CQC report explained · a residential care home
What the CQC found at 54a
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risk assessments, safeguarding arrangements, staffing, medicines and infection control were all found to be managed safely.
- Effective?
- Good
- Care plans reflected people's needs and choices. Staff were trained and supported, and the home was working within the principles of the Mental Capacity Act.
- Caring?
- Good
- This question was not inspected during this focused inspection, so no new rating was given.
- Responsive?
- Good
- This question was not inspected during this focused inspection, so no new rating was given.
- Well-led?
- Good
- Managers understood their responsibilities and used audits, feedback and learning to monitor and improve the service.
What inspectors found, December 2022
54a was rated Good; inspectors found safe, person-centred care and improvements since the previous inspection.
This was an announced focused inspection. Inspectors visited on 11 and 15 November 2022, spoke with all three people living there and four staff, and checked care, medicine, staff and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that people were protected from avoidable harm, supported to make choices, and cared for by trained staff who knew their needs.
The previous inspection rated the service Requires Improvement and found a breach about consent. The provider had completed an action plan. Inspectors found enough improvement had been made and the home was no longer in breach.
Caring and Responsive were not inspected during this visit. Their previous ratings were used when calculating the overall Good rating.
People's safety
Staff knew people well and understood their risks. Risk assessments and support plans were detailed and kept up to date.
“People had detailed risk assessments and associated support plans.” from the report
Choice and independence
People were supported to make decisions, try new experiences and live as independently as possible.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Medicines
Medicines were given at the right time, reviewed regularly and checked through internal and external audits.
“People's medicines were regularly reviewed to monitor the effects of medicines on their health and wellbeing.” from the report
Staff support
Staff received induction, training, supervision and competency checks. There were enough staff to meet people's needs.
“All staff regularly completed core training, including refresher training.” from the report
Management and learning
The management team used audits, feedback and incident reviews to improve care and shared learning with staff.
“Managers carried out a range of checks and audits to monitor and improve the quality of the care and support people received.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you keep checking that mental capacity assessments and best-interest decisions remain up to date?
- 02How often will my relative's medicines be reviewed, and how will you tell us about any changes?
- 03How do you check that care plans continue to reflect my relative's wishes, preferences and future goals?
- 04What feedback do you collect from people who live here, and what changes have you made as a result?
- 05How do you make sure staffing levels change when people's care and support needs change?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating also used previous ratings. This explanation was written from the published report of 13 December 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.
What inspectors found, November 2019
Rated Requires Improvement; inspectors found safe, caring and responsive support, but consent records and oversight were not always good enough.
Inspectors visited on 26 September 2019. They spoke with everyone living at the home, two staff and the registered manager. They looked at care plans, medicines records, the building and records about how the home was run.
People were protected from abuse and avoidable harm. There were enough staff, medicines were managed safely and people were treated with kindness and respect. People had choice in their daily lives, could go out into the community and received personalised support.
The main problem was how the home recorded decisions for people who might not have the mental capacity to make them. Records did not always show which decision was being considered, how the decision was made or whether the person had been involved. The home was in breach of Regulation 11, need for consent.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe, Caring and Responsive were rated Good. Effective and Well-led were rated Requires Improvement.
Enough staff
Inspectors found there were enough staff to support people at all times. Recruitment checks and staff training were also described as safe and effective.
“There were sufficient staff on duty at all times to provide the support and guidance people may need.” from the report
Kind and respectful care
People told inspectors they were happy and got on with staff. Observations showed people were relaxed and involved in decisions about their care.
“People told us they were happy at 54a, and that they got on with all the staff.” from the report
Choice and independence
People could plan their own days, go into the community and maintain relationships. They were supported to work, see family and take part in activities.
“People were able to access the community and activities such as visiting family and friends, going out for meals or to the cinema.” from the report
Consent records were incomplete
seriousRecords did not always show which specific decision was being assessed, how a best-interest decision had been made or whether people with capacity had consented. This led to a breach of Regulation 11.
“There was an inconsistent approach to ensuring people with capacity had given and recorded their consent, for example by signing care plans.” from the report
Checks missed important gaps
needs fixingThe home's quality checks had not identified the weaknesses in mental capacity and best-interest records. This was one reason the Well-led rating was Requires Improvement.
“The weaknesses in documentation relating to assessment of people's mental capacity and best interests decisions had not been identified or addressed by these processes.” from the report
- 01How do you now record which specific decision is being assessed when someone may lack capacity?
- 02How do you show that a best-interest decision was properly considered and that the person was involved as far as possible?
- 03How do you record consent from people who have capacity, including their agreement to care plans?
- 04What checks now make sure capacity and consent records are complete and accurate?
- 05Have all risk assessments and care-plan wording been reviewed to remove information that is historic or not person-centred?
This was a planned inspection of the care home covering all five CQC questions, including accommodation, personal care, care plans, medicines and management records. This explanation was written from the published report of 14 November 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 54a
4 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- March 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- November 2012
Registered with the Care Quality Commission on 15 November 2012.
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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92 live-in carers within about an hour of Wakefield
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Most charge £980 to £1,260 a week. 79 can care for a couple. 12 years' experience on average.
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