CQC report explained · a residential care home
What the CQC found at Alandale Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines, infection control, accident monitoring and risk guidance were not always safe or complete. Inspectors found an increased risk that people could be harmed.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Management did not have effective systems to audit medicines, risks, accidents, care plans and health and safety. The rating remained Requires Improvement.
What inspectors found, February 2023
Rated Requires Improvement; inspectors found caring staff and enough workers, but medicines, infection control, risk management and oversight were not consistently safe.
This was an unannounced focused inspection on 7 December 2022. Two inspectors spoke with five people, eight relatives and seven staff. They observed care, reviewed care and medicines records, and checked management and recruitment documents.
Inspectors found positive feedback about the care. People and relatives said staff were kind, people felt safe, and there were enough staff. Staff supported people to make choices and worked with health professionals.
However, medicines were not always managed safely. Records were incomplete or inaccurate, some creams were out of date or not dated, and storage checks were not reliable. Infection control, accident records, risk guidance and checks on complex health needs also had gaps.
The overall rating fell from Good at the previous inspection in 2017 to Requires Improvement. Only Safe and Well-led were inspected this time. The other ratings used for the overall rating carried over from the previous inspection.
Enough staff
People, relatives and staff said there were enough staff to meet people's needs. Recruitment checks were also completed before staff started work.
“People, relatives and staff told us there were enough staff.” from the report
People felt safe
People said they felt safe, and staff understood how to recognise and report possible abuse.
“People we spoke with told us they felt safe living at Alandale Residential Home.” from the report
Respect for choices
Inspectors found that the home was working within the principles of the Mental Capacity Act. Staff supported people to make as many choices as possible.
“Staff we spoke with understood their responsibilities regarding the MCA and told us examples of how they ensured people made as many choices for themselves as possible” from the report
Positive relationships
Relatives described a positive culture and said staff kept them updated about changes in their loved one's needs. Staff also worked with health professionals to arrange joined-up care.
“The registered manager had completed the relevant referrals to healthcare professionals to ensure people received joined up care.” from the report
Medicines records and storage
seriousOne prescribed medicine was missing from a medicines record, and staff were initially unsure whether it should be given. Inspectors also found an out-of-date ointment, incomplete dating and inaccurate stock records.
“One person had a prescribed medicine that was not listed on the medicines administration records (MAR).” from the report
Infection control
seriousUsed protective equipment and continence aids were not always put in the correct bins. A rusty bath hoist also created an infection control risk.
“Used PPE had been discarded in open bins, or swing bins. This increased the risk of infection.” from the report
Risk information and checks
seriousCare plans did not always give staff clear instructions for choking, falls, skin care or catheter care. Staff records did not always show that required checks had been completed.
“Care plans and risk assessments did not contain enough information to inform staff how to mitigate risks to people.” from the report
Weak management audits
seriousThere was no formal system covering all areas of the service. Management did not have effective audits for medicines, health and safety, accidents, care plans and risks.
“The registered provider and registered manager did not have an effective system in place to monitor and make improvements in relation to medicines administration and storage.” from the report
- 01What action has been taken to make sure every medicine is listed correctly, stored safely and checked against accurate stock records?
- 02How are used protective equipment and continence aids now disposed of, and has the rusty bath hoist been replaced or made safe?
- 03How are care plans updated when someone falls, develops skin breakdown, has choking risks or needs catheter care?
- 04How are all accidents and incidents recorded on one reliable system and reviewed for repeated patterns?
- 05What regular audits are now in place, and can you show us the action plan and evidence of completed improvements?
This was a focused inspection of Safe and Well-led only, following concerns about visiting; the other ratings were carried over from the previous inspection in 2017. This explanation was written from the published report of 9 February 2023 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 2017
Rated Good overall, but well-led Requires Improvement because two serious falls were not reported to the CQC without delay.
This was an unannounced comprehensive inspection on 20 October 2017. Inspectors spoke with people living at the home, relatives, staff and managers. They observed care and checked care plans, medicines, staff records and management checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines management, personalised care, kind treatment, support with health needs and activities people enjoyed.
Well-led was rated Requires Improvement. Two people had serious injuries after falls in April and July 2017, but these events were not reported to the CQC at the time. The home had taken action to keep people safe and sent the notifications after the inspection.
Enough staff
Inspectors found staffing levels met people's needs. Staff responded promptly when people asked for help.
“There were enough staff who knew people well, to provide the support people needed.” from the report
Kind and respectful care
Staff treated people with dignity, respected their choices and supported them to remain independent.
“Staff were kind and caring to people and treated them with dignity and respect at all times.” from the report
Personalised support
People helped plan their care, and staff followed their preferred routines, choices and activities.
“People had planned their care with staff. They received their care and support in the way they preferred.” from the report
Safe medicines
Medicines were ordered, stored, given and recorded safely. Staff received training and checks on their competence.
“Effective systems were in place to order, store, administer, record and dispose of medicines.” from the report
Late notification of serious falls
needs fixingTwo serious injuries after falls were not reported to the CQC when they happened. The home later submitted the notifications and said it would improve its process.
“Two people had sustained serious injuries following falls in April and July 2017 that had not been reported to the CQC.” from the report
- 01What changes have been made to make sure all notifiable events are reported to the CQC without delay?
- 02What action was taken after the two serious falls, and how is the home checking that the action remains effective?
- 03Are any people currently waiting for a Deprivation of Liberty Safeguards assessment, and how are their choices supported while they wait?
- 04How are care plans reviewed with each person and their relatives when needs or preferences change?
- 05What refurbishment work was planned for bedrooms and en suite facilities, and has it been completed?
This was an unannounced comprehensive inspection covering all five key questions, with observations, discussions and checks of selected records. This explanation was written from the published report of 24 November 2017 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 Alandale Residential Home
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 9 November 2010.
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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