CQC report explained · a residential care home
What the CQC found at 66 & 66a Lemsford Road
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, April 2020
United Response - 66 & 66a Lemsford Road was rated Good; inspectors found safe, kind and personalised care, with some learning processes still being developed.
Inspectors visited on 12 and 17 February 2020 without giving notice. They spoke with one person, two relatives and six staff. They observed care and reviewed care, medicine, staff and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives said they were happy with the care. Inspectors found that people were supported to make choices, stay safe, develop skills and take part in activities.
There were enough trained staff. Medicines, risks, safeguarding and infection control were managed safely. Care plans were personalised, staff knew people well, and managers used audits and feedback to identify improvements.
The home was larger than current best practice guidance for this type of service. Inspectors said the design and location helped reduce any negative effect. The process for learning from things that went wrong was still being developed.
People felt safe
People and relatives told inspectors they felt safe and were happy with the support. Staff understood safeguarding and how to report concerns.
“People told us they felt safe in the home and they liked living there.” from the report
Personalised support
Care plans reflected people's individual needs, preferences and communication styles. Staff knew people well and supported choice and independence.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Kind and respectful care
People and relatives described staff as kind and respectful. Inspectors found that privacy, dignity and involvement in decisions were promoted.
“People told us staff were kind and respectful.” from the report
Activities and community life
People were supported to follow their interests and take part in regular activities, outings and community activities.
“People had planned weekly activities which included outings, day centre, shopping trips, walks and pub nights.” from the report
Strong oversight
The manager and provider used audits, feedback, meetings and records to monitor quality and identify areas for improvement.
“Audits done by the registered manager and the provider were effective in identifying areas in need of improvement and actions were taken to improve the quality of the service provided” from the report
Learning from incidents was still developing
minorInspectors said the process for learning lessons when things went wrong was still being built into everyday practice. Staff were updated through meetings and supervision when incidents occurred.
“This was an area the registered manager was further developing to ensure it was imbedded in everyday practice.” from the report
The home is larger than current guidance
minorThe home can accommodate 11 people and is larger than current best practice guidance. Inspectors said the building design and its setting helped reduce any negative effect on people.
“The service was a large home, bigger than most domestic style properties.” from the report
- 01How are you developing the process for learning from incidents and making sure lessons become part of everyday practice?
- 02How does the size of the home affect my relative's experience, privacy, choice and independence?
- 03How would you support my relative's particular communication needs, including any use of pictures, facial expressions or body language?
- 04What activities and community outings would be available for my relative based on their interests?
- 05How would you involve our family in care reviews and decisions if my relative could not make a particular decision?
This was an unannounced planned inspection that assessed all five CQC questions, and the previous Good ratings in all five areas remained unchanged. This explanation was written from the published report of 4 April 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.
What inspectors found, August 2017
Rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an unannounced, comprehensive inspection on 25 July 2017. The inspector reviewed care records, staff recruitment and management records, observed care, and spoke with relatives, staff and the registered manager. People living at the home could not speak with inspectors because of their complex medical conditions.
The home supported nine people, although it had space for up to 11. Relatives said people were safe and well cared for. Inspectors found enough trained staff, suitable risk assessments, safe medicines processes and support with nutrition, health and activities.
Staff treated people with kindness and respect. Care was personalised, and relatives and people were supported to give feedback or complain. The home had systems to check quality and act on shortfalls.
The overall rating was Good, and each of the five areas was also rated Good. This means inspectors found the service met the relevant standards at the time of this inspection. The home had remained Good since the previous inspection.
Managing risks
Staff understood people's risks and took practical steps to reduce harm, including changing furniture and using equipment for one person's falls risk.
“Risks to individuals were assessed and when identified actions put in place to mitigate and manage the risks to help keep people safe.” from the report
Staffing and training
Inspectors found enough staff, with recruitment checks and training in areas such as moving and handling, medicines, epilepsy and diabetes.
“Staff had been recruited through the provider's robust recruitment procedure and pre-employment checks were completed including a (DBS) Disclosure and Barring check and taking up of references.” from the report
Kind and respectful care
Staff spoke respectfully, explained what they were doing and protected people's privacy. Relatives were involved in care decisions.
“We observed that staff spoke with people in a respectful manner and made eye contact.” from the report
Personalised support
Care plans described people's needs, interests and preferred support. Staff helped people take part in activities and keep everyday skills where possible.
“People's care plans were both detailed and person centred.” from the report
Listening and improvement
The home sought views from relatives, people and staff. Inspectors found that identified shortfalls were followed by action to improve the service.
“There was a robust quality assurance system in place and shortfalls identified were promptly acted on to improve the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you understand and record my relative's choices if they cannot communicate verbally?
- 02What is the current status of my relative's Deprivation of Liberty Safeguards application?
- 03How will you match staff skills and staffing levels to my relative's activities, health needs and changing support needs?
- 04How will you support my relative's specialist diet and ongoing appointments with health professionals?
- 05How can my relative and our family give feedback or raise a concern, and how will you show us what action was taken?
This was an unannounced comprehensive inspection covering all five key questions, but inspectors could not speak directly with people living at the home because of their complex medical conditions. This explanation was written from the published report of 19 August 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 66 & 66a Lemsford Road
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 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.
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At least 100 live-in carers within about an hour of Hertfordshire
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 £980 to £1,300 a week. 82 can care for a couple. 12 years' experience on average.
“She handled the new situation in front of her with such professionalism and I felt I could trust her 100%.”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.