CQC report explained · a residential care home
What the CQC found at The Larches - Tiverton
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, August 2023
The Larches - Tiverton was rated Requires Improvement; inspectors found risks in medicines, fire safety, staffing and management systems.
This was an unannounced focused inspection on 11 and 19 July 2023. Inspectors checked Safe and Well-led, spoke with five people, 10 relatives and nine staff, observed care, and reviewed care, medicines, recruitment, training and management records.
Inspectors found that medicines were not always managed safely. Fire risk checks and emergency evacuation information were out of date. Staff raised concerns about staffing levels and communication, although extra staffing was put in place during and after the inspection.
People were generally described as safe and well cared for. Staff knew people well, supported choices and responded sensitively when giving medicines. However, audits and other management systems had not found or dealt with important risks.
The overall rating changed from Good at the previous inspection to Requires Improvement. The report says the provider took immediate action and agreed to work with the local authority quality team, but CQC will continue to monitor the home.
Staff knew people well
Inspectors found that staff understood people's needs and knew how to protect them from avoidable harm.
“People were kept safe from avoidable harm because the management team and the staff knew them well and understood how to protect them from abuse.” from the report
Kind support with medicines
Although medicine systems had serious gaps, inspectors saw staff supporting people sensitively and checking how they felt.
“We observed people were supported sensitively with their medicines.” from the report
People could make choices
Staff asked people about everyday preferences, such as what to eat and where to spend their time.
“Staff consulted people about their day-to-day preferences; for example, what they ate and where their spent their day.” from the report
Action during inspection
The provider and manager responded to concerns during the inspection and started changes to reduce risks.
“The provider and registered manager responded immediately to the concerns we shared and took steps to improve the service.” from the report
Medicine safety
seriousRecords did not consistently have the required signatures or identity photographs. Storage temperatures and medicines given when needed were not always properly managed.
“These issues placed people at risk of harm. This was a breach of regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Fire safety
seriousThe fire risk assessment had not been reviewed since 2017, evacuation plans were out of date and training records showed that many staff had not completed fire training.
“People were not always protected from the risk of fire at the service.” from the report
Staffing and recruitment
needs fixingStaff reported that there were not enough staff at lunchtime and described poor communication about staffing changes. Recruitment records and checks were not readily available or complete.
“Staff told us, and we observed on the first day of our visit, that there were not enough staff to support people over the lunchtime period.” from the report
Weak management checks
seriousAudits did not always identify risks or show that action had been taken. The report also found gaps in training records and accident and incident analysis.
“The provider's systems failed to identify all the shortfalls we found at the inspection.” from the report
Limited family involvement
needs fixingPeople and relatives had not been given regular opportunities to review care or complete surveys about the service.
“No quality assurances surveys had been sent out to find out peoples' and/or relatives' experience of the care provided.” from the report
- 01What specific changes have been made to medicine records, storage temperature checks, PRN protocols and medicine audits?
- 02Has the fire risk assessment been reviewed, and have all people's emergency evacuation plans and staff fire training been brought up to date?
- 03What staffing levels are now in place at lunchtime, and how are they checked against people's needs?
- 04How are staff recruitment checks and training records now kept complete and easy to verify?
- 05How are families now involved in care reviews and asked for feedback about the home?
This was an unannounced focused inspection of Safe and Well-led, with infection prevention and control also considered; the other question ratings were carried forward from the previous inspection. This explanation was written from the published report of 24 August 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, March 2022
The Larches - Tiverton was inspected but not rated; inspectors found good infection control and safe visiting arrangements.
This was an unannounced, targeted inspection on 2 February 2022. It looked at infection prevention and control, visiting arrangements, and whether COVID-19 staffing pressures affected the service.
Inspectors found that infection control procedures were being followed. The home was clean, PPE and hand hygiene supplies were available, and people and staff were tested regularly. The home was also supporting visits in line with the guidance at that time.
The inspection did not give an overall rating or a rating for the Safe question. This report therefore gives a picture of infection control at that visit, rather than a full assessment of all aspects of care.
Infection control
The home had infection control procedures, audits and guidance in place. Staff had received training and there were reminders about using PPE correctly.
“The registered manager had followed guidance on infection control procedures to safely support people living at the service during the pandemic.” from the report
Clean environment
Inspectors found the home clean and without unpleasant smells. Cleaning schedules and frequent cleaning of regularly touched surfaces were in place.
“The home was clean and free from odours.” from the report
Testing and PPE
People and staff were tested regularly, and the home had supplies of PPE and hand hygiene products. Staff told inspectors that PPE helped people feel safe.
“People and staff had regularly been tested for COVID-19 and this process was monitored and kept under review by the registered manager.” from the report
Family visiting
The home had checks for visitors and followed guidance intended to reduce infection risks. People said relatives could visit and were kept informed about the arrangements.
“People told us their relatives were able to visit and they were kept informed by the registered manager of visiting guidance.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, and when were they last reviewed?
- 02How are visitors currently checked and supported to visit safely?
- 03How do you manage staffing pressures when staff are absent because of illness or infection?
- 04How often are people and staff tested when there is an infection risk?
- 05Can I see the latest full inspection report or any ratings that are not covered by this targeted inspection?
This was an unannounced targeted inspection of infection prevention and control, visiting arrangements and COVID-19 staffing pressures; it did not rate the service overall or the Safe question. This explanation was written from the published report of 4 March 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 The Larches - Tiverton
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Inspected but not ratedSafe: Inspected but not rated
- May 2018Goodstayed GoodSafe: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
17 live-in carers within about an hour of Devon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.