CQC report explained · a residential care home
What the CQC found at Agbrigg and Sandal
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, suitable risk assessments and safe medicines arrangements. Infection prevention and control arrangements were also considered satisfactory.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- People had personalised support plans and were helped to make choices, develop independence and take part in activities. Communication information was provided in an accessible format.
- Well-led?
- Good
- Inspectors found approachable managers, regular audits, involvement of people and families, and action plans to address issues and improve the service.
What inspectors found, November 2022
Heathcotes (Wakefield) is rated Good; inspectors found safe, personalised care and improvements since the previous inspection.
Inspectors visited unannounced on 18 and 19 October 2022. They spoke with seven people, six staff and three relatives. They reviewed care records, medicines records, recruitment files and management records.
The home supported 18 people with learning disabilities in two houses and four flats. Inspectors found enough staff, safe medicines support, suitable risk assessments and infection control. People were supported to make choices and take part in activities.
The home was rated Good for Safe, Responsive and Well-led. The previous rating was Requires Improvement, with two breaches of regulations. Inspectors found that improvements had been made and the home was no longer in breach.
This was a focused inspection. Inspectors did not reassess Effective or Caring. Those ratings were carried forward from the previous inspection when calculating the overall Good rating.
Safe staffing and recruitment
Inspectors saw enough staff to support people's needs and interests. Recruitment included checks designed to help make safer decisions.
“We observed staff interacting with people and found there were enough staff available to support people to meet their needs and take part in social interests.” from the report
Safe medicines
People received medicines as prescribed. Medicines were stored safely, and audits were used to identify and act on concerns.
“People received their medicines as prescribed and were supported in a safe way.” from the report
Personalised support
Staff knew people well and supported their preferences, choices and independence. The four flats offered opportunities to develop independent living skills.
“People were supported by staff who knew them well and supported them in a person-centred way.” from the report
Activities and relationships
People had activity schedules based on their interests. The home also supported social opportunities, including trips, celebrations and holidays.
“People had schedules in place of activities they had expressed an interest in.” from the report
Management and improvement
Managers understood their roles and used audits and action plans to monitor quality and make improvements.
“Action plans were used to address issues and make improvements to the service where needed.” from the report
Inspectors raised no specific concerns in this report.
- 01How have you maintained the improvements that led to the change from Requires Improvement to Good?
- 02What are the current arrangements for supporting my relative to make choices and develop independent living skills?
- 03How do you check that medicines are given correctly and that any concerns are acted on promptly?
- 04What activities and community opportunities would be available for my relative based on their interests?
- 05What were the previous ratings for Effective and Caring, which were not inspected during this visit?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 15 November 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, February 2021
Rated Requires Improvement; inspectors found caring support and safe medicines practice, but concerns about staffing, infection control, personalised care and leadership.
This was an unannounced focused inspection after concerns about the use of power and restraint, management and staffing culture. Inspectors visited on several dates, spoke with people, relatives, staff and professionals, and reviewed care, medicines and staffing records.
The home was rated Requires Improvement overall. Safe, Responsive and Well-led were also rated Requires Improvement. Inspectors found that medicines were generally managed safely and that staff often supported people positively, but staffing arrangements did not clearly show that people received the support they needed.
There were concerns about incorrect use of personal protective equipment, infection risks during COVID-19, staff training, restraint records and whether people received their planned support. The provider breached Regulation 9 on person-centred care and Regulation 12 on safe care and treatment.
The last overall rating was Good, published on 22 May 2018. A new manager and senior managers were taking action, but CQC required an action plan and said it would monitor progress and return to inspect.
Medicines
People generally received their medicines when needed. Staff supported people individually and records were clear.
“People received their medicines when they needed them.” from the report
Individual risk plans
People's individual risks were recorded in their support plans, and staff understood how those risks affected care.
“Individual risks were documented in people's support plans and staff understood these and how they impacted upon people's care.” from the report
Communication aids
Staff used simple gestures, signs, pictures and easy-read information to help people understand information.
“Pictures, photographs and easy-read documentation was available to support people to understand information, such as in their support plans.” from the report
Family contact
Relatives were supported to visit in the garden during COVID-19 restrictions, and most relatives said they were kept informed.
“Staff had facilitated garden visits from people's relatives in line with the guidelines for the COVID-19 restrictions and relatives commented positively about this.” from the report
Staffing was not clearly matched to need
needs fixingRotas and records did not clearly show which staff supported which people. Staff said shortages sometimes affected people's community activities and planned 2:1 support.
“Staff deployment to meet people's individual needs was not clearly demonstrated.” from the report
Infection control
seriousSome staff did not wear face masks correctly. Staff were also moved between houses despite different COVID-19 situations, creating a risk of spreading infection.
“Due to robust infection prevention and control procedures not being followed, people were at risk of harm.” from the report
Personalised support
seriousPeople did not always receive care based on their preferences and assessed support levels. Some people did not receive their full planned 2:1 support.
“Records did not evidence people had the amount of 2:1 support they were entitled to, which meant their choices and autonomy may be limited.” from the report
- 01How do you now show on rotas and daily records that each person receives their planned 2:1 support?
- 02What has changed to make sure staff wear personal protective equipment correctly and are not moved between houses in a way that increases infection risk?
- 03Which staff have completed positive behaviour support and medicines training, and how do you check their confidence and competence?
- 04How are restraint incidents now reviewed, debriefed and used to improve people's support plans?
- 05What changes has the new manager made to improve leadership and oversight across both houses?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were carried forward when calculating the overall rating. This explanation was written from the published report of 2 February 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.
Every inspection of Agbrigg and Sandal
4 rated inspections over 7 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- June 2012
Registered with the Care Quality Commission on 15 June 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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