CQC report explained · a nursing home
What the CQC found at Adlington Manor
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments and care records did not always explain how to manage falls, diabetes, skin care, nutrition and wounds. Staffing levels and agency staff induction also needed improvement, although people generally felt safe and infection control was satisfactory.
- Effective?
- Good
- Staff had training and support, people could access healthcare, and equipment and adaptations supported independence. Food quality received mixed feedback, and some care plans did not fully reflect professional advice or best-interest decisions.
- Caring?
- Good
- People were generally treated with kindness, dignity and respect. Staff usually promoted choice and independence, but some reviews were late and inspectors saw occasions where privacy or involvement in decisions could have been better.
- Responsive?
- Requires improvement
- Care plans varied in detail and did not always record people's preferences or needs fully. Families and professionals spoke positively about end-of-life care, but records lacked person-centred detail and people wanted more activities.
- Well-led?
- Requires improvement
- The home had audits, meetings and systems for complaints, but checks did not consistently lead to improvements. The provider had not taken enough action after earlier concerns, including concerns about risk management and care planning.
What inspectors found, September 2022
Requires Improvement; inspectors found kind and effective care, but risks, care records and quality checks were not always managed safely.
This was an unannounced follow-up inspection on 4 July and 3 August 2022. Inspectors observed care, checked the building, reviewed records and medicines, and spoke with people, relatives, staff and healthcare professionals.
People generally felt safe and were treated with kindness, dignity and respect. The home was clean, staff had suitable training, healthcare support was available, and infection control arrangements were satisfactory.
However, risk assessments and care plans did not always give staff enough information. Staffing levels and agency staff arrangements needed improvement. Activities were limited, and governance checks had not consistently led to improvements. The overall rating stayed Requires Improvement, with the same rating for Safe and Well-led, while Responsive fell from Good to Requires Improvement.
Kind and respectful care
People were generally treated well. Inspectors observed positive interactions and found that privacy, dignity and independence were usually promoted.
“People generally felt well treated and supported by staff.” from the report
Healthcare support
People were supported to access healthcare when needed. The home worked with local healthcare services and held regular doctor visits.
“The home worked closely with local healthcare services and ward rounds with the local doctor were held regularly.” from the report
Staff training
Staff received a range of training, checks and induction support. Staff said they felt supported in their roles.
“Staff received a variety of training and checks of skills to ensure they had the skills needed to support people.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements to prevent and manage infections, including the safe use of protective equipment.
“We were assured that the provider was using PPE effectively and safely.” from the report
Risk records were not reliable enough
seriousCare plans and records did not always show how risks were assessed or managed. This included falls, diabetes, skin care, nutrition and wound care.
“Risks to people were not always fully assessed and mitigated and we noted areas for improvement to ensure lessons were learnt when things went wrong.” from the report
Quality checks did not drive enough improvement
seriousThe provider had not acted robustly enough on earlier findings. Audits identified problems, but records and oral care were still not consistently improved.
“Checks had not led to records being effectively addressed and learning across the home.” from the report
Limited activities
minorThere was no activity lead during the inspection. Staff provided activities when time allowed, but several people said they were bored.
“However, it was evident that staff struggled to have enough time to provide meaningful activities. and several people told us they were bored.” from the report
Care plans lacked personal detail
needs fixingCare plans did not always record people's preferences, communication about care, pressure relief needs or end-of-life wishes in enough detail.
“The quality of care plans varied and did not always contain the enough detail or consider associated needs.” from the report
- 01What has changed to make sure falls, head injuries, diabetes, skin care, nutrition and wound care are assessed and recorded correctly?
- 02How do you check that agency staff receive a proper introduction and understand each person's needs before working alone?
- 03What action has been taken to make care plans more personal and to record people's end-of-life wishes?
- 04How are you checking that people receive oral care and that audit findings lead to lasting improvements?
- 05Has an activity lead been appointed, and how will people be supported to take part in more meaningful activities and community trips?
This was an unannounced comprehensive follow-up inspection covering all five key questions, including infection prevention and control, after the previous Requires Improvement rating. This explanation was written from the published report of 2 September 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, March 2022
Inspected but not rated; inspectors found effective infection control, safe visiting arrangements and measures to manage COVID-19 staffing pressures.
This was an unannounced, targeted inspection on 27 January 2022. It followed concerns about visiting arrangements and focused on infection prevention and control, visiting and COVID-19-related staffing pressures.
Inspectors found that the home was using PPE safely, arranging regular COVID-19 testing and following government guidance. They found the home clean and hygienic, with cleaning schedules and audits in place.
Visiting arrangements had been updated and visits were taking place. The home was meeting the requirement for non-exempt staff and visiting professionals to be vaccinated. The home was inspected but not rated, so this report does not give an overall quality rating.
Infection control
The home had measures to reduce COVID-19 risks. Inspectors were assured that infection prevention arrangements were working across several areas.
“There were effective measures in place to minimise the risks around COVID-19.” from the report
Clean environment
The home was clean and hygienic. Cleaning schedules, audits and regular cleaning of frequently touched surfaces were in place.
“The environment was clean, well maintained and hygienic.” from the report
Visiting arrangements
The visiting policy had been updated in line with government guidance. Inspectors saw evidence that visits were being supported, including visits for people receiving end-of-life care.
“There were no concerns around visiting at the time of the inspection and essential care givers and visitors of people at end of life were visiting the home.” from the report
Testing and vaccination
People and staff were tested regularly for COVID-19. The report says all staff employed at the home had been vaccinated.
“People and staff were tested regularly for COVID-19, in line with government guidance.” from the report
Inspectors raised no specific concerns in this report.
- 01What measures are currently in place when COVID-19 causes staffing pressures?
- 02How will you keep the visiting policy up to date if government guidance changes?
- 03How often are residents and staff tested for COVID-19 now?
- 04How do you check that PPE is being used safely and that high-touch areas are cleaned regularly?
- 05How do you support visits for essential care givers and people receiving end-of-life care?
This was an unannounced targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not rate the other four questions or give an overall rating. This explanation was written from the published report of 1 March 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 Adlington Manor
6 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- September 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2022Inspected but not ratedSafe: Inspected but not rated
- October 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- April 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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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