CQC report explained · a residential care home
What the CQC found at Littlebourne House Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks to people's health and safety were assessed, with guidance for staff. Medicines, staffing, recruitment, safeguarding, accidents and infection control were found to be managed safely.
- Effective?
- Good
- People had pre-admission assessments, trained staff, food and drink choices, healthcare support and help to make decisions. Inspectors found that people's outcomes were consistently good.
- Caring?
- Good
- People were treated with dignity and respect. Staff supported independence, privacy, personal choices, religious and cultural needs, and involvement in care decisions.
- Responsive?
- Good
- Care plans recorded people's histories, choices and preferences. People had activities, contact with important people, accessible information and a complaints process.
- Well-led?
- Good
- The management structure and quality checks had been strengthened. The home had systems to keep records up to date, involve people and relatives, and act on concerns.
What inspectors found, September 2019
Littlebourne House Residential Care Home was rated Good; inspectors found safe, kind and personalised care after earlier problems were addressed.
Inspectors visited without notice on 12 and 13 August 2019. They spoke with 12 people, five relatives and 10 staff. They observed care and reviewed care plans, medicine records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people felt safe and happy, medicines were managed safely, care plans were personalised and staff supported people's choices, health and independence.
The previous inspection rated the home Requires Improvement and found multiple breaches. This inspection found improvements in risk assessments, medicines, care planning and management systems. The home was no longer breaching regulations.
Improved safety systems
Risk assessments and guidance had improved since the previous inspection. The home also introduced an electronic system to monitor medicines.
“Now potential risks to people's health, welfare had been consistently assessed and there was detailed guidance in place for staff to mitigate the risk.” from the report
Kind and respectful care
Inspectors saw staff respecting privacy and supporting people with dignity, choices and independence.
“People were treated with dignity and respect. Staff knew people's choices and preferences and made sure these were respected.” from the report
Personalised support
Care plans included people's histories, routines, preferences and important relationships. Activities were arranged around what people enjoyed.
“Now each person had a care plan that had been developed with them or their relatives, this included information about their lives before they moved into the service” from the report
Open management
The manager used audits, meetings and action plans to identify and address problems. People and relatives were invited to give their views.
“There was an open and transparent culture within the service. People were supported to be as involved in developing their care as possible.” from the report
More detail needed in assessments
minorThe pre-admission assessment recorded protected characteristics but did not contain enough information about people's sexual orientation.
“The assessment had information about people's protected characteristics under the Equalities Act 2010 but required more about people's sexual orientation.” from the report
New medicines system still settling in
minorStaff had made some initial mistakes while learning the new electronic medicines system, although their competence had been assessed and inspectors observed safe administration.
“Staff told us, they were becoming more confident with the system following some initial mistakes.” from the report
- 01How do you check that risk assessments and care plans remain accurate when a person's needs change?
- 02How are staff monitored now that the electronic medicines system has replaced the previous process?
- 03What has been done to improve assessments of people's sexual orientation and other personal characteristics?
- 04How are people's activity choices, routines and relationships recorded and reviewed?
- 05How are concerns and complaints recorded, investigated and checked to make sure the agreed action is completed?
This was an unannounced inspection of all five CQC questions, including the premises and care provided; it followed the previous Requires Improvement rating. This explanation was written from the published report of 3 September 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, August 2018
Littlebourne House Residential Care Home was rated Requires Improvement; care was kind, but medicines, care plans, risk assessments and management systems were not reliable enough.
The inspection was unannounced and took place on 19 and 20 July 2018. One inspector and an expert by experience reviewed records, spoke with people, relatives and staff, and observed care.
Inspectors found that people were treated kindly and supported to make choices. There were enough staff, recruitment checks were completed, the home was clean, and people were supported with food, activities, healthcare and end of life care.
However, eight people who had moved in since May 2018 had no recorded pre-admission assessments, risk assessments or care plans. Medicines were not always recorded or administered safely. Audits had not led to effective action, and there was no registered manager in post.
The overall rating was Requires Improvement. Caring was rated Good. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. Three legal regulations were breached.
Kind and respectful care
People were treated with kindness and compassion. Staff supported dignity, independence and involvement in decisions.
“We observed people being treated with kindness and compassion.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and saw that recruitment checks had been completed.
“There were sufficient staff to meet people's needs, who had been recruited safely.” from the report
Food and health support
People had meal choices, help to eat and drink, and support to access health professionals when needed.
“People were supported to eat and drink to remain healthy.” from the report
Activities and end of life care
People could choose from daily activities, and staff recorded end of life wishes when known and worked with health professionals to keep people comfortable.
“There were a variety of activities available for people to take part in if they wanted.” from the report
Missing care and risk plans
seriousEight people admitted since May 2018 had no recorded pre-admission assessment, risk assessment or care plan. This meant staff lacked written guidance about their needs and risks.
“None of the eight people had a pre-admission assessment, risk assessments or care plan recorded.” from the report
Unsafe medicines procedures
seriousHandwritten medicine instructions were not properly signed. Some medicines were not recorded or administered in line with the required procedure, and opened eye drops were not dated.
“Some medicines had specific procedures which should be followed with regards to their storage, recording and administration.” from the report
Weak management oversight
seriousThere was no registered manager, and responsibilities were not reassigned clearly after senior staff left. Audits had identified some issues but had not ensured they were corrected.
“The audits had not been effective in identifying the shortfalls found at this inspection, such as the lack of care plans for new admissions.” from the report
Limited accessible complaints information
needs fixingThe complaints policy was available at reception but not in easy-read or pictorial formats to help people living with dementia understand it.
“The policy was not available in other formats such as easy read or pictorial to support people living with dementia to understand.” from the report
- 01Have all new residents got complete care plans and risk assessments before or immediately after moving in?
- 02How are handwritten medicine instructions checked and double-signed, and how are medicines requiring two staff administered and recorded?
- 03Who is currently responsible for medicines, care plans, risk assessments and checking that staff complete these tasks?
- 04What changes have been made to make audits identify problems and ensure they are corrected?
- 05Is the complaints information now available in easy-read or pictorial formats?
This was an unannounced inspection covering all five CQC questions and the overall rating; it was the first inspection since the provider changed its legal entity in August 2017. This explanation was written from the published report of 30 August 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 Littlebourne House Residential Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Littlebourne House Residential Care Home →
- August 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Littlebourne House Residential Care Home →
- August 2017
Registered with the Care Quality Commission on 29 August 2017.
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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