CQC report explained · a nursing home
What the CQC found at Allerton Park Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Rated Inadequate and placed in special measures; inspectors found serious risks in care, medicines, premises and leadership.
Inspectors visited without notice on 11 and 13 July 2023. They spoke with people, a relative and staff, and checked care records, medicines, recruitment files and management records.
They found people were at risk because safety checks and repositioning records were often missing or incomplete. Medicines were not always given or recorded safely. The home was run down, sometimes unclean, and had hazards including unsecured decorating materials and unsafe fire doors.
Staffing levels and recruitment were suitable, and accidents and incidents were reviewed. However, the systems used to check the quality of care had not identified or fixed the wider problems. The overall rating fell from Good at the previous inspection to Inadequate.
Staffing
Inspectors found enough staff and said they were deployed safely across the home. Recruitment checks were also completed safely.
“We found deployment within the service was safe, with a good staff presence in all communal areas.” from the report
Incident reviews
Accidents and incidents were recorded and reviewed for patterns and repeated risks.
“Accidents and incidents were well recorded and reviewed regularly by the registered manager who analysed these for trends, patterns, and commonalities.” from the report
Infection arrangements
Inspectors were assured about several arrangements for preventing and managing infections, including admissions and responding to infection risks.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
External involvement
People's records showed involvement from health professionals, including tissue viability nurses, speech and language therapists and GPs.
“People's records showed involvement from Tissue Viability Nurses, Speech and Language Therapists and GP's.” from the report
People at risk
seriousRequired safety checks and repositioning were often not recorded. Inspectors could not be assured that people consistently received care intended to prevent harm.
“We found large gaps in this documentation, with 1 person on some days only having 1 or 2 repositioning entries documented in a 24-hour period.” from the report
Unsafe medicines
seriousSome doses were missed, medicines were not always given at the correct time, and records did not always show that medicines had been given as prescribed.
“Some people missed doses of their medicines, including a thickening powder which is a high-risk medicine, as it is added to fluids to prevent choking and pain relief.” from the report
Unsafe premises
seriousThe home was tired and sometimes unclean. Inspectors found unsecured hazardous materials, uncovered light bulbs, damaged fire doors and other maintenance risks.
“Hazardous materials such as paints, flammable liquids, and tools were stored in these rooms, but they were not locked.” from the report
Consent and restrictions
seriousSome restrictions were used without the required mental capacity assessments or best interest decisions. People, relatives or advocates were not always involved.
“Mental capacity assessments and best interest decisions were not always in place for people who had restrictions.” from the report
Weak oversight
seriousThe home's audits and checks did not identify or resolve the problems found by inspectors. This meant risks continued without effective management.
“Provider oversight and monitoring was ineffective in identifying and managing organisational risks.” from the report
Poor infection practice
needs fixingStaff did not always change protective equipment between interactions, and parts of the home appeared unclean and smelled unpleasant.
“We observed staff failed to change PPE between interactions with people and when providing food and drink.” from the report
- 01What has been done to make medicines safe, including the electronic records, missed doses and thickening powders?
- 02Which repairs and cleaning issues identified by inspectors have been completed, including the fire doors, uncovered lights and unsecured hazardous materials?
- 03How are required safety checks, repositioning and food records now checked for accuracy every day?
- 04How are mental capacity assessments and best interest decisions being completed and reviewed, with relatives or advocates involved?
- 05What independent checks are now in place to make sure the provider's audits identify and fix risks?
This was a focused inspection of Safe and Well-led; ratings for Effective, Caring and Responsive were not inspected and were carried over from the previous inspection. This explanation was written from the published report of 16 September 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, January 2021
Inspected but not rated; inspectors found safe staffing and building checks, but gaps in visitor infection checks and food and fluid records.
This was an unannounced targeted inspection on 17 December 2020. Inspectors looked into concerns about staffing, risks and the safety of the building. They observed care, toured the building, spoke with people and staff, and checked care records, rotas, incident reports and safety records.
Inspectors found enough staff, with call bells answered quickly. They found that building safety checks were up to date, fire systems were working, and repairs were under way for roof and pest problems. The home was clean and staff used protective equipment appropriately.
There were some gaps in food and fluid monitoring records. The home also did not have a clear process for checking visitors for COVID-19 symptoms, contacts or temperature when they arrived. The provider said it would act immediately.
The service was inspected but not rated at this visit. Its previous overall rating of Good, published in November 2019, remained unchanged. This inspection did not assess every part of the service.
Enough staff
Inspectors found enough staff to meet people's needs safely. Staff were available in communal areas and call bells were answered quickly.
“There were enough staff available to meet people's needs safely.” from the report
Building safety checks
Records showed that safety and maintenance checks were being completed and were up to date. Fire systems and window restrictors were also found to be in place.
“Safety and maintenance checks of the building and equipment were in place and up to date.” from the report
Incident learning
Accident and incident records were complete and reviewed. They showed monthly analysis and evidence that lessons had been learned.
“These were well completed and showed evidence of management review, monthly analysis and lessons learned.” from the report
Infection controls
Inspectors were assured about the use of protective equipment, testing, hygiene, social distancing and the infection control policy.
“We were assured the provider was using PPE effectively and safely.” from the report
Food and fluid records
needs fixingInspectors found some gaps in records showing what two people had eaten and drunk. The provider said it would take action.
“However, we found some gaps in food and fluid monitoring records.” from the report
Visitor checks
needs fixingThere was no clear process to check visitors for COVID-19 symptoms, contacts or temperature before entry. The provider said it would put checks in place immediately.
“We were not fully assured the provider was preventing visitors from catching and spreading infections as there was no clear process for visitors.” from the report
Repairs and pest problem
minorThe roof had recently been repaired, but some plaster was damaged and a pest situation was still being managed. One shower room was out of use and repairs were under way.
“Documentary evidence showed the provider was working with an external pest control company to manage a current pest situation.” from the report
Manager registration
needs fixingThe manager had not registered with the CQC after the previous registered manager left. The report says the manager and provider were legally responsible for the service.
“The service had a manager however they had not registered with the Care Quality Commission.” from the report
- 01How were the gaps in food and fluid monitoring records corrected, and how are these records checked now?
- 02What visitor checks are now carried out for symptoms, recent contacts and temperature before entry?
- 03What is the current position with the pest problem and the repairs to damaged plaster?
- 04When was the out-of-use shower room repaired, and how many bathrooms and showers can people use now?
- 05What is the progress towards registering the current manager with the CQC?
This was a targeted inspection of specific parts of Safe and infection prevention and control; the previous overall Good rating remained in place and the other questions were not assessed. This explanation was written from the published report of 20 January 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 Allerton Park Care Centre
5 rated inspections over 8 years: the service has held its Inadequate rating throughout.
- September 2023Inadequatecurrent ratingSafe: InadequateEffective: GoodCaring: GoodResponsive: GoodWell-led: Inadequate
- January 2021Inspected but not ratedSafe: Inspected but not rated
- November 2019Goodstayed GoodSafe: GoodWell-led: Good
- March 2017Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- September 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 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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