CQC report explained · a residential care home
What the CQC found at The Lawn Residential 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, March 2023
Rated Good overall; inspectors found effective, well-led care, but medicines safety was not always reliable and Safe was rated Requires Improvement.
This was an unannounced focused inspection on 23 February 2023. Inspectors spoke with people, relatives and staff. They reviewed care records, medicines storage and records, watched part of a medicines round, and checked how the home was managed.
People said they were happy and felt safe. Inspectors found enough staff, safe recruitment, safeguarding arrangements, infection controls and good support with food, health care and consent. Staff were trained and worked with health professionals.
The main weakness was medicines management. Some information was missing or inconsistent, including allergy details, instructions for medicines given when needed, and actions to take after audits. The home had improved since the previous inspection and was no longer in breach of regulations, but Safe was still rated Requires Improvement.
The overall rating changed from Requires Improvement to Good. Effective and Well-led were rated Good. Caring and Responsive were not assessed in this inspection, so their previous ratings were carried forward.
People felt safe and happy
People and relatives said they were happy with the care and felt safe. Staff understood how to report safeguarding concerns.
“People were happy with the care they received.” from the report
Trained staff
Staff, including agency staff, received induction and training. Inspectors found staff understood people's needs and had the skills to support them.
“All staff, including agency staff received an induction to their role when they commenced work.” from the report
Food and health support
The home assessed risks linked to eating and drinking and followed guidance for people needing modified diets. Staff worked with health professionals to meet people's needs.
“People had a choice of nutritious meals provided.” from the report
Improved management
The home had improved since the previous inspection. Managers used audits, care records and action plans to identify and monitor improvements.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Medicines information
seriousMedicines information was not consistently included in care plans and risk assessments. Allergy information was not always recorded consistently, which increased the risk of a person receiving a medicine they were allergic to.
“People's allergies were not always consistently recorded across different records.” from the report
Medicines checks
needs fixingTemperature checks and medicines audits were not always followed by clear action or written evidence that the action had worked.
“Nor was there written evidence that these were followed up to ensure that they had been effective.” from the report
Inconsistent risk records
needs fixingSome care records contained conflicting information about how often one person should be repositioned. Daily records showed staff had followed the latest guidance.
“The records contained conflicting information about how often they were to be re-positioned.” from the report
Call bell response
needs fixingSome people said call bells could sometimes take longer to answer than they wanted. The manager was monitoring response times and working with staff on this.
“Some people reported on occasions call bells could take a little longer than they would like to be answered.” from the report
- 01How do you now check that every person's allergies and preferred way of taking medicines are recorded consistently?
- 02How are medicines given when needed, or PRN medicines, explained in each person's care plan?
- 03How do you record and check that actions from medicines audits have been completed and were effective?
- 04What is the current average response time for call bells, and what has changed to improve this?
- 05What changes are planned to make the environment easier for people living with dementia to navigate?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 9 March 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, September 2022
Inspected but not rated; improvements were found after the previous Requires Improvement rating, but some medicines records still needed work.
This was an unannounced targeted inspection. Two inspectors visited on 22 August 2022, with inspection activity continuing until 25 August. They spoke with five people and four staff, reviewed care and medicines records, and checked the environment.
The inspection focused on safety, medicines, the environment, and people's eating and drinking needs. Inspectors found enough improvement for the home to no longer be in breach of Regulations 12, 14 and 15.
People said they were happy and felt well cared for. Risks were generally identified and managed, and there had been significant improvements in medicines management. However, some allergy records, as-required medicines instructions and other medicines records were still incomplete.
The service was inspected but not rated at this visit. The overall rating stayed Requires Improvement because this targeted inspection did not reassess every area. The previous Safe and Effective ratings were not changed, and the previous governance concern under Regulation 17 was not reviewed.
Risk management
People had relevant risk assessments and care plans. Staff had access to the electronic care planning system, including agency staff.
“People had risk assessments in place which were relevant to their assessed risks, to guide and inform staff.” from the report
Fire and building safety
Fire arrangements, evacuation plans and the home environment had improved. Hazards such as the asbestos cupboard and mobility scooters had been dealt with.
“The home environment, including fire escapes was uncluttered, for people's safety.” from the report
Eating and drinking support
People had choking and nutrition assessments, with care plans reflecting specialist guidance. Staff had training on appropriate food textures and drink thickness.
“People had an eating and drinking support plan to instruct staff about their needs and the management of any potential risks.” from the report
Improved medicines security
Medicines storage, stock checks and staff competency checks had improved significantly. Senior managers also increased their oversight.
“The provider had made significant improvements to medicines security.” from the report
People felt cared for
People told inspectors they were happy living at the home and felt well cared for by staff who understood their risks.
“People told us they were happy living at the home and felt well cared for by staff who understood how to manage risks to them.” from the report
Incomplete medicines information
needs fixingAllergies had been requested for inclusion on medicines records but had not yet been added. Some as-required medicines lacked detailed instructions and records did not always explain why they were given or what happened afterwards.
“The protocols were not sufficiently detailed for staff to support people they did not know well.” from the report
Medicine temperature records
needs fixingStaff did not report that the medicines fridge temperature had been too high for 14 days. The manager took action and replaced the thermometer after inspectors raised it.
“We found staff had failed to report the fridge temperature had exceeded the recommended temperature for 14 days in August.” from the report
Records were not always complete
minorRepositioning was not always recorded in the expected electronic system. There were also missing second signatures or reasons when medicines were stopped.
“We noted people's re-positioning records did not always demonstrate people had been re-positioned as often as recommended, as staff sometimes recorded this information within the person's daily notes, instead.” from the report
Unlocked medicine drawer
needs fixingOne drawer containing preparations used to thicken drinks was unlocked, despite improvements to medicines security.
“However, we identified one drawer was unlocked.” from the report
- 01Have all residents' allergies now been added to their medicines administration records?
- 02What information is now included in protocols for as-required medicines, and how are the reason for giving them and the outcome recorded?
- 03How do you check and respond to medicines fridge temperatures each day?
- 04How are repositioning records and medicine changes checked for completeness?
- 05What progress has been made on the outstanding governance requirements under Regulation 17?
This was a targeted inspection of specific parts of Safe and Effective, including infection prevention and control; it did not reassess all five key questions, so the overall Requires Improvement rating carried over from the previous inspection. This explanation was written from the published report of 15 September 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 Lawn Residential Care Home
6 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- March 2023Goodcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Lawn Residential Care Home →
- September 2022Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not rated
Read what inspectors found at The Lawn Residential Care Home →
- July 2022Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementWell-led: Requires improvement
- July 2018Goodstayed GoodSafe: Requires improvementEffective: GoodWell-led: Good
- March 2017Goodstayed GoodEffective: Good
- August 2016Goodup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2016InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- March 2015
Report published without a new overall rating.
- November 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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