CQC report explained · a residential care home
What the CQC found at Old Leigh House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found suitable risk assessments, recruitment checks, medicines systems, infection controls and arrangements for learning from incidents.
- Effective?
- Good
- This area was not assessed during this focused inspection. The previous comprehensive inspection rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not assessed during this focused inspection. The previous comprehensive inspection rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not assessed during this focused inspection. The previous comprehensive inspection rating was used in calculating the overall rating.
- Well-led?
- Good
- The registered manager and provider had good oversight. Staff understood their roles, people and relatives were asked for their views, and action plans were used when issues were found.
What inspectors found, March 2021
Old Leigh House was rated Good, improving from Requires Improvement, with safe care and stronger management found.
This was an unannounced focused inspection on 9 February 2021. One inspector spoke with people using the service, staff and managers, and reviewed care, medicines, recruitment, audits and other records. Infection prevention arrangements were also checked.
The home supported five people, with space for up to six. Inspectors found that people felt safe and were positive about their care. Staff supported independence, followed personalised care plans and had the training and checks needed for their roles.
Safe and Well-led were both rated Good. The home had improved since the previous inspection, when it was rated Requires Improvement and had multiple breaches. The provider was no longer in breach of the regulations at this inspection.
This report did not assess Effective, Caring or Responsive. Their previous ratings were carried forward when calculating the overall Good rating.
Personalised support
Care was tailored to people's needs and goals. Staff supported independence, confidence and inclusion in the community.
“Staff promoted people's independence and care was personalised to each individual person's needs and goals.” from the report
Care planning and risk management
Care plans and risk assessments gave staff the information needed to support people safely, including when people needed continuous observation or support in the community.
“Care plans and risk assessments were person centred and contained all the information staff needed to provide support safely.” from the report
Safe medicines arrangements
Trained staff supported people with medicines. The home had systems for ordering, storage, administration, monitoring and disposal, with regular pharmacist and manager checks.
“There were suitable systems in place for the storage, ordering, administering, monitoring and disposal of medicines.” from the report
Positive culture
People said they were happy and staff described a focus on independence and quality of life. The home held regular meetings so people could discuss the service and raise concerns.
“There was a positive culture at the service.” from the report
Learning and oversight
Incidents were investigated and discussed with staff. Provider and manager audits were used to identify and follow up actions.
“The registered manager and provider had good oversight of the service through the auditing systems they had in place.” from the report
Inspectors raised no specific concerns in this report.
- 01What has changed since the focused inspection in February 2021?
- 02How will you assess and support my relative's individual goals, independence and community activities?
- 03How are medicines checked, including as-required medicines and possible side effects?
- 04How do you make sure enhanced observation plans are followed consistently?
- 05How can my relative and our family raise concerns, and how will we be kept informed about any incidents?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 5 March 2021 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, March 2020
Rated Requires improvement; inspectors found kind, effective care, but safety checks and management oversight were not always reliable.
This was an unannounced focused inspection on 15 January 2020. Inspectors reviewed records, medicines, the environment and policies. They spoke with three patients, the service manager and four staff members. They could not speak with families or carers.
The home was clean and staffed safely. Patients described staff as kind and respectful. Care plans were personalised, patients received physical healthcare and medicines were managed properly. The ratings for Effective, Caring and Responsive were Good.
Inspectors found important weaknesses in safety and management. Observation records had gaps, staff sometimes stayed on enhanced observations longer than the provider's policy allowed, and four incidents were not reported to the CQC. The ligature risk assessment was inaccurate and there were not enough private rooms for therapy and visits.
The overall rating was Requires improvement. Safe and Well-led were also Requires improvement. The provider was told it must improve observation practice and report all notifiable incidents and safeguarding concerns to the CQC.
Clean environment
Inspectors found the ward areas clean, well furnished and maintained. Cleaning records were completed appropriately.
“All ward areas were clean, had good furnishings and were well maintained.” from the report
Safe medicines practice
Medicines were stored securely and the records checked showed they were given appropriately.
“We found that staff administered medication appropriately and in line with the Nursing and Midwifery Council standards for medication administration.” from the report
Kind and respectful staff
Patients told inspectors that staff treated them well. Staff respected privacy and dignity and understood individual needs.
“Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity.” from the report
Accessible communication
Staff used communication passports and easy-read information to help patients understand their care and treatment.
“All patients had communication passports that had been completed with the input of the speech and language therapist.” from the report
Observation records and practice
seriousSeven observation records had gaps. On two occasions, staff recorded enhanced observations lasting three hours and seven hours, against the provider's two-hour policy.
“We found that staff had breached the provider’s policy of not being on enhanced observations for more than two hours.” from the report
Incidents not reported to CQC
seriousFour incidents or safeguarding concerns from the records reviewed had not been notified to the CQC.
“We reviewed 13 records of incidents and safeguarding referrals and found staff had failed to notify the Care Quality Commission about four incidents.” from the report
Inaccurate ligature risk assessment
needs fixingThe risk assessment said bathrooms had anti-ligature tap fittings, but inspectors found these fittings were not present.
“The ligature risk assessment was not accurate.” from the report
Limited private space
needs fixingThere was no separate room for individual therapy or one-to-one time, and no separate private area for visitors. Staff used bedrooms or took patients outside the home.
“There were no separate rooms for individual therapy sessions or one to one time with patients.” from the report
Staff knowledge and training
minorSome registered nurses could not identify the best practice guidance used to plan care. The report also found specialist learning disability and autism training was not evidenced for agency staff.
“Registered nurses were unable to tell us what best practice guidance they used to plan and deliver care.” from the report
- 01How do you now make sure every patient observation is recorded and that enhanced observations do not continue beyond the allowed time?
- 02What changes have you made to ensure all notifiable incidents and safeguarding concerns are reported to the CQC?
- 03Has the ligature risk assessment been corrected, and have the bathroom fittings been updated?
- 04Where can patients now have private therapy, one-to-one discussions and visits?
- 05How do you check that permanent and agency staff understand current learning disability and autism best practice guidance?
This was a focused inspection prompted by concerns about two escorted-leave incidents, but inspectors reported ratings for all five key questions; the previous ratings from May 2017 were Good in all areas. This explanation was written from the published report of 20 March 2020 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 Old Leigh House
4 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- November 2012
Registered with the Care Quality Commission on 27 November 2012.
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 £960 to £1,200 a week. 44 can care for a couple. 12 years' experience on average.
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