previous ratings were carried forward. This explanation was written from the published report of 15 September 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, August 2022
Rated Requires Improvement; inspectors found improved risk management but concerns about medicines records, staffing, the environment and oversight.
This was an unannounced focused inspection. Inspectors checked whether earlier improvements had been made, especially around safety and leadership. They spoke with people using the service, relatives, staff and professionals, and reviewed care, medicines, recruitment and management records.
The home had improved how it assessed risks, and falls had reduced substantially. Staff recruitment, safeguarding and infection control systems were in place. People and relatives described staff as kind and caring, although staff were often very busy.
The inspection found that medicines records were not always complete or accurate. There were not enough staff to provide timely, meaningful and person-centred support. Some parts of the home were worn or not clean, and management checks had failed to identify several of these problems.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The earlier breach about safe care and treatment had been resolved, but the home was in breach of Regulation 17 about good governance.
Improved risk management
Risk assessments were regularly reviewed and staff understood how to reduce avoidable harm. Inspectors also found a substantial reduction in falls.
“There had been a substantial reduction in the number of falls to people.” from the report
Safe recruitment
The provider followed its recruitment processes correctly.
“The provider had processes in place to ensure the safe recruitment of staff and these had been correctly followed.” from the report
Kind direct care
People and relatives trusted the staff and described them as kind, caring and supportive, even though staff were busy.
“They said staff, although, "very busy", were kind and caring and supportive of people and their families.” from the report
Working with professionals
Staff worked with other health and social care professionals to understand people's needs and arrange support.
“Staff communicated with a range of professionals to ensure that people's needs were considered and understood so that they could access the support they needed.” from the report
Medicines records
seriousRecords for some topical and as-needed medicines, thickening agents, patches and allergies were not consistently complete or reliable. Inspectors could not be sure one person was receiving the correct amount of thickener.
“Some improvements had been made to the safe management of medicines. However, robust records were not always kept.” from the report
Staffing and stimulation
needs fixingThere were not enough staff to provide care promptly and to support people's social and emotional needs. Inspectors found that care was task-focused and some people lacked activities and stimulation.
“People were safe but not enough staff had been deployed to meet people's social and emotional needs and provide care in a timely and meaningful way.” from the report
Condition of the home
needs fixingSome carpets were marked or stained, and parts of the home showed wear and tear. The provider later supplied a refurbishment plan, including replacing some carpets.
“An infection control system was in place. However, not all areas were well maintained or clean and there were signs of wear and tear.” from the report
Weak quality checks
seriousManagement audits failed to find several problems identified by inspectors. This meant issues with medicines, staffing, infection control and care quality had not been dealt with quickly enough.
“The provider did not have effective systems in place to monitor and improve the quality of the service.” from the report
- 01What has changed in the medicines records since the inspection, including records for as-needed medicines, thickening agents, patches and allergies?
- 02How many staff are now deployed on each shift, and how do you make sure people receive timely personal care, conversation and activities?
- 03Which refurbishment work has been completed, especially the carpets and worn areas on the top floor?
- 04How are your audits now checking medicines, staffing, infection control and the quality of person-centred care?
- 05What actions were included in the plan sent to CQC, and what evidence can you show of progress?
This was a focused inspection of Safe and Well-led, prompted partly by concerns about falls and staffing; the other key question ratings were not covered and were not given in this report. This explanation was written from the published report of 31 August 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.
Every inspection of Lindisfarne Crawcrook
6 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- May 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- September 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 2 February 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
48 live-in carers within about an hour of Gateshead
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 £950 to £1,240 a week. 42 can care for a couple. 10 years' experience on average.
“Petty introduced herself to Mum every time she was caring for her and responded very quickly to Mum if she was distressed in the night.”
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.