CQC report explained · a residential care home
What the CQC found at Agnes House Flat 1
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff understood the person's risks and knew how to respond to anxiety and self-harming behaviour. Medicines were given as required, although guidance for one as-needed sedative needed more detail, and window and cleaning-product risks needed action.
- Effective?
- Good
- Staff had training and supported the person's health, diet, appointments and independence. Inspectors found the service was working within the Mental Capacity Act, although some staff could not explain all its key principles.
- Caring?
- Good
- Staff were observed to be kind, respectful and caring. They offered choices, sought consent and encouraged the person to do things independently.
- Responsive?
- Good
- The support plan reflected the person's needs, preferences, goals and routines. Staff supported hobbies, college, family visits and complaints, although a relative reported reduced updates from the service.
- Well-led?
- Requires improvement
- Quality assurance systems did not identify several shortfalls. Evidence about risk assessments, staff supervision, appraisals, training and management visits was not always readily available or complete.
What inspectors found, October 2018
Rated Good overall, but inspectors found weaknesses in quality checks, records and management oversight.
This was an unannounced inspection on 25 September 2018. The inspector met the person living at the home, observed staff support, and spoke with the person, a relative, staff and the manager. Records about care, medicines, recruitment, training and quality checks were reviewed.
The person was supported safely and had staff available at all times. Staff understood the person's risks, gave medicines as required, supported healthcare appointments and encouraged independence. Inspectors saw kind and respectful care, with support based on the person's choices, routines and interests.
The home was rated Good for Safe, Effective, Caring and Responsive. It was rated Requires Improvement for Well-led because quality checks did not find some problems, records were not always easy to provide, and there were gaps in evidence about staff supervision, appraisals and updated training.
The manager took action after the visit, including plans for window restrictors, locked cleaning products, repairs and clearer medicines guidance. The report does not say that enforcement action was taken.
Staff understood risks
Staff knew how to support the person's anxiety, self-harming behaviour, cooking and community access. Risk assessments gave staff guidance while allowing the person freedom.
“We reviewed the support plans for the person and saw risk assessments were in place to guide staff on the risks they should be aware of” from the report
Kind and respectful care
The person described staff as kind and respectful. Inspectors observed a trusted relationship that helped the person feel calmer and supported.
“We observed the person become less anxious and saw the person refer to the staff member as 'their friend'” from the report
Choice and independence
Staff supported the person to make choices, manage parts of daily life and remain involved in decisions about their support.
“We saw the person was encouraged to be independent and to have choice and control over their life.” from the report
Personalised support
The support plan included the person's preferences, routines, interests, relationships, abilities and goals. Staff supported activities such as shopping, college and family visits.
“The person's support plan focused on their whole life including their goals, skills and abilities to do things for themselves and manage their health.” from the report
Quality checks missed problems
needs fixingManagement audits did not identify issues such as unrestricted windows, unlocked cleaning products, cleanliness and repairs. The manager produced an action plan after the inspection.
“The systems in place for assessing the quality of the service did not always identify short falls in the service provided.” from the report
Training and staff records
seriousSome staff were waiting for refresher training, and records did not show consistently that supervision, appraisals and updated training had taken place. Inspectors said some techniques could not be used safely until refresher training was provided.
“Therefore, staff would not be able to use certain techniques safely until refresher training was provided.” from the report
Communication with relatives
minorA relative said communication had reduced after the management change and that regular updates had stopped. This was passed to the manager to address.
“I think the communication between us and the management team has deteriorated since the change of management.” from the report
- 01Have window restrictors been fitted and are cleaning products now locked away?
- 02How do you check that staff have completed refresher training, supervision and appraisals?
- 03What clearer guidance is now in place for the person's as-needed sedative medicine?
- 04How will relatives receive regular updates, particularly when a keyworker leaves?
- 05How do you now make sure quality checks identify repairs, cleanliness issues and missing records?
This was an unannounced comprehensive inspection covering all five CQC questions; at the previous inspection in November 2015, the service was meeting the regulations. This explanation was written from the published report of 31 October 2018 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 Agnes House Flat 1
2 rated inspections over 3 years: the service has held its Good rating throughout.
- October 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- April 2012
Registered with the Care Quality Commission on 19 April 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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