CQC report explained · a residential care home
What the CQC found at 17 York Avenue
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, safeguarding arrangements and safe medicines systems for people who needed staff to administer their medicines. However, some self-medication records and risk assessments were incomplete.
- Effective?
- Requires improvement
- People received support with health, food, training and decision-making. The rating was reduced because the décor and furnishings were poor, one bedroom needed redecoration, and two annual health checks were overdue.
- Caring?
- Good
- Staff knew people well and treated them with dignity and respect. People were supported to make choices, practise their religion and remain independent.
- Responsive?
- Good
- Care was personalised and people had support with communication, relationships, activities, work and personal goals. People and relatives knew how to raise concerns.
- Well-led?
- Requires improvement
- The home had a positive, person-centred culture and staff felt supported. However, governance systems had not identified inaccurate records, poor cleanliness and other shortfalls, and some policies were out of date.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found safe, kind and responsive care, but records, premises and management needed improvement.
Inspectors visited on 17 and 19 May 2022. They spoke with all four people living at the home, two relatives, staff and managers. They observed a staff handover and checked care records, medicines files, recruitment records, audits and policies.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safe recruitment, appropriate medicines support, respectful care and good support for people's independence, interests, family relationships and cultural needs.
The home was rated Requires Improvement for Effective and Well-led. Records were sometimes incomplete, out of date or unsuitable. Inspectors also found poor décor, some grease and stains in the kitchen, and checks that had not identified these problems.
The overall rating was Requires Improvement. This was a change from Good at the previous inspection, published in March 2019. There was a breach of Regulation 17 relating to good governance. The manager began addressing some issues during the inspection, and the provider later updated its policies.
Independence and choice
People had control over everyday decisions and were supported to live as independently as possible.
“People had the maximum possible choice, control and independence over their own lives.” from the report
Active lives
People were supported to take part in work, social events, family visits, day services and daily living activities.
“Most people had full weekly schedules that included voluntary work, social events, family visits, day centre attendance and daily living activities.” from the report
Culturally appropriate care
The home supported people's Jewish faith, cultural activities and dietary requirements.
“Staff supported people to practise their religions and attend culturally appropriate activities.” from the report
Kind and respectful staff
Inspectors observed respectful interactions, and people and relatives gave positive feedback about the care.
“We observed good, respectful interactions between staff and people.” from the report
Care records were not reliable
seriousSome records lacked dates, had not been updated or used unsuitable templates. Medicine plans and risk assessments did not always reflect current needs or changes in medicines.
“The service did not always ensure people's care records were accurate, up to date, appropriate and consistent.” from the report
Poor décor and furnishings
needs fixingInspectors found poor décor in communal areas and one bedroom. The provider had plans for communal areas, but bedrooms were not included in regular refurbishment plans.
“The care home had a poor standard of décor and furnishings.” from the report
Kitchen cleanliness
needs fixingMost of the home was clean, but some kitchen cupboards and appliances had grease and stains. Staff started deep cleaning during the inspection.
“Most of the home was clean and tidy although some kitchen cupboards and small appliances had stains and coatings of grease.” from the report
Checks did not spot problems
needs fixingThe home carried out audits and other checks, but these had not identified gaps in records, cleanliness or care plans.
“However, these had not identified gaps and inaccuracies in medicines records and care plans, and shortfalls in cleanliness.” from the report
- 01What changes have you made to ensure all care records, risk assessments and self-medication plans are dated, accurate and kept up to date?
- 02How do you now check that changes to medicines lead to an immediate review of the relevant risk assessments and care plans?
- 03What refurbishment has been completed in the communal areas, and what is the plan for the bedroom that needed redecoration?
- 04How are kitchen cleaning tasks now monitored, and how do managers make sure their audits identify problems?
- 05Have the two overdue annual health checks been completed?
This was a full inspection covering all five key questions, including infection prevention and control; all five ratings were assessed during this inspection. This explanation was written from the published report of 30 June 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 17 York Avenue
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2020
Registered with the Care Quality Commission on 2 January 2020.
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 Bury
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 £1,260 a week. 94 can care for a couple. 11 years' experience on average.
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