CQC report explained · a residential care home
What the CQC found at Allerton Court
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were supported by enough staff, risks were assessed and safeguarding arrangements were understood. However, some medicines were not stored or recorded safely, including problems with fridge checks and unlocked thickener.
- Effective?
- Good
- Staff had received induction and training, and people received suitable food, drinks and healthcare support. Staff understood people's needs and supported choice and consent.
- Caring?
- Good
- People said staff were caring and respectful. Inspectors saw staff protecting privacy and dignity, although some private medical information was displayed in communal areas.
- Responsive?
- Good
- Care plans reflected people's preferences and were reviewed. Activities had improved, complaints were handled appropriately, and people could maintain relationships and access community activities.
- Well-led?
- Requires improvement
- The manager and staff had made improvements and people felt able to raise concerns. However, audits had not identified several medicines problems, and some competency checks were not signed by the senior person completing them.
What inspectors found, February 2020
Allerton Court was rated Requires Improvement; care had improved, but medicines safety and management checks were still not reliable.
Inspectors made an unannounced visit on 09 January 2020. They spoke with people living at the home, relatives, staff and visiting professionals. They observed care and checked care records, medicines records, staff recruitment files, complaints, accidents and quality checks.
People were generally supported by enough staff and received kind, respectful care. Staff training, activities, care planning, complaints handling and partnership with health professionals had improved since the previous inspection.
There were still problems with medicines. Some medicines were not stored correctly, fridge temperatures were not checked properly, thickener was unlocked, and some medicine information and records were incomplete. The home’s audits had not found these problems.
The overall rating was Requires Improvement. Safe and Well-led were also Requires Improvement. Effective, Caring and Responsive were rated Good.
Staff availability
Inspectors found enough staff were available and people's needs were attended to in a timely way. Recruitment checks had also been completed safely.
“We found all pre-employment checks had been carried out including the obtaining of references and Disclosure and Barring Service (DBS) checks.” from the report
Kind and respectful care
People and relatives described staff as caring. Inspectors saw staff speak respectfully, knock before entering bedrooms and support people's independence.
“We saw staff knock on people's bedroom doors before entering and speaking to people in a respectful manner.” from the report
Improved activities
The home had responded to earlier concerns about boredom. People could take part in crafts, trips, games, discussions and weekly exercise sessions.
“This included arts and crafts, trips into the community, bingo sessions and one to one and group discussions on enjoyable topics.” from the report
Improved staff training
Staff received induction and training, including the care certificate. Inspectors found staff were more knowledgeable about people's needs than at the previous inspection.
“We saw that staff had completed the care certificate.” from the report
Medicine storage and records
seriousSome time-specific medicines did not have an exact administration time recorded. Medicine care plans lacked detail, allergies were not always recorded, and some fridges and thickener were not stored safely.
“We found medicines were not always stored correctly and the use of some medicines were not always documented as required.” from the report
Medicine fridge checks
seriousStaff recorded the same fridge temperature repeatedly without resetting the thermometer. They therefore could not always know whether medicines were kept at the right temperature.
“This meant that staff did not always know if medicines were kept at the optimum temperature to maintain its effectiveness.” from the report
Quality checks missed problems
needs fixingThe home had audits, but these did not identify all the medicines issues found during the inspection. This limited assurance that the home was being managed safely.
“Although improvements had been made, audits completed had not identified all of the issues raised within this inspection.” from the report
- 01How have you fixed the storage of medicines, including locked fridges and safe storage of thickener?
- 02How do you now record exact times for time-specific medicines and allergies or side effects in care plans?
- 03How often are medicine fridge temperatures checked, and how do staff reset the thermometers?
- 04How are medicine competency checks signed off by the senior staff member completing them?
- 05How do your audits now make sure medicine problems are found and corrected promptly?
This was an unannounced planned inspection based on the previous rating and covered all five key questions, including the premises and care provided. This explanation was written from the published report of 19 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, January 2019
Allerton Court is rated Requires Improvement; inspectors found unsafe medicines practice, gaps in training and weak quality checks, although people also experienced kind care.
The inspection was unannounced and took place on 20 November 2018. Inspectors spoke with people, relatives, staff and the manager. They observed care and checked care records, medicines records, recruitment files and management audits.
The home was not consistently safe, effective, caring, responsive or well-led. Medicines were sometimes given, stored or recorded incorrectly. Some staff training was out of date, people were sometimes left without attention, and many people said they were bored because there were too few activities.
The overall rating was Requires Improvement. All five areas received the same rating. This was a decline from the previous inspection in June 2016, when all five areas were rated Good. The report found a breach of the rules about good governance.
Risk planning
Risk assessments covered areas such as falls, moving people, nutrition and pressure areas. Staff were seen following these assessments.
“We found that risk assessments were in place.” from the report
Kind and respectful care
When staff spent time with people, they were described as friendly and caring. Inspectors saw that privacy, dignity and independence were supported.
“We saw that people's privacy and dignity was respected in the way that staff spoke to people and acted towards them.” from the report
Care planning
Care plans gave detailed information about people's needs, preferences and how support should be provided. Reviews were completed in a timely way.
“We found that people's care plans were detailed and they gave information on needs and requirements and how people wanted their care needs met.” from the report
Food and healthcare support
People liked the food and received help to eat when needed. Staff supported people's healthcare needs and access to healthcare professionals.
“People told us they enjoyed the food.” from the report
Medicines were not always safe
seriousInspectors found an out-of-date medicine, missed doses, incorrect tablet doses and incomplete records. This created a risk of harm, although the report says no harm occurred on the occasions described.
“People did not consistently receive their medicines as prescribed.” from the report
Training gaps
seriousSome mandatory training, including safeguarding and medicines training, was out of date. One staff member involved in a recent medicines error had not had medicines training since 2014.
“The training matrix confirmed that for some staff mandatory training was up to four years out of date, this included safeguarding and medicines training.” from the report
People were sometimes left without attention
needs fixingInspectors saw long periods with no interaction between people and staff. Some people said staff were too busy to help when needed.
“We saw some examples of long periods of time, sometimes over an hour where there were no interactions between people and staff.” from the report
Too few activities
needs fixingPeople in different areas of the home said there was not enough to do and that they felt bored. Inspectors saw people watching television for much of the day without staff starting an activity.
“People said they lacked interesting things to do to pass their time.” from the report
Quality checks missed problems
seriousManagement audits did not identify medicines, training and falls-monitoring concerns. This meant the home did not have a reliable overview of risks and needed improvements.
“Audits had not identified issues around the unsafe administration of medicines and the lack of adequate recording of medicines given.” from the report
Mental capacity safeguards
needs fixingOne approved deprivation of liberty had not been reported to CQC until the inspection. Some staff were unsure about the relevant safeguards because training had been cancelled or was not remembered.
“However, CQC had not been notified of this and it was submitted retrospectively on the day of the inspection.” from the report
- 01What checks now make sure every medicine is in date, given as prescribed and recorded correctly?
- 02Which staff currently have up-to-date medicines, safeguarding and Mental Capacity Act training?
- 03How do you make sure people are not left without attention for long periods?
- 04What regular activities are now available for people who previously said they were bored?
- 05What changes have been made to quality audits, including medicines and falls monitoring, since this inspection?
This was an unannounced inspection covering all five key questions, and the report compares the findings with the previous inspection in June 2016. This explanation was written from the published report of 23 January 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 Allerton Court
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- February 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 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.
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