CQC report explained · a nursing home
What the CQC found at Alma Court Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors looked at risk management, the response to a scalding concern and infection prevention. They found risk assessments and control measures in place, but did not assess the whole Safe question.
- Effective?
- Requires improvement
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Requires improvement
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, November 2021
Rated Requires Improvement; this targeted inspection found no evidence of harm from the scalding concern, but did not reassess the whole service.
The inspection took place on 8 November 2021 and was unannounced. One inspector spoke with people living in the home, a relative and staff. They reviewed four people's risk assessments and other information.
The inspection followed a reported incident and focused on whether the home was managing risks, including the risk of scalding. Inspectors found risk assessments and control measures in place. Staff understood people's risks and how to reduce harm. They found no evidence that people were currently at risk from the concern that prompted the inspection.
The overall rating stayed Requires Improvement, the same as at the previous inspection in April 2019. This was a targeted inspection, so it did not assess all areas of the service or change the Safe rating.
Risk assessments
People had assessments covering risks such as falls, skin damage, mobility, diet and nutrition, as well as scalds and burns. Staff could explain how they used these assessments.
“People had assessments of risk in place to support and guide staff members on how to safely support them.” from the report
Learning from incidents
After an incident involving hot liquid, the provider reviewed its risk assessment system and introduced further assessments and control measures.
“They introduced further specific assessments and control measures to minimise the potential for harm.” from the report
Infection precautions
Inspectors were assured about visiting arrangements, shielding, social distancing, admissions, personal protective equipment, testing and managing outbreaks.
“We were assured the provider was using PPE effectively and safely.” from the report
Worn surfaces
minorSome doors and furniture were worn, which made them harder to clean effectively. Inspectors saw that furniture replacement and an ongoing refit were under way.
“some doors and furniture was showing signs of wear which prevented effective cleaning of these items.” from the report
- 01What further changes were made after the incident involving hot liquid, and how do you check that the new scalding controls are working?
- 02Which doors and items of furniture have now been replaced as part of the refit?
- 03How do you make sure staff read and follow updated risk assessments when a person's needs change?
- 04When will the next comprehensive inspection assess all five key questions?
- 05How do you check that infection control remains effective while doors and furniture are being replaced?
This was a targeted inspection of specific risk management and infection prevention concerns under Safe; the overall Requires Improvement rating and other areas were not reassessed. This explanation was written from the published report of 19 November 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.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found kind and respectful care, but safety, records, staffing and management were not consistently good.
Inspectors visited on 19 and 20 March 2019. The first visit was unannounced and the second was announced. They spoke with people, relatives, staff and visiting professionals. They observed care and checked care records, medicine records, staff recruitment files and management checks.
Some improvements had been made since the previous inspection in November 2017, including safer moving and handling. However, people were left unsupervised for a period in one unit. Medicine records were not always accurate, care plans did not always reflect risks, and many staff were not receiving regular supervision.
People were generally treated with kindness, dignity and respect. The home offered activities, dealt with complaints promptly and had improved some dementia-friendly areas. However, staff were not always proactive enough when supporting people to eat and drink, and some end of life care planning was incomplete.
The overall rating of Requires Improvement means the home was not consistently safe, effective or well-led. Caring and Responsive were rated Good. No enforcement action was required, but the CQC said it would continue monitoring the home.
Kind and respectful care
Inspectors saw staff supporting people patiently and reassuring people who were distressed. People were offered choices and their privacy and independence were respected.
“We observed staff supporting people with calmness and patience.” from the report
Safer moving and handling
The home had completed the action from the previous inspection about moving people safely. Inspectors saw staff using equipment and following care plans safely.
“At the last inspection, we asked the provider to ensure there were improvements to moving and handling processes to ensure people were moved safely. We found that these actions had been completed.” from the report
Safeguarding and incident response
Staff knew how to recognise and report abuse. Incidents were investigated and actions were taken to reduce the risk of them happening again.
“The provider had effective safeguarding systems in place.” from the report
Complaints were investigated
People and relatives knew how to complain. The report says complaints were investigated promptly and the outcomes were communicated.
“All had been responded to promptly and investigated with any outcomes being clearly communicated.” from the report
Clean environment
Inspectors found the home clean and saw staff using protective equipment. Kitchen hygiene had improved and the home had a five-star food hygiene rating.
“The home was clean and staff used personal protective equipment to reduce the risk of infection.” from the report
Staffing and supervision
seriousStaffing views were mixed. Inspectors saw one unit where people were left unsupervised because it was short staffed, and many staff were not receiving regular supervision.
“We are always short staffed and things don't always get done to the highest standard as we are rushed.” from the report
Medicine records
needs fixingPeople received medicines at the right time, but records did not always show whether as-needed medicines had helped. The medicine stock did not always match the records.
“However, the stock of medication stored in the home did not always match records.” from the report
Support with eating and drinking
needs fixingStaff were not always proactive in encouraging people to eat and drink in some units. Some relatives felt they had to visit to make sure their family member was fed properly.
“Staff were available to support people but in some units, were not always proactive in supporting and encouraging people to eat and drink.” from the report
Care records
needs fixingSome assessed risks were not included in care plans. Inspectors also found that some records did not show whether people and relatives had been asked about end of life wishes.
“Some risks that had been assessed were not reflected in people's care plans.” from the report
Communication and laundry
minorSome relatives said communication about issues and incidents was poor. Relatives also reported clothes going missing, and the planned change to the laundry system had not yet happened.
“Relatives were generally unhappy with the laundry service in the home and complained that people's clothes went missing on a regular basis.” from the report
- 01How do you make sure each unit has enough staff at all times, including when people need one-to-one supervision?
- 02What has changed in the electronic medicines system, and how do you check that medicine stocks and records match?
- 03How are staff now supported through regular supervision and appraisals?
- 04How do you record and review each person's end of life wishes with them and their relatives?
- 05What changes have been made to stop clothes going missing and to improve communication with relatives?
This was a planned inspection covering all five key questions, the premises and the care provided, and it followed up concerns from the previous inspection. This explanation was written from the published report of 25 April 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 Alma Court Care Home
5 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- November 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementstayed Requires improvement
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- September 2016Goodstayed GoodSafe: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 5 May 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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