CQC report explained · a residential care home
What the CQC found at Albany House - Tisbury
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2019
Albany House - Tisbury was rated Requires Improvement, with kind care and better leadership but continued medicines and monitoring weaknesses.
Inspectors visited unannounced on 07 November 2019 and 13 November 2019. They spoke with eight people, two visiting professionals and seven staff. They reviewed care records, staff recruitment files, audits and meeting minutes.
The home had improved since its previous Inadequate rating. Inspectors found caring, effective and responsive care. People were treated kindly, staff knew them well, meals offered choice, and people were supported with activities, healthcare and independence.
Safety still required improvement because medicines records were not always completed accurately. Leadership also required improvement because monitoring systems and new care plans were still being developed and had not had enough time to become fully effective.
The home was no longer rated Inadequate and was no longer in Special Measures. The provider was asked to submit monthly action plans while CQC and the local authority monitored progress.
Kind and respectful care
People told inspectors that staff were kind and caring. Inspectors also saw staff treating people with dignity and respect.
“People were supported by staff who knew them well.” from the report
Improved staffing
Inspectors found safe recruitment and enough staff to meet people's needs. The use of agency staff had reduced and teamwork had improved.
“There were enough staff available to meet people's needs.” from the report
Choice and independence
People were offered choices about food, drinks, activities and personal care. Staff supported people to maintain their independence and interests.
“There was a culture of positive risk management and supporting people to maintain their independence.” from the report
Community involvement
The home had developed links with the local community and churches. People could take part in events and services at the home.
“There was good community engagement.” from the report
Medicines records
seriousMedicines were prepared and given safely when inspectors observed this, but administration records were not always completed accurately. The manager was identifying problems, but the monitoring system had not yet reached a consistently good standard.
“Shortfalls remained in accurate completion of medicines administration records.” from the report
Quality monitoring still developing
needs fixingThe manager was introducing audits and other monitoring systems. These systems needed more time to become established and consistently show that risks and quality were being managed well.
“Both the newly appointed manager and senior carer were developing into their roles and needed more time to embed the positive changes taking place at the home.” from the report
Care plans not yet complete
needs fixingCare plans were being transferred to a newer, clearer format, but this work was unfinished at the inspection. Management plans were in place to continue the work.
“While the care plans were not complete in their new format, there were management plans in place to continue the development of these.” from the report
- 01How are medicines administration records checked now, and what action is taken when a record is incomplete or inaccurate?
- 02Have all people's care plans now been transferred into the new format, and how are families involved in reviewing them?
- 03What improvements have been made in the monthly action plans requested by CQC?
- 04How do you check that new quality monitoring systems identify and resolve problems quickly?
- 05How many agency staff are currently being used, and how do you make sure they know each person's needs and preferences?
This was a planned, unannounced inspection covering all five key questions, with ratings compared against the previous inspection published on 21 May 2019. This explanation was written from the published report of 3 December 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.
What inspectors found, November 2019
Rated Inadequate overall, with serious concerns about safety and management despite kind care.
This was an unannounced, comprehensive inspection over two days. One inspector spoke with people, staff and healthcare professionals, and checked care plans, medicines records, staff files, training records and quality checks.
Inspectors found that risks were not always assessed or managed. Medicines records had gaps, the medicines fridge was not locked, water temperature checks were not consistent, and two staff had started work before references were received.
Some improvements had been made. Training records were easier to monitor, mental capacity assessments and best-interest decisions were in place, and care plans contained more information. However, record keeping, staff supervision, hydration records and care planning still needed improvement.
The home was rated Good for Caring, Requires Improvement for Effective and Responsive, and Inadequate for Safe and Well-led. The report says earlier improvements had not been maintained, so the overall rating was Inadequate.
Kind and respectful care
People told inspectors that staff were kind and helpful. Inspectors saw friendly interactions and respect for people's dignity and choices.
“People told us the staff were kind and helpful.” from the report
Clean environment
The home was clean and did not have unpleasant smells. Its kitchen had also received a five-star food hygiene rating.
“The home was clean and free from odours throughout.” from the report
Improved training records
A new electronic system gave the manager a clearer view of staff training completed and training still due.
“This allowed the registered manager to maintain an overview who which staff had accessed their training.” from the report
Mental capacity processes
Inspectors found that mental capacity assessments and best-interest decisions had been completed where needed. DoLS applications had also been made and monitored.
“We found that mental capacity assessments and best interest decisions were in place.” from the report
Unsafe risk management
seriousImportant risks were not assessed or acted on promptly. These included flammable creams used by a smoker, support with insulin, and water temperatures above the recommended level.
“Risks continued to not be identified and assessed sufficiently.” from the report
Medicines not safely controlled
seriousThe medicines fridge was not locked, temperatures were not recorded every day, and medicine administration records had 19 unexplained gaps for four people.
“There were gaps in the medicine's administration records (MAR's), without reasons recorded as to why these gaps were present.” from the report
Incomplete recruitment checks
seriousTwo staff had started work before employer or character references had been received.
“We saw that two members of staff had begun work at the home without employer or character references being received.” from the report
Poor management oversight
seriousQuality assurance systems had been bought but were not used effectively. Previous improvement actions had not been maintained.
“The registered manager had been unable to drive improvements following our two previous inspections.” from the report
Incomplete care records
needs fixingCare plans did not always explain people's needs, including behavioural support, skin care, social needs and mental stimulation. Hydration records also did not show clear fluid targets or amounts.
“It was not possible from the records to identify how much fluid the person had and whether their hydration needs were being met.” from the report
Limited staff supervision
needs fixingStaff were not receiving supervision meetings as planned. Some staff had received only one supervision meeting in a year.
“Staff continued to not receive supervision meetings with their senior or the registered manager in a timely manner.” from the report
- 01How have you fixed the problems with medicine storage, fridge temperature records and unexplained gaps in medicine administration records?
- 02How do you now assess and manage risks involving high water temperatures, paraffin-based creams and insulin support?
- 03How are you making sure all staff have the required recruitment references before starting work?
- 04How often do staff now receive supervision, and how do you check that this improves their practice?
- 05Can you show how care plans and hydration records now contain enough detail for each person's needs?
This was an unannounced comprehensive inspection covering all five CQC questions, including the care provided and the home's premises. This explanation was written from the published report of 15 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 Albany House - Tisbury
4 rated inspections over 2 years: the service has held its Requires improvement rating throughout.
- December 2019Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 3 December 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about two hours of Wiltshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,340 a week. 82 can care for a couple. 12 years' experience on average.
“Linet became her carer and all changed, my daughter started eating, taking her medications and more important her happiness came back.”
“I cannot recommend Prisca highly enough, she is one in a million.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.