CQC report explained · a residential care home
What the CQC found at The Palms
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, safe medicines systems and arrangements to protect people from abuse. They noted that risk assessments should be reviewed more regularly, and the system for renewing DBS checks had not been in place, although this was corrected immediately.
- Effective?
- Good
- Staff were trained, supervised and supported, and people received help with healthcare, communication, decision-making and a balanced diet. The building had been adapted to people's needs, although the dining and sitting area had been partly used as an office and this was addressed after the inspection.
- Caring?
- Good
- Staff treated people with respect and supported their privacy, dignity, independence and choices. Inspectors noted that a written protocol was needed for the use of a listening monitor in one person's room.
- Responsive?
- Good
- People had personalised support, took part in activities and maintained links with family and the community. Some care plans did not explain support clearly enough for more independent people, and care plans were not regularly evaluated.
- Well-led?
- Good
- The manager was described as approachable, and audits, meetings and feedback were used to monitor the service. Inspectors could not see a written report showing that the provider had checked how effective the manager's audits were.
What inspectors found, September 2019
Rated Good; inspectors found safe, caring and person-centred support, with some records and review systems needing improvement.
The inspection took place on 17 July 2019 and was published on 11 September 2019. One inspector visited the home, spoke with two people, three staff members and two relatives, and reviewed care, medicines, staff and management records.
The home supported seven younger adults with learning disabilities or related conditions. Inspectors found enough staff, safe medicines arrangements, kind and respectful relationships, suitable training, and support for people to make choices, build independence and take part in community activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall and question rating as the previous inspection, published on 18 January 2017.
Inspectors identified several areas for improvement. These included more regular risk assessment reviews, fuller care plan evaluations, a written protocol for a listening monitor, and clearer evidence that the provider checked the manager's audits. Some issues were dealt with immediately after the inspection.
Kind, respectful relationships
Staff knew people well and supported them in a caring, person-centred way. People were encouraged to make choices and become more independent.
“Staff had developed good relationships with people, were caring in their approach and treated people with respect.” from the report
Community involvement
People were supported to follow hobbies, attend college or work placements, keep in touch with others and take part in trips and holidays.
“They went shopping, swimming, for meals out and cinema trips, to concerts, discos, socialised with people in other homes and went on holidays and day trips.” from the report
Safe medicines support
Medicines were managed through established systems. Staff had to complete training and regular competency checks before administering medicines.
“Staff did not administer medicines until they had been trained to do so.” from the report
Staff training and support
New staff completed an induction and shadowed experienced colleagues until they were considered competent. Existing staff received regular supervision and further training.
“New staff shadowed experienced staff until they, and the registered manager were satisfied they were competent to work alone.” from the report
People's involvement
People and families were involved in care decisions and the running of the home. People could help choose menus, activities and their keyworker.
“They selected menus, leisure activities and their keyworker to support them.” from the report
Risk reviews
needs fixingRisk assessments reflected people's needs, but inspectors said they should be reviewed more regularly. The manager said this would be raised with the provider.
“However, we discussed with the registered manager that a more regular review of risk assessments should be in place.” from the report
Care plan reviews
needs fixingSome plans for more independent people did not explain the support needed clearly enough for consistent care. Care plans were also not regularly evaluated.
“Care plans were not regularly evaluated.” from the report
Privacy monitor protocol
needs fixingA listening monitor was used to help keep one person safe, but there was no written protocol explaining how to use it while respecting privacy and dignity.
“A written protocol monitor was not in place to advise staff how it should be used so it respected the person's privacy and dignity.” from the report
Provider oversight
needs fixingThe home carried out regular audits, but inspectors could not find a written report showing that the provider had checked whether the manager's audits were effective.
“However, a written report was not available to show they had checked the effectiveness of the registered manager's audits.” from the report
Building wear and shared space
minorSome carpets were marked and worn, and part of the dining and sitting room had been set up as an office. The report says both issues were addressed after the inspection.
“However, we identified that some carpets were marked and showing signs of wear and tear.” from the report
- 01How often are each person's risk assessments reviewed now, and how are changes recorded?
- 02How are care plans for more independent people evaluated and updated to ensure staff provide consistent support?
- 03What written protocol is now used for the listening monitor, and how is the person's privacy protected?
- 04What evidence does the provider now produce to show that it checks the effectiveness of the manager's audits?
- 05What changes were made to the dining and sitting area after the inspection?
This was a planned inspection of all five key questions, and CQC looked at both the care provided and the premises. This explanation was written from the published report of 11 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, January 2017
The Palms was rated Good; inspectors found safe, kind and personalised care, with strong activities and management.
The announced inspection took place on 15 December 2016. One inspector spoke with six people living in the home, three relatives, managers and staff. The inspector also observed care, visited community activities and checked care, medicines, staffing, training, complaints and quality records.
All five areas were rated Good: safe, effective, caring, responsive and well-led. People had risk assessments, suitable staffing and safely managed medicines. Staff were trained, people could access healthcare, and care was based on individual needs and choices.
Inspectors saw respectful relationships and examples of outstanding care practice, although the overall rating remained Good. The home supported people to develop independence, take part in work and activities, and maintain links with family and the community.
Safe medicines
Staff administering medicines had been trained and assessed as competent. Inspectors found no gaps in the medicine records they checked.
“People received their prescribed medicine safely from staff that were competent to do so.” from the report
Skilled staff
Staff received induction, mandatory training, supervision and appraisals. Training also covered conditions and needs specific to people living in the home.
“People were cared for by staff that had the knowledge and skills to carry out their roles and responsibilities effectively.” from the report
Kind and respectful care
People were treated as individuals and supported with dignity, privacy, personal choices and everyday independence.
“People were always treated with dignity and respect.” from the report
Meaningful activities
People were supported to take part in education, work, hobbies, exercise and community activities. The home also helped people build independence and social connections.
“The service was committed to ensuring strong links with the community and placed a strong emphasis on enhancing people's lives through the provision of meaningful activities and opportunities.” from the report
Quality monitoring
The home used audits, surveys, staff meetings and follow-up action plans to check care and make improvements.
“There were systems and processes in place to check the quality of care to improve the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you support my relative to take part in activities, work or education that match their interests?
- 02How will you involve my relative and our family in care plan reviews and decisions about care?
- 03If my relative needs medicines when going out, what arrangements will be used to store, carry and give them safely?
- 04What is the current position on the four Deprivation of Liberty Safeguards applications that were awaiting written authorisation?
- 05How will you support my relative to develop daily living skills and maintain their independence?
This was an announced inspection covering all five areas, and each area was rated Good. This explanation was written from the published report of 18 January 2017 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 Palms
2 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 15 November 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.
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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.