CQC report explained · a nursing home
What the CQC found at Allambie Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2022
Requires Improvement; inspectors found safe staffing and kind care, but weaknesses in nursing risk management, visiting and oversight.
This was an unannounced focused inspection on 25 and 26 January 2022. Inspectors reviewed Safe and Well-led, following concerns about staffing and nursing care. They spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The home had enough staff to keep people safe, medicines were administered as prescribed, and staff were described as kind. However, risks linked to wound care, catheter care, fluid monitoring and complex nursing needs were not always properly monitored. Some staff also needed more training.
During a COVID-19 outbreak, most visits were stopped for four weeks without proper consultation or support for essential caregivers. The home was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement. The other three key questions were not assessed in this inspection, so their previous ratings were used for the overall rating.
Enough staff
Inspectors found there were enough staff to keep people safe. Recruitment checks included enhanced DBS checks and additional checks for nurses.
“There were enough staff to keep people safe.” from the report
Medicines
Medicines were stored and given safely, and people received them as prescribed. Staff were trained and checked as competent before administering medicines.
“Medicines were stored and administered safely, and people received their medicines as prescribed.” from the report
Kind staff
Staff were described as kind and compassionate. People and relatives said they felt safe and trusted the staff.
“Staff were recruited safely and were kind and compassionate towards the people living at the home.” from the report
Response to feedback
Managers responded to inspectors' feedback and made some immediate changes, including updating night risk assessments and reopening visiting.
“The registered and general manager were responsive to our feedback and immediately started to take action on some of our findings.” from the report
Nursing risks
seriousWounds were not always measured, described or photographed clearly. Fluid monitoring and catheter-related risks were also not consistently recorded or followed up.
“Action had not always been taken to mitigate and monitor risks related to catheter care and wound management.” from the report
Weak oversight
seriousManagement systems had not driven lasting improvement, and similar problems had been found at earlier inspections. Inspectors also found inaccurate night risk assessments and no registered general nurse employed during the day.
“Effective governance had not been robust enough to drive forward the required improvements.” from the report
Visiting restrictions
needs fixingDuring a COVID-19 outbreak, most visits were stopped for four weeks without consulting people or relatives. Essential caregiver visits were not being facilitated at the time.
“With the exception visits to people at the end of their life, the provider had stopped all other visitors for a period of four weeks without consulting with relatives or people living at the home.” from the report
Infection control
needs fixingInspectors were not asked to wash or sanitise their hands or answer COVID-19 screening questions. A manager was also reminded to wear a face mask consistently.
“Although we were not asked to wash or sanitise our hands or asked any COVID-19 screening questions” from the report
Training and communication
needs fixingSome staff needed further training for high-quality care, and some had not received recent safeguarding training. Relatives also reported delays when calling the home.
“Further training was required to ensure some staff had the skills and competencies to provide high quality care.” from the report
- 01Who is responsible for monitoring complex nursing needs, including wounds and catheter care, during the day and at night?
- 02How are wounds now measured, described and photographed, and how is deterioration identified quickly?
- 03How are fluid intake records checked each day when monitoring is required?
- 04What visiting arrangements are currently available, including the essential caregiver role?
- 05What training have staff completed since the inspection, particularly for nursing tasks, safeguarding and recognising deterioration?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were carried over from the last inspection when calculating the overall rating. This explanation was written from the published report of 6 April 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, May 2021
Rated Requires Improvement; care was judged safe, but the home needed stronger oversight of fire, legionella, medicines and staffing risks.
This was a focused inspection on Safe and Well-led. Inspectors visited the home, observed care, reviewed five care plans and 22 medicine records, checked audits and records, and spoke with staff, managers and relatives.
Safe was rated Good, improving from Requires Improvement at the previous inspection. Inspectors found enough staff, safer care planning, good infection control and suitable safeguarding arrangements. They also found some gaps, including incomplete checks on skin patches and unresolved fire and legionella risks.
Well-led remained Requires Improvement. Audits usually identified problems, but medicine checks were not reliable enough. Staff training had been affected by the pandemic, and the provider was caring for three people outside its registered service user bands.
The overall rating stayed Requires Improvement. The CQC said it would continue to monitor the service.
Staffing and safeguarding
Inspectors found enough staff to meet people's agreed care needs. Staff understood how to report abuse or poor practice, and recruitment checks were completed.
“There were enough staff on duty to keep people safe.” from the report
Improved health risk records
Records showed better monitoring of food and fluid intake. Staff also responded to risks such as sore skin and changes in people's health needs.
“Improvements had been made to manage the risks of people not drinking enough to maintain their health.” from the report
Infection control
The home had improved kitchen cleanliness and provided individually allocated hoist slings. Inspectors found PPE, visiting controls and COVID-19 measures were being used.
“Premises were clean and housekeeping practices minimised infection risks.” from the report
Approachable managers
Staff and relatives described the managers as approachable. Staff said they could raise concerns and make suggestions, and gave examples of changes being made.
“Staff felt able to share concerns and make suggestions knowing they would be listened to.” from the report
Fire evacuation planning
seriousThe provider had not assessed whether night staffing was enough to evacuate people safely to a place of safety. Fire extinguishers had also missed their service date, although this work was completed after the inspection.
“The provider had not assessed the minimum staffing levels to safely carry out an evacuation of the premises or zone to a place of safety within the time period given by the fire service.” from the report
Legionella controls
needs fixingStaff were running taps and showers, but there was no written guidance about how long to run them and records did not show which outlets had been checked. The risk assessment also did not identify older people as a vulnerable group.
“Records made by staff did not record which water outlets had been run.” from the report
Medicine monitoring
needs fixingMedicine administration records were generally accurate, but staff did not record daily checks that some skin patches remained in place. The available medicine audit was also not recent enough to give reliable oversight.
“However, there was no record of a daily check made to ensure transdermal (skin) patches remained in place.” from the report
Staff training
needs fixingTraining had been affected by the COVID-19 pandemic. Staff said some new starters had not received training from someone qualified to provide it.
“Staff told us they felt improvements in training were needed.” from the report
Registered service user bands
needs fixingThree people living at the home were in their 50s, although the registered service user bands covered people with dementia and older people aged 65 and over.
“During our inspection, we found the provider was operating outside of their Service User Bands.” from the report
- 01Have you now assessed the minimum night staffing needed to evacuate everyone safely, and have you tested this through a simulated drill?
- 02How are you recording checks on taps and shower heads, and what written guidance do staff now follow to reduce legionella risks?
- 03How often are medicine audits completed now, and how do you record daily checks that transdermal patches remain in place?
- 04What training have new and existing staff completed since the inspection, especially training delivered by qualified trainers?
- 05Has the provider updated its Statement of Purpose and registered service user bands to include people in their 50s?
This was a focused inspection of Safe and Well-led only; ratings for the other key questions came from previous comprehensive inspections and were used to calculate the overall rating. This explanation was written from the published report of 26 May 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 Allambie Court
7 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- April 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2017Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 13 April 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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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 £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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