CQC report explained · a residential care home
What the CQC found at Littlemoor House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found medicines were not always stored or recorded safely. They also found damp and mould, trip hazards, unsafe chemical storage and gaps in recruitment checks.
- Effective?
- Requires improvement
- People's needs were assessed and staff were trained, but restrictions were used without recorded consent. The environment also needed repair and redecoration.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw warm interactions and found that people were treated with dignity and supported to maintain independence.
- Responsive?
- Requires improvement
- People received personalised day-to-day support and took part in activities, but end-of-life care plans did not explain how people wanted to be supported before death. Minor complaints and concerns were not always recorded.
- Well-led?
- Requires improvement
- Quality checks did not identify important problems, records were incomplete and audit findings were not analysed. Financial records had not been kept up to date, putting people at risk of financial abuse.
What inspectors found, November 2023
Littlemoor House is rated Requires Improvement; inspectors found kind care, but serious gaps in consent, safety checks, medicines and management.
Inspectors visited on 12 September 2023 and carried out inspection activity until 20 September. They visited the home, spoke with people, a relative and staff, and reviewed care records, medicines, recruitment and management systems.
People were described as treated with kindness, dignity and respect. Staff knew people well, supported activities and helped people attend health appointments. There were enough staff, and staff had training relevant to people's needs.
However, inspectors found unsafe medicines storage, unclear instructions for applying creams, damp and mould in two occupied bedrooms, loose door thresholds and chemicals that were not safely stored. Recruitment checks, care records and financial records were also incomplete.
The overall rating is Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement, while Caring was rated Good. The home was rated Good at the previous inspection, published in 2017.
Kind and respectful care
People and relatives said staff were kind. Inspectors saw friendly relationships and found that people were treated with dignity.
“People were treated with dignity and respect. Staff formed trusted relationships with people and those who were important to them such as relatives.” from the report
Staff training and support
Staff had the skills and knowledge needed to support people. They received induction, refresher training, learning disability training and regular supervision.
“Staff were trained effectively to meet the needs of people in the home. Staff had the skills and knowledge they needed to support people.” from the report
Support with health and activities
People were supported to attend health appointments and take part in hobbies, community activities and social interests.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Enough staff
Inspectors found there were enough staff to meet people's needs.
“There were enough staff to meet people's needs.” from the report
Damp, mould and maintenance
seriousTwo occupied bedrooms had damp and green mould. Loose door thresholds created trip hazards, and some areas needed repair and redecoration.
“Two occupied bedrooms were damp and areas of green mould had built up on the walls and ceilings.” from the report
Medicines were not always safely managed
seriousInstructions for creams were unclear and records did not show where they had been applied. Some medicines were kept in an unlocked drawer.
“Medicine storage was not always secure and organised. For example, medicines including paracetamol and an inhaler were found in the office in an unlocked drawer.” from the report
Restrictions and consent
seriousSome restrictions, including locked access to food and drink and limits on personal items, were not supported by recorded consent or care plan information.
“Restrictions were placed on people without recorded consent. For example, the kitchen door was locked overnight preventing access to food and drink for people.” from the report
Weak management checks
seriousAudits did not identify key problems or lead to shared improvement plans. Records about people's money had not been updated since February 2023.
“The last recorded entries were February 2023. The registered manager did not have a running total of money they held for people and records were not audited.” from the report
Incomplete recruitment checks
needs fixingThe provider did not always complete or keep the required information about staff recruitment, including employment gaps and interviews.
“Suitable pre-employment checks had not always been carried out. For example, checks including reviewing gaps in people's employment history and interviews were not always completed.” from the report
End-of-life planning
needs fixingCare plans mainly recorded people's wishes after death, rather than how they wanted to be supported before death.
“The information in peoples care plans concentrated on peoples wishes for after they had died, rather than information about how they wished to be supported before they died.” from the report
- 01What work has been completed to remove the damp and mould from the two occupied bedrooms, and how are affected people being protected while work takes place?
- 02How are medicines, including creams and as-required medicines, now stored, administered and recorded?
- 03How do you record consent and best-interest decisions for restrictions such as locked doors or limits on personal items?
- 04How are people's money records checked, kept up to date and protected from financial abuse?
- 05How have you improved end-of-life care plans so they explain how each person wants to be supported before death?
This was a comprehensive inspection covering all five key questions, including infection prevention and control; all ratings were reassessed rather than carried over. This explanation was written from the published report of 1 November 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, December 2017
Rated Good; inspectors found safe, kind and personalised care, with a few policies and staff knowledge needing strengthening.
The inspection was unannounced and took place on 27 October 2017. One inspector spoke with four people using the home, two care assistants and the deputy manager. They also reviewed care plans, medicines records, staff records and quality checks.
Inspectors found that people felt safe and that there were enough staff. Medicines were managed safely, people were supported to make choices, and staff helped people access health care and take part in activities they enjoyed.
People were treated with kindness, dignity and respect. Staff knew people's preferences well and supported their independence. The home had a consistent staff team and people, relatives and professionals gave positive feedback.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors noted some minor weaknesses, including missing contact details in the safeguarding policy, gaps in staff knowledge about consent, and an out-of-date complaints policy.
People felt safe
People were involved in decisions about risks, and staff understood how to identify and report safeguarding concerns. Staffing levels supported people's needs and activities.
“People were protected from abuse and avoidable harm because staff had received training and had the knowledge and skills they required to do their job effectively.” from the report
Kind and respectful care
Inspectors saw warm relationships between people and staff. Staff respected privacy, dignity and personal space, while encouraging independence.
“Positive and caring relationships had been developed between people living in the service and staff.” from the report
Good management oversight
The management team sought feedback and used audits to monitor the service. Inspectors found an open culture and a consistent staff team.
“Quality monitoring and assurance systems were in place to help drive improvements and ensure sustainability.” from the report
Safeguarding contact details
needs fixingThe safeguarding policy explained what staff should do but did not include actual contact details for reporting concerns. Inspectors said this should be strengthened.
“This also included details of where else staff could report any allegations to, however this could have been further strengthened by including actual contact details so that staff had them readily available to them.” from the report
Consent knowledge
needs fixingStaff understood the importance of gaining consent, but inspectors found their knowledge of what to do when someone could not consent needed further strengthening.
“their knowledge and understanding of what they needed to if people were unable to consent needed to be further strengthened.” from the report
Complaints information
needs fixingPeople knew how to complain, but the complaints policy did not explain where concerns could be taken if the provider's response was not satisfactory.
“The policy needed to be updated to include the details of the where people could escalate their concerns to if they were not satisfied with the provider's response.” from the report
- 01Have you added the missing contact details for reporting safeguarding concerns, and where can families find them?
- 02How have you strengthened staff training about supporting people who cannot give consent?
- 03Has the complaints policy been updated to explain how concerns can be escalated?
- 04How would staffing arrangements change if a resident began to need personal care or more support overnight?
- 05How are people's care plans and risk assessments reviewed when their needs or preferences change?
This was an unannounced inspection of the overall service, covering all five CQC questions and reviewing care, staffing, medicines, recruitment and quality monitoring. This explanation was written from the published report of 8 December 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 Littlemoor House
2 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016
Registered with the Care Quality Commission on 29 November 2016.
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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