CQC report explained · a residential care home
What the CQC found at 30 & 32 Church Lane
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff knew how to report safeguarding concerns and risk assessments had been reviewed after incidents. CQC was assured about most infection control arrangements, but visitor temperature checks and health screening were not completed when the inspector arrived.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, April 2021
Walsingham Support - 30 & 32 Church Lane was inspected but not rated; the previous Good rating remained, with safe risk management but a gap in visitor health screening.
This was an unannounced targeted inspection on 10 March 2021. One inspector checked safeguarding, risk management and infection control because CQC had received a specific concern about people's safety and wellbeing.
Inspectors found that staff understood people's needs and how to keep them safe. Safeguarding procedures were followed, risk assessments were updated after incidents, and staff discussed lessons learned. People appeared comfortable with staff.
The home supported people with activities indoors and contact with relatives during COVID-19 restrictions. CQC was assured about most infection control arrangements, but visitors were not temperature checked or health screened when the inspector arrived.
The home was not given a new rating because this was a targeted inspection. The previous overall rating was Good and remained unchanged. CQC said it would assess all parts of the Safe question at the next comprehensive inspection.
Staff understood people's needs
Inspectors found that staff knew how to support people safely and people appeared comfortable in their company.
“People were observed to be comfortable in the presence of staff. Staff were knowledgeable about people's needs and how to keep them safe.” from the report
Safeguarding procedures
Staff knew how to report concerns, and safeguarding matters had been referred to the local safeguarding authority for investigation.
“Safeguarding concerns had been reported to the local safeguarding authority.” from the report
Risk management
Risk assessments were detailed and updated after incidents. Staff understood the need to report changes in people's needs.
“Risk assessments had been reviewed and updated following specific incidents at the service.” from the report
Learning from incidents
Staff discussed incidents afterwards to identify lessons and consider what could have been done differently.
“Where there have been incidents, we have all met and discussed them afterwards.” from the report
Infection control arrangements
CQC was assured about shielding, social distancing, admissions, PPE, testing, hygiene and the infection control policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Visitor health screening
needs fixingCQC was only somewhat assured that visitors were protected from infection. The inspector was not temperature checked or given health screening on arrival.
“When we arrived at the service, our temperature was not taken, and health screening not completed.” from the report
- 01How do you now complete temperature checks and health screening for visitors?
- 02How are risk assessments reviewed after incidents or changes in a person's needs?
- 03How are safeguarding concerns reported, investigated and shared with staff?
- 04What activities and ways of keeping in touch with relatives are available now?
- 05When is the next comprehensive inspection expected, and will all five key questions be assessed?
This was a targeted inspection of specific concerns about safeguarding and risk management, with infection control also checked; it did not assess the whole Safe question or change the previous Good rating. This explanation was written from the published report of 30 April 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.
What inspectors found, April 2019
Rated Good; inspectors found safe, kind and personalised care, with some redecoration and damp needing attention.
This was an unannounced planned inspection over two days. One inspector spoke with people living at the home, relatives, staff and managers. They reviewed care files, staff records, medicines, accidents, complaints, health and safety records, audits and surveys.
The home supports up to 12 adults with a learning disability. There were 11 people living there during the inspection. Inspectors found that people were safe, medicines were managed properly, staffing was sufficient and staff understood people's needs.
Inspectors found kind care, support with communication, good access to healthcare and a range of activities. People were involved in decisions and their privacy and dignity were respected. Some shared bathrooms had chipped paint and damp, but the report says these issues were already being acted on.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published in March 2016.
Communication support
Staff used sign language, communication aids and people's body language to understand and respond to people who could not speak with inspectors.
“we observed staff supported them with a range of communication aids, which included sign language and interpreting people's body language” from the report
Kind and respectful care
People had positive relationships with staff. Inspectors saw staff protect privacy and respond patiently when someone became anxious.
“We saw the staff member gently take their hand and reassure them in a calm and soft voice” from the report
Personalised activities
People were supported to choose activities and outings that suited their interests, including day-centre activities, cinema visits and football matches.
“We saw that one person was regularly supported to go to watch their football team play at both home and away games” from the report
Safe medicines management
Staff were trained and assessed to give medicines. Inspectors observed medicines being administered competently.
“This was carried out in a competent and proficient manner.” from the report
Learning from incidents
After a recent safeguarding incident, the provider updated reporting arrangements and provided further safeguarding and whistleblowing training.
“additional safety measures were in place to further protect people from harm” from the report
Redecoration and damp
minorSome areas needed updating, including chipped paint and damp in shared bathrooms. The report says these problems had been reported and were being dealt with urgently.
“Some areas of the service required re-decorating and updating, this included chipped paint and areas of damp within the shared bathrooms.” from the report
- 01Have the chipped paint and damp in the shared bathrooms now been fully repaired?
- 02Who is currently managing the home, and how is management covered when the registered manager is away?
- 03How will staff support my relative's individual communication needs, including if they cannot communicate verbally?
- 04How are staff competency checks kept up to date for medicines and other important care tasks?
- 05What activities and community outings could be arranged around my relative's interests?
This was an unannounced planned inspection that looked at the overall quality of the home and all five CQC questions. This explanation was written from the published report of 18 April 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.
Every inspection of 30 & 32 Church Lane
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- April 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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