CQC report explained · a residential care home
What the CQC found at Loran 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
- Medicines were not always managed safely, and risk records did not always give staff the information they needed. Inspectors also found gaps in repositioning records and weaknesses in fire safety and learning from incidents.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Requires improvement
- Checks and audits did not reliably identify or address problems. Records of actions, care needs and lessons from incidents were not always complete or effective.
What inspectors found, May 2023
Rated Requires Improvement; inspectors found unsafe medicines and risk management, and weak checks on quality, while staff were available and supportive.
This was an unannounced focused inspection on 04 April 2023. Three inspectors spoke with people, a relative and staff. They reviewed care records, medicine records, staff recruitment files and management checks. They also looked around the home and observed care and infection control.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found problems with medicine storage and records, missing medicines, incomplete risk information, gaps in repositioning records and limited evidence of learning from accidents. Quality checks did not reliably find or fix these problems.
There were also positive findings. There were enough staff, recruitment was safe, and staff understood safeguarding. People were treated with privacy and dignity. The manager was open to feedback and worked with health and social care professionals.
This inspection only examined Safe and Well-led. The overall rating fell from Good at the previous inspection because of the findings in these areas. The other key question ratings were carried forward from the previous inspection.
Enough staff
Inspectors found enough staff on duty to support people safely. Recruitment and induction processes promoted safety.
“Staff recruitment and induction training processes promoted safety, including those for agency staff where required.” from the report
Safeguarding
Staff had safeguarding training and understood their responsibility to report concerns. People said they felt safe.
“Staff had received training in how to keep people safe from abuse. Staff were clear on their responsibility to raise concerns” from the report
Respectful care
Inspectors saw staff respecting people's privacy and dignity during care and support.
“We observed staff respecting people's privacy and dignity when providing care and support.” from the report
Open management
The manager was described as approachable and open to feedback. The home worked with health and social care professionals.
“We found the registered manager to be open and honest throughout the inspection. They were responsive to feedback, and keen to make the required improvements.” from the report
Medicines
seriousMedicine temperatures and stock records were not always accurate. One person had missed doses of four prescribed medicines, and controlled drug checks were not regular enough.
“One person had not received any doses of 4 of their prescribed medicines.” from the report
Risk records
seriousSome risks, including falls and pressure-area risks, were not fully recorded. Inspectors found gaps in records showing when one person had been repositioned.
“There was no clear guidance for staff to follow on how to keep people safe and reduce the risk of reoccurrence.” from the report
Quality checks
seriousAudits were in place but did not reliably identify or correct problems. Actions were not always recorded with completion details or accountability.
“Systems designed to monitor the safety and quality of the service and take action to mitigate risk, were not robust.” from the report
Mental capacity records
minorRecords did not always clearly show how people's capacity had been assessed. The CQC recommended that the provider review its systems.
“Clear and complete records were not always available to show how people's capacity was assessed.” from the report
Fire safety and cleaning
needs fixingThere was no evidence of timed simulated evacuations. Some areas needed refurbishment for more effective cleaning, and cleaning schedules were not always completed consistently.
“There was no evidence to support staff completing time simulated evacuations.” from the report
- 01What has changed to make sure medicines are stored at the right temperature, available when needed and accurately recorded?
- 02How are falls, pressure-area risks and repositioning now recorded and checked?
- 03What evidence can you show that timed fire evacuation exercises have been completed?
- 04How do managers now make sure audits identify problems and that actions are completed by named people?
- 05How are mental capacity assessments and best-interest decisions recorded and kept up to date?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 13 May 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
Inspected but not rated; inspectors found generally assured infection control, with some cleaning schedule gaps corrected promptly.
This was an unannounced, targeted inspection on 27 January 2022. It focused on infection prevention and control during COVID-19, and asked about staffing pressures. It was not a full inspection of the home.
Inspectors were assured that the home was managing visiting, testing, PPE, social distancing, admissions and infection outbreaks safely. People could keep in touch with family and friends through visits or alternative arrangements while the home was temporarily closed because of an outbreak.
Inspectors found some gaps in cleaning schedules. The provider acted promptly, including arranging extra waste bins and deep cleans in some bedrooms. The service was inspected but not rated, so this report does not give an overall quality rating.
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infection, including testing, PPE, hygiene and outbreak procedures.
“We were assured the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Family contact
People were supported to receive visitors in line with national guidance. Alternative ways to maintain contact were available during the outbreak closure.
“People were supported to have visitors in line with national guidance and alternative arrangements were available to support people to maintain contact with their family and friends in the event of an outbreak.” from the report
Prompt action
The provider acted quickly on recommendations from the local infection control team, including extra waste bins and deep cleaning in some bedrooms.
“We found the provider had taken prompt action to remedy shortfalls.” from the report
Infection control checks
Regular infection control audits were carried out, and actions were followed up when needed.
“Regular infection control audits took place and actions had been followed up when required.” from the report
Cleaning records
needs fixingInspectors found some gaps in the cleaning schedules. The provider took prompt action to address them.
“The provider took prompt action to address some gaps we found in the cleaning schedules.” from the report
- 01What changes have been made to the cleaning schedules since the inspection?
- 02How are cleaning tasks checked and recorded now?
- 03How would visits and family contact be managed if there were another infection outbreak?
- 04What measures are currently in place to manage COVID-19-related staffing pressures?
- 05How are PPE, testing and infection control practices monitored?
This was a targeted inspection of infection prevention and control and staffing pressures; it was not a full inspection and the service was inspected but not rated. This explanation was written from the published report of 23 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 Loran House
4 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- May 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2022Inspected but not ratedSafe: Inspected but not rated
- May 2021Goodup from Requires improvementSafe: GoodWell-led: Good
- October 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- August 2019GoodSafe: Requires improvementEffective: GoodWell-led: Good
- June 2018
Registered with the Care Quality Commission on 1 June 2018.
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 £1,350 a week. 12 can care for a couple. 8 years' experience on average.
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