CQC report explained · a residential care home
What the CQC found at Littlecroft
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable risk assessments, safe recruitment and safe medicines management. Fire procedures, emergency evacuation plans and water safety checks had also been improved since the previous inspection.
- Effective?
- Good
- Staff had suitable training and supervision. People had access to GPs and other health professionals, and staff supported their dietary, communication and healthcare needs.
- Caring?
- Good
- Staff communicated patiently and respectfully. They knew people's personal histories, preferences and communication cues, and supported privacy, dignity and independence.
- Responsive?
- Good
- Care plans were detailed, personal and kept up to date. People were supported with chosen activities, community outings, family contact and complaints in accessible ways.
- Well-led?
- Good
- Inspectors found effective quality checks, an open culture and staff who felt supported. The manager and provider had improved systems that had not worked well enough at the previous inspection.
What inspectors found, April 2018
Littlecroft was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced, comprehensive inspection on 14 February 2018. One inspector and an expert by experience observed care, spoke with staff and the manager, and checked care records, medicines records, staff files, training records, rotas and audits.
The home supported up to nine people with learning disabilities. Five people were living there during the inspection. Inspectors found enough staff, safe medicines arrangements, suitable care plans and good access to health professionals.
Staff were described as kind, respectful and familiar with people's needs, communication styles and preferences. People were supported to make choices, stay in contact with family and friends, and take part in activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was an improvement from the previous inspection in October 2016, when the overall rating was Requires Improvement and five regulations had been breached.
Safe medicines
Staff were trained and medicines records were complete. This included medicines given only when needed, with suitable guidance in place.
“Medicines were managed safely and people received them as prescribed, including as and when required medicines.” from the report
Kind and respectful care
Staff took time to understand people and supported them in a calm, dignified way. They respected privacy and encouraged people to do things for themselves.
“Staff treated people with kindness and respect for their privacy and dignity.” from the report
Personalised support
Care plans described people's communication, routines, preferences, risks and health needs. Staff were observed following this guidance.
“Care plans contained information about people's wishes and preferences and detailed guidance on people's likes and dislikes around food, drinks, activities and situations.” from the report
Activities and relationships
People were supported to take part in activities they chose, including outings and activities in the community. Staff also supported contact with family and friends.
“People were supported to participate in activities of their choice, within the service and the community.” from the report
Improved oversight
The provider had strengthened its checks and monitoring. Inspectors found that actions were identified and followed through.
“Quality assurance processes were effective to ensure required actions were identified and progressed.” from the report
Inspectors raised no specific concerns in this report.
- 01The home is not registered to provide nursing care. What support would be arranged if my relative needed nursing care?
- 02How would staff understand and respond to my relative's communication if they could not explain pain, distress or choices verbally?
- 03How often would the manager be present at this home, and who would lead the service when the manager was working at another service?
- 04What Deprivation of Liberty Safeguards arrangements apply to my relative, and how are any conditions reviewed?
- 05What activities and contact with family and the community could my relative expect?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 4 April 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.
What inspectors found, December 2016
Rated Requires Improvement; inspectors found kind, person-centred care, but important safety, consent and management shortfalls.
This was an unannounced inspection on 5 and 6 October 2016. Inspectors spoke with everyone living in the home, staff and the registered manager. They reviewed care plans, risk information, medicines records, recruitment files, incident records and quality checks.
People appeared happy, relaxed and comfortable. Staff treated people with kindness, respected their privacy and understood their communication needs. Care was personalised, health needs were supported and people were helped to enjoy activities and keep in contact with family.
There were important problems. Personal emergency evacuation plans and fire drill records were missing. Some hot water was too hot, one safeguarding incident was not reported, some medicine records were incomplete and required legal applications about people's freedom had not been made. The home's checks had not found these problems.
The overall rating Requires Improvement means the home was not consistently meeting the required standard. Caring and Responsive were rated Good, but Safe, Effective and Well-led were rated Requires Improvement. The previous inspection in August 2014 found no breaches, but this inspection found five breaches.
Kind and respectful staff
Staff gave people time, understood their communication and treated them with dignity. Inspectors saw a strong person-centred approach.
“Staff took the time needed to communicate with people and included people in conversations.” from the report
Personalised care plans
Care plans recorded people's histories, preferences, communication needs, risks and support needs. They were up to date and matched the care seen during the inspection.
“Care plans were kept up to date and reflected the care and support given to people during the inspection.” from the report
Good health support
People had access to GPs and other health professionals. Specialist advice was followed, including advice about communication, swallowing and epilepsy.
“People had regular appointments with GPs, health and social care specialists, opticians, dentists, chiropodists and podiatrists to help them maintain their health and well-being.” from the report
Activities and family contact
People were supported to take part in activities they chose, both at home and in the community. Staff also supported contact with relatives and friends.
“People were supported to participate in activities of their choice, within the service and the community.” from the report
Emergency safety arrangements
seriousThere were no personal emergency evacuation plans, and the home could not provide records of fire drills. Inspectors said this placed people at risk in an emergency.
“A lack of emergency evacuation plans and fire drills meant risks were not identified or reasonably mitigated.” from the report
Safeguarding incident not reported
seriousAn incident involving one person injuring another was not recognised as requiring a safeguarding referral. This meant it was not investigated by the local authority.
“People were not protected from the risk of abuse because systems had not been operated effectively to include referral to the appropriate body.” from the report
Consent and liberty safeguards
seriousThe home had not completed the required capacity assessments, best-interest meetings or applications for legal authorisation where people's freedom was restricted.
“Applications had not been made to the local authority for DoLS authorisations and mental capacity assessments or best interest meetings had not been completed” from the report
Quality checks missed problems
needs fixingThe home's monitoring system did not identify several of the shortfalls found by inspectors. This reduced the home's ability to improve safety and quality.
“The concerns identified illustrated that the quality assurance measures currently in place were not fully effective.” from the report
Medicine records
needs fixingStaff recorded when 'as and when needed' medicines were given, but only some recorded the quantity. Inspectors recommended that the home review this practice.
“Although its administration and time given was always recorded each time, only some staff recorded the quantity given.” from the report
Hot water and recruitment checks
seriousSome water temperatures were marginally above the stated maximum and action had not been taken promptly. Some identity checks for staff were incomplete, although these were resolved during the inspection.
“Unresolved excessive water temperatures potentially placed people at risk of scalding.” from the report
- 01Are personal emergency evacuation plans now completed for every person, and how often are fire drills carried out and recorded?
- 02What changes have been made to ensure safeguarding incidents are recognised and reported to the local authority?
- 03Have capacity assessments, best-interest decisions and any required DoLS applications now been completed for each person?
- 04How are 'as and when needed' medicine quantities recorded and checked?
- 05How does the home now make sure its quality checks identify and resolve safety, recruitment and reporting problems?
This was an unannounced inspection covering all five key questions and giving an overall rating; the previous inspection on 8 August 2014 found no breaches. This explanation was written from the published report of 30 December 2016 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 Littlecroft
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- April 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 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.
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