CQC report explained · a residential care home
What the CQC found at Ling Crescent
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were identified and staff understood how to reduce avoidable harm. The provider had reviewed safety after a person died following a fall from height, although some risk assessments and records were still being updated.
- Effective?
- Requires improvement
- Mental capacity assessments and best interest records were not always detailed enough. Some supervision, appraisals and staff training were overdue, and care records were not always reviewed regularly.
- Caring?
- Good
- Staff treated people with kindness, compassion, dignity and respect. People were supported to make choices, communicate in their preferred ways and maintain their independence.
- Responsive?
- Good
- Care plans contained person-centred information and people took part in activities suited to their interests. However, there were no end-of-life care plans in place.
- Well-led?
- Good
- The home had audits, an improvement plan and systems for learning from incidents and feedback. Staff and relatives described a positive culture, although meetings for relatives had been less frequent recently.
What inspectors found, July 2023
Rated Good overall; inspectors found kind, safe care, but the home needed to improve mental capacity records, staff support and some care planning.
This was an unannounced inspection after a person died following a fall from height. CQC examined risks linked to falls, but did not examine the circumstances of that death. Inspectors visited on 31 May, 5 June and 6 June 2023, and also reviewed records, spoke with staff and received feedback from a relative.
People were protected from abuse and avoidable harm. Staffing, recruitment, medicines and infection control were generally managed safely. Staff knew people well, treated them with kindness and supported their choices, communication, activities and access to healthcare.
The main weakness was effectiveness, which was rated Requires Improvement. Mental capacity assessments and best interest records did not always contain enough detail. Some staff supervision, appraisals and training were overdue, and care records were not always reviewed regularly. The manager had identified these issues and had improvement plans under way.
The overall rating remained Good. Safe, Caring and Well-led stayed Good. Responsive changed from Outstanding to Good, meaning people's needs were still met, but inspectors found the service was no longer performing at the highest level in that area.
Kind and respectful staff
Inspectors saw staff treating people with kindness, compassion, dignity and respect. Staff knew people's likes, dislikes and preferences.
“We observed staff interactions with people which showed they were treated with kindness, compassion, dignity, and respect.” from the report
Personalised support
Care plans contained detailed, person-centred information. People were supported to make choices and take part in activities that matched their interests.
“Care plans were detailed and contained person centred information.” from the report
Safe staffing and medicines
There were enough staff to meet people's needs, and recruitment checks were completed. Medicines were stored, given and disposed of safely.
“There were enough staff to support people safely and to ensure people's needs could be met.” from the report
Positive leadership
The manager used audits and an improvement plan to identify shortfalls and track actions. Staff described good teamwork and support from management.
“There was a clear action plan in place to address concerns found in audits and from feedback and this evidenced continuous improvement.” from the report
Mental capacity records
needs fixingSome mental capacity assessments did not show enough detail about how people were helped to understand decisions or how they were involved. The provider had started work to improve this.
“People had some mental capacity assessments in place; however, these did not always contain the detail required to demonstrate how people had been involved and supported to understand the decisions to be made.” from the report
Staff supervision and training
needs fixingSome staff did not receive supervision every three months as the provider's policy required, and staff had not had an appraisal in the last year. Some required training was also incomplete.
“Some staff had not always received supervision 3 monthly in line with the providers policy, although, all staff spoken with told us they felt supported by the management team.” from the report
Care records not always reviewed
needs fixingCare plans and risk assessments were not always reviewed promptly or when people's needs changed. The manager had begun reviewing and updating them.
“Care was planned and delivered in line with people's individual assessments, however, these were not reviewed regularly or when needs changed, in line with best practice guidance.” from the report
No end-of-life plans
needs fixingThere were no end-of-life care plans. This meant staff might not know a person's wishes if their health suddenly deteriorated.
“There were no end-of-life care plans in place at the service.” from the report
Food labelling
minorInspectors found out-of-date food and opened sauces without labels. These were removed immediately and extra checks were added.
“We observed some out-of-date foods and opened sauces which were not labelled in the kitchen.” from the report
- 01What progress has been made with completing mental capacity assessments and recording best interest decisions?
- 02Have all staff now received supervision, appraisals and the outstanding MCA, Basic Life Support and epilepsy training?
- 03How often are care plans and risk assessments now reviewed, especially when a person's needs change?
- 04How will you record each person's wishes about end-of-life care and funeral arrangements?
- 05What changes were made after the fall-related death, and how are risks of falls now checked for everyone living in the home?
This was an unannounced inspection prompted partly by a fall-related death; it examined all five key questions but did not examine the circumstances of that death, and the previous ratings were from the 2018 inspection. This explanation was written from the published report of 8 July 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, November 2018
Rated Good; inspectors found kind, personalised care and outstanding responsiveness, but weight-monitoring records needed improvement.
This was an unannounced comprehensive inspection over 26 and 27 September 2018. The inspector met everyone living at the home, observed care, spoke with staff, relatives and professionals, and checked care records, medicine records, staffing and quality checks.
The home was rated Good overall. Safe, Effective, Caring and Well-led were rated Good. Responsive was rated Outstanding. Inspectors found enough safely recruited staff, safe medicines practice, clean surroundings and respectful care.
People had very personalised support. They were helped to communicate, make choices, become more independent and take part in activities they enjoyed. The home also worked with health professionals to reduce unnecessary medicines used to manage behaviour.
There was one important weakness. Records for a person who was underweight did not clearly show the healthy weight range or what staff should do if their weight fell further. The home was asked to review its systems for monitoring and recording weight and diet.
Personalised activities
The home supported people to enjoy activities suited to their interests and ambitions, including holidays, sport, music and community outings.
“People did a wide range of activities which took into account their individual preferences, interests and aspirations.” from the report
Communication support
Staff understood how people communicated, including when people did not use speech. Care plans gave detailed information about individual communication methods.
“People were supported by staff who understood their communication needs and preferences.” from the report
Kind and respectful care
Inspectors observed warm and compassionate interactions. Families and professionals also gave strongly positive feedback about the care.
“People were treated with kindness and compassion. People were supported to express their views and be actively involved in decisions about their care and support as far as possible.” from the report
Reducing unnecessary medicines
The home worked with health professionals to reduce medicines used to manage behaviour, while finding other ways to reduce distress and self-injury.
“The registered manager had led a piece of work, alongside staff and health professionals, to reduce inappropriate use of psychotropic medicines.” from the report
Weight records were unclear
needs fixingRecords for a person who was underweight did not clearly show the person's healthy or average weight, or what staff should do if weight fell further. The CQC recommended that the home review its weight and diet monitoring systems.
“Although staff were recording the person's weight each month, it was unclear from the records what action they should follow if the person dropped below a certain weight.” from the report
- 01How do you now record the person's healthy weight range, and what action do you take if their weight falls?
- 02How quickly would you refer someone for medical or specialist advice after concerning weight loss?
- 03How would you support my relative to communicate choices, discomfort or concerns if they do not use speech?
- 04What activities and community opportunities would be planned around my relative's interests and ambitions?
- 05How do you review medicines used for behaviour, and what non-medical support would be tried?
This was a comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 29 November 2018 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 Ling Crescent
3 rated inspections over 8 years: the service has slipped, from Outstanding to Good.
- July 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2018Gooddown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- March 2015OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Outstanding
- June 2014
Registered with the Care Quality Commission on 18 June 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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Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
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