CQC report explained · a residential care home
What the CQC found at Allambie House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, but some care and medicines records were not always clear.
This was a planned inspection because of the home’s previous Requires Improvement rating. Two inspectors and an expert by experience visited on 11 February 2020. They spoke with people, relatives, staff and managers, and checked care plans, medicines records, recruitment files, training records and quality checks.
The home was supporting 22 people and could provide care for 30. Inspectors found enough staff, safe medicines practice overall, suitable training and good access to health professionals. People said staff were kind, respectful and caring. People had choices about their care, meals and activities, including support for religious and cultural needs.
Some records did not clearly show all care that had been provided. Some medicines records did not accurately show the amount of medicine available, and the manager said this would be addressed. Inspectors also found that feedback records did not clearly show what improvements had been made, although the provider could explain these.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home had improved from Requires Improvement at the previous inspection and was no longer in breach of Regulation 12.
Enough staff
Inspectors found enough staff to meet people’s needs and keep them safe. People and staff also said staffing levels were sufficient.
“There were enough staff on duty to keep people safe and meet their needs.” from the report
Kind and respectful care
People described staff as caring. Inspectors saw respectful interactions and support for privacy, dignity and independence.
“People told us that staff were kind and caring and treated them with dignity and respect.” from the report
Personalised support
Staff knew people well and supported their choices, communication needs, activities, relationships and end-of-life wishes.
“People were involved in decisions about their care and experienced personalised care.” from the report
Improvement since the last inspection
The home improved from Requires Improvement. The earlier breach about assessing risks had been resolved by this inspection.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Care records were not always clear
needs fixingSome care records did not clearly confirm what care had been provided. Inspectors said this had not caused a negative impact on people, but the manager addressed some records during the visit.
“Some records related to people's care were not sufficiently clear to confirm care provided, however this had not resulted in a negative impact on people.” from the report
Medicine records needed correcting
needs fixingSome medicine records did not accurately show how much medicine was available. This made effective checks more difficult, although medicines were otherwise managed, stored and given safely.
“People received their medicines as prescribed by suitably trained staff but some medicine records did not show accurately the amount of medicines available to enable effective audits to be completed.” from the report
Feedback records were incomplete
minorThe analysis of questionnaires did not clearly show what improvements had been made or planned. The provider and manager could explain improvements that had taken place.
“The analysis of questionnaire comments did not show what improvements were made or planned to demonstrate changes happened.” from the report
- 01How do you now check that care records clearly show all care provided?
- 02How do you check medicine stock records are accurate and that audits can be completed?
- 03What changes have you made since the inspection to record and act on questionnaire feedback?
- 04How do you make sure staff recruitment files contain signed contracts and start dates?
- 05How are people’s individual communication, cultural, religious and end-of-life wishes recorded and followed?
This was a planned inspection covering all five CQC questions, including the home and the care provided; it followed the previous Requires Improvement rating. This explanation was written from the published report of 28 February 2020 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, March 2019
Rated Requires Improvement; inspectors found kind and effective care, but concerns about staffing, safety risks, activities and management checks.
This was an unannounced, planned comprehensive inspection on 23 January 2019. Inspectors reviewed five care records and documents about medicines, incidents, complaints, audits and staff recruitment. They spoke with people, relatives, staff and visiting professionals.
The home was rated Good for Effective and Caring. People were treated kindly, staff understood their needs, people could access health professionals, and staff generally supported choice and consent. The environment had also been improved, including features intended to support people living with dementia.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Staffing levels had not been reassessed when people's needs increased, which sometimes caused delays. Risk records, medicines records and some care plans were not complete enough. Activities were limited, and checks had not found some of these problems.
The overall rating remained Requires Improvement, the same as at the previous inspection. The report says improvements had been made and one of the two previous breaches had been addressed, but Regulation 12 remained breached.
Kind and respectful staff
People and relatives were positive about the staff. Inspectors saw staff speak respectfully, protect privacy and respond with warmth and patience.
“People and their relatives all told us staff were caring.” from the report
Improved staff training
The home had addressed gaps in training identified at the previous inspection. Staff had completed training and were knowledgeable about people's needs.
“At our last inspection we had identified gaps in staff training. The provider told us this would addressed and we confirmed improvements had been made.” from the report
Safer moving and handling
People were moved using the equipment they had been assessed as needing. This was an improvement since the previous inspection.
“At this inspection people were moved safely using equipment they had been assessed as needing.” from the report
Improved environment
The home had been decorated and made more familiar. Changes included visual signs, themed corridors and a reminiscence area for people living with dementia.
“They had considered how the environment could be made homelier and how the environment could be improved to support people living with dementia.” from the report
Access to healthcare
People could see health professionals when needed, including GPs, opticians, chiropodists and physiotherapists.
“People told us they could see healthcare professionals when required.” from the report
Staffing and delays
seriousStaffing levels had not been changed when more people needed two staff members. People sometimes waited for personal care and staff said busy periods made it hard to meet needs.
“Staffing arrangements sometimes meant people received delayed care as the provider had not reassessed staffing levels when people's needs increased.” from the report
Falls and other safety risks
seriousSome falls assessments had not been reviewed after repeated falls. Inspectors also found equipment and environmental hazards that audits had missed, although action was taken during the visit.
“One person had fallen five times during November and December 2018 which meant risk management had not been fully effective.” from the report
Medicine recording errors
seriousRecords did not always show clearly where skin patches had been applied. Creams were also given to the wrong people or without a prescription.
“A person was administered a cream which had not been prescribed to them, and another person, had a cream administered which was meant for another person.” from the report
Limited activities
needs fixingPeople had little stimulation for several months after the activity worker was unavailable. A care worker had started an activity role on the inspection day.
“People had received little stimulation or engagement because the care staff were unable to spare the time to provide these.” from the report
Incomplete care records
needs fixingOne person had no completed assessment or care plan after admission. Some end-of-life plans also lacked enough detail about people's wishes.
“One person did not have any assessment or care plan information that had been completed following their admission.” from the report
Quality checks missed problems
needs fixingAudits had not identified issues with staffing, safety hazards, medicines, care records or out-of-date legal authorisations. The provider was still improving its monitoring systems.
“Audits and checks had not identified issues we found during our inspection visit.” from the report
- 01How many staff are now available during busy morning periods, and how do you reassess staffing when people's needs increase?
- 02What changes have been made to falls assessments and checks of walking frames, furniture and other environmental hazards?
- 03How do you now record and check the application of creams and skin patches?
- 04How are activities planned for people who are less mobile or spend much of their time in bed?
- 05Have every person's care plan and end-of-life wishes been reviewed and updated since this inspection?
This was an unannounced comprehensive inspection covering the home, the care provided and all five CQC questions. This explanation was written from the published report of 9 March 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 Allambie House
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- December 2016Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- June 2012
Registered with the Care Quality Commission on 6 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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Most charge £950 to £1,260 a week. 80 can care for a couple. 11 years' experience on average.
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