CQC report explained · a residential care home
What the CQC found at Loring Hall Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, safely managed risks, secure medicines, safe recruitment and suitable infection control arrangements.
- Effective?
- Good
- Staff had relevant training, supervision and appraisals. People had access to healthcare, support with food and drink, and care that followed their needs and choices.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in decisions about their care and were encouraged to be independent.
- Responsive?
- Good
- Care plans reflected people's needs, preferences and routines. People enjoyed activities, maintained relationships and were supported to pursue education, work, holidays and other interests.
- Well-led?
- Good
- Inspectors found supportive leadership, good teamwork and regular checks on care, medicines, finances, infection control and the environment. The home sought people's views and worked with other agencies.
What inspectors found, September 2019
Rated Good; inspectors found safe, kind and person-centred care, with improvements since the previous inspection.
This was an unannounced inspection over two days. Inspectors spoke with five people, eight staff members and a healthcare professional. They reviewed care records, staff files, medicines records and the home's quality checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines arrangements, suitable training, kind care and support tailored to people's choices, needs and interests.
The previous inspection in August 2018 rated the service Requires Improvement. The provider had been in breach of regulations about medicines, incident monitoring, governance and notifications. At this inspection, inspectors found enough improvement and said the home was no longer in breach.
Safe staffing and medicines
Inspectors found enough staff to support people promptly. Medicines were stored securely, administered safely and checked by trained staff.
“There were enough staff on duty each day to support people when needed.” from the report
Choice and independence
People were supported to make decisions, choose their routines and develop their independence. Staff used the least restrictive approach and followed best-interest processes where needed.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Kind and respectful care
Staff were caring and compassionate. Inspectors saw staff respect privacy, ask permission and encourage people to do things for themselves.
“Staff treated people with dignity and respected people's privacy.” from the report
Meaningful activities and relationships
People took part in activities linked to their interests and were supported to maintain important relationships. Some people attended college, worked, went on holidays or visited relatives.
“People took part in activities which were relevant to their interests.” from the report
Improved management
The provider had acted on the previous inspection findings. Audits, incident reviews and staff checks were being used to identify and address problems.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Large building
minorThe home is larger than most domestic-style properties and larger than current best practice guidance. Inspectors said the provider had reduced the negative impact through person-centred support, but families may still want to see how the size affects daily life.
“The service is a large home, bigger than most domestic style properties and larger than current best practice guidance.” from the report
- 01How do you make sure staffing levels are adjusted when someone needs extra support or an appointment escort?
- 02How are medicines audits and staff competency checks carried out now?
- 03How often are people's risk assessments reviewed and updated when their needs change?
- 04How do you make sure the size of the home does not reduce people's choice, privacy or sense of belonging?
- 05What activities, work, education and family visits could be available for my relative?
This was an unannounced inspection of the care home, including the premises and care provided, and it assessed all five CQC questions. This explanation was written from the published report of 28 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, September 2018
Rated Requires Improvement; inspectors found kind and responsive care, but serious medicines and management checks were not reliable.
Inspectors visited the home without notice on 2 and 3 August 2018. They spoke with people, staff and the manager, and reviewed care plans, staff files, medicines records and quality checks.
People were treated with kindness and respect. Their care plans reflected their needs and preferences. There were activities, support to keep in touch with relatives, enough staff on duty and access to healthcare.
However, medicines were not always given or recorded safely. Some risks were not updated when people's needs changed. Staff training and supervision were not always up to date, and checks on incidents, medicines, weights and health conditions did not reliably identify problems.
The overall rating was Requires Improvement. Safe, Effective and Well-led were also Requires Improvement. Caring and Responsive were rated Good. The home had improved care plan reviews and medicines storage checks since the previous inspection, but earlier problems with quality monitoring had not been sufficiently resolved.
Kind and respectful care
Inspectors saw friendly interactions and found that staff respected people's privacy, dignity and choices.
“We observed caring and friendly interactions between staff and people throughout our inspection.” from the report
Activities and independence
People took part in work, college, exercise, outings and other activities. Staff also encouraged people to develop everyday skills and independence.
“People were supported to take part in activities that reflected their interests and met their need for social stimulation.” from the report
Medicines were not consistently safe
seriousStaff did not always sign medicines records. There were gaps, unclear records about missed doses and insufficient guidance for some medicines taken when needed.
“People's medicines were not safely managed.” from the report
Risk assessments were not always updated
needs fixingSome risk assessments did not reflect changes in people's needs after incidents. This could lead to inconsistent or unsafe support.
“The registered manager had failed to ensure that risk assessments were always updated when people's needs had changed.” from the report
Staff training and supervision
needs fixingNine staff had not completed autism training, and some staff had gone up to six months without formal supervision.
“Improvement was required to ensure staff were supported through regular supervision.” from the report
Required notifications were missed
needs fixingThe home had not submitted all required notifications about DoLS outcomes. The outstanding notifications were submitted after the inspection.
“The registered manager had not always submitted notifications of incidents to CQC where required to do so.” from the report
- 01What changes have been made to ensure every medicine dose is given correctly and every MAR entry is signed?
- 02What did the medicines audit completed after the inspection find, and can you show how those issues were fixed?
- 03How do you now check that risk assessments are updated promptly when a person's needs or relationships change?
- 04How many staff supporting people with autism have completed the recommended training, and how often is staff supervision now held?
- 05How are incidents, people's weights and seizure records reviewed over time so that emerging risks are identified?
This was an unannounced inspection covering the home, care provided and management records, including five care plans, five staff files, medicines records and quality audits. This explanation was written from the published report of 11 September 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 Loring Hall Limited
5 rated inspections over 4 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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