CQC report explained · a nursing home
What the CQC found at The Laurels and The Limes Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2023
Requires Improvement; inspectors found safe medicines and caring staff, but gaps in risk records, activities, training and management oversight.
The unannounced inspection took place on 29 November 2022. Inspectors spoke with people, relatives and staff, observed daily life, checked the buildings and reviewed care, medicines, staff and management records.
The home had enough staff to meet people's care needs and medicines were managed safely. Safeguarding systems, healthcare support, food and drink provision, and consent arrangements were also working well in the areas checked.
However, records did not always show that risks such as falls and pressure damage were being managed properly. People were often bored, care plans were not always updated, many staff training records were out of date, and staff said they lacked support. Management audits had not found all these problems.
The overall rating changed from Good to Requires Improvement. The home breached Regulation 17 on good governance. The provider must send an action plan, and the CQC will monitor progress with the provider and local authority.
Medicines
Medicines records contained enough information to support people to receive the correct medicines at the correct times. Regular audits identified and addressed medicine-related issues.
“Medicines were managed safely. There were systems in place to support people to receive their medicines as prescribed.” from the report
Food and drink
The home met people's nutritional and hydration needs, including special diets. Staff monitored people at risk of malnutrition and people had choices of meals, drinks and snacks.
“People's nutritional and hydration needs were met. Where people required a special diet, this was catered for.” from the report
Safeguarding
Staff had safeguarding training and managers made appropriate referrals when needed. The home had systems to protect people from abuse.
“The provider used appropriate systems to safeguard people from abuse.” from the report
Consent and choice
Staff obtained consent before providing care and understood the importance of helping people make their own decisions. Mental Capacity Act and Deprivation of Liberty Safeguards processes were in place.
“Staff understood the importance of supporting people to make their own decisions.” from the report
Meaningful activities
needs fixingPeople reported having too little to do, and inspectors saw significant periods when people were not occupied or engaged. The CQC made a recommendation about improving daily activities.
“We observed there were significant periods of time during the day when people were not meaningfully occupied or engaged in anything.” from the report
Staff training and support
needs fixingMany staff had not completed the training the provider expected, and staff had not recently received regular one-to-one supervision. Some staff said they did not feel supported or listened to.
“Staff had not recently received regular one to one supervision meetings with their line manager.” from the report
Management oversight
seriousAudits had not identified all the risk-recording problems found during the inspection. The home also had no registered manager in post at the time of the visit.
“The provider's governance and audit system was not robust enough.” from the report
Agency staffing
needs fixingAgency staff helped maintain staffing levels, but people were not always supported by staff who knew them well. Regular staff had to spend time helping agency workers understand people's needs.
“However, this meant people were not always supported by staff who knew them well.” from the report
- 01How do you now check that falls observations, wound photographs and repositioning records are completed at the required times?
- 02What activities are available each day for people living with dementia and other residents who say they are bored?
- 03How many staff have now completed the required training, and how often are one-to-one supervision meetings taking place?
- 04How are you reducing the use of agency staff and making sure temporary staff understand each person's needs?
- 05What action has been taken following the Regulation 17 breach, and how is progress being checked?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating used ratings from the last comprehensive inspection for those areas. This explanation was written from the published report of 12 January 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, June 2021
Inspected but not rated; inspectors were assured that infection prevention and control arrangements were in place.
This was an announced, targeted inspection on 26 May 2021. It focused on how the home prevented and controlled COVID-19 infections.
Inspectors were assured that visitors could meet relatives safely, staff used protective equipment, people and staff had access to testing, and the home was clean and hygienic.
Staff were allocated to one building and did not mix between the two buildings. People living and working at the home had been offered a vaccine and were regularly tested.
The home was inspected but not rated. This report does not assess the wider quality of care or give ratings for the other four questions.
Safe visiting
The home had arrangements for relatives and friends to keep in contact by telephone, video call and appointments for visits inside or in the visitor pod.
“The home had systems in place to support relatives to visit their family members, minimising the risk of infection.” from the report
Separate staffing teams
Staff were allocated to one of the two buildings and did not mix between them, helping to reduce the risk of spreading infection.
“The home had implemented cohorting effectively, with staff allocated to either The Laurels (building one) or The Limes (building two), and they did not mix between the two buildings.” from the report
Clean surroundings
Inspectors saw guidance about protective equipment and handwashing. They found the premises clean, with frequently touched surfaces regularly cleaned.
“We observed signage around the home to guide staff on the use of protective personal equipment (PPE) and appropriate handwashing technique.” from the report
Testing and vaccination
Everyone living and working at the home had been offered a vaccine and was regularly tested in line with government guidance.
“All people living and working at The Laurels and The Limes Care Home had been offered a vaccine and were regularly tested for COVID-19 in line with government guidance.” from the report
Inspectors raised no specific concerns in this report.
- 01How have your visiting arrangements changed since the inspection on 26 May 2021?
- 02How do you now prevent staff from mixing between the two buildings?
- 03How are residents and staff tested for infections now?
- 04How do you keep frequently touched surfaces and communal areas clean?
- 05Can you provide information about the areas of care that this targeted inspection did not assess?
This was a targeted inspection of infection prevention and control under the Safe question; the other four questions and the overall service were inspected but not rated. This explanation was written from the published report of 5 June 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.
Every inspection of The Laurels and The Limes Care Home
6 rated inspections over 8 years: the service has improved, from Inadequate to Requires improvement.
- January 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at The Laurels and The Limes Care Home →
- June 2021Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at The Laurels and The Limes Care Home →
- February 2020Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- May 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- September 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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