CQC report explained · a residential care home
What the CQC found at Alston Court Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staffing levels, risk assessments, recruitment checks, medicines and infection control were found to be satisfactory.
- Effective?
- Good
- People received care based on assessed needs, with trained staff, suitable food and drink, and support to use healthcare services. Inspectors recommended better knowledge of Deprivation of Liberty Safeguards and the Mental Capacity Act.
- Caring?
- Good
- Staff were kind, friendly and respectful. People were treated as individuals, involved in decisions and supported to maintain independence and dignity.
- Responsive?
- Good
- Care plans were personalised and reviewed with people's involvement. People were supported with communication, relationships, activities, community access and future end of life wishes.
- Well-led?
- Good
- The management team and providers were closely involved and staff worked well together. However, formal recorded audits and improvement plans were not consistently in place.
What inspectors found, February 2020
Rated Good; inspectors found safe, kind and personalised care, but legal safeguards and quality checks needed improvement.
This was a planned inspection on 16 and 17 January 2020. One inspector spoke with people, staff, the manager, families and a healthcare professional. They also observed care and checked all 11 care records, training records, policies, complaints, audits and meeting notes.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training, good healthcare support and care that respected people's choices and independence.
There were two areas for improvement. One Deprivation of Liberty Safeguards authorisation had expired and a new application had not been made, although this was addressed during the inspection. The provider also needed a formal recorded system for quality checks and improvement actions.
The overall rating stayed Good, the same as at the previous inspection published on 20 July 2017.
Kind and personal care
Staff knew people's preferences and supported them as individuals. Inspectors observed positive interactions and found people looked relaxed and content.
“We observed positive interactions between staff and people during our inspection and it was evident the staff team knew people's preferences and how they liked to be looked after.” from the report
Safe staffing and medicines
There were enough staff to meet people's needs and support planned activities. Medicines were administered by trained and competent staff and records were checked during medicine rounds.
“The staffing numbers per shift were enough to ensure each person's care and support needs were met and planned activities, away from the home could be managed.” from the report
Strong knowledge of people's needs
Care plans were person-centred and staff could explain what made people happy, how to respond to anxiety and what support each person needed.
“The registered manager and the care team all demonstrated how knowledgeable they were about the people they looked after.” from the report
Expired legal authorisation
seriousOne Deprivation of Liberty Safeguards authorisation had expired and a new application had not been made. The issue was addressed during the inspection, but inspectors recommended improving the home's knowledge of the relevant legal requirements.
“The one DoLS in place however had expired and a new application had not been made.” from the report
Quality checks not formally recorded
needs fixingThe home carried out some informal checks, but did not have formal audits for infection control, medicines and health and safety. Inspectors asked for a recorded system linked to action and improvement plans.
“Whilst there were no issues apparent at inspection there were no formal audits completed in respect of infection control, written checks regarding medicine audits and health & safety.” from the report
Damaged carpet
minorOne area of carpet was damaged, although it had been securely taped down. The report says carpets were due to be replaced as part of ongoing refurbishment.
“It was noted that one area of the carpet on the first floor was damaged but had been securely taped down.” from the report
- 01How do you now check that every Deprivation of Liberty Safeguards authorisation is current?
- 02What formal quality audits are now completed for infection control, medicines and health and safety?
- 03When was the damaged first-floor carpet replaced?
- 04How will you involve my relative in creating and reviewing their person-centred care plan?
- 05How do you support people to keep their independence while managing risks when they go out?
This was a planned inspection covering all five CQC questions, the premises and the care provided, and all five ratings remained Good. 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, July 2017
Rated Good; inspectors found safe, kind and personalised care, with some records and quality checks needing improvement.
This was an unannounced inspection on 22 and 23 June 2017. Inspectors spoke with people living at the home, staff and the manager. They observed care and checked care plans, medicines records, staff files and training records.
People said they felt safe and happy. Inspectors found enough trained staff, safe medicine arrangements, personalised care plans, support with health and nutrition, and activities in the home and local community. Staff were described as kind, respectful and responsive to people's choices.
The overall rating was Good. All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors also found some paperwork and monitoring that needed strengthening, including risk assessments, medicines records, complaints records and formal quality audits.
People felt safe
Everyone inspectors spoke with said they felt safe. Staff understood how to recognise abuse and what action to take.
“I feel safe and secure here and the staff look after me well".” from the report
Kind and respectful staff
Inspectors observed compassionate care. Staff respected people's dignity, privacy, choices and need for independence.
“People were cared for by staff who treated them with kindness and respect.” from the report
Personalised care
Care plans were written with people and reflected how they wanted their care delivered. Staff knew people's communication methods and individual needs.
“People had care plans in place which were personalised and reflected their current needs.” from the report
Activities and community life
People could choose from activities such as cooking, pottery and drawing. They also used local facilities, travelled by bus where possible and went on holidays.
“People were provided with a range of opportunities to remain cognitively, physically and socially stimulated.” from the report
A missing choking risk assessment
needs fixingA person had been identified as being at risk of choking, but a separate choking risk assessment had not been completed. Staff were following care guidance and keeping the person safe during the inspection.
“However, a choking risk assessment had not been completed.” from the report
Some medicines records were incomplete
needs fixingHandwritten medicines records were not signed by two staff as guidance required. The manager acted during the inspection to address this.
“Hand written MARs were not signed by two staff in line with guidance to ensure they were accurate.” from the report
Quality checks were not formal enough
needs fixingThere were no formal audits of medicines administration, infection control or care plans. The manager was reviewing how to introduce more formal checks as people's needs changed.
“We discussed how they registered manager ensured the quality of the service as there were no audits of the medicine administration, infection control and care plans in place.” from the report
Concerns were not recorded
minorPeople's concerns were dealt with quickly, but the home did not record them. The manager planned to record concerns so patterns could be identified.
“People's concerns were acknowledged quickly and speedily resolved. These were not recorded.” from the report
- 01What action was taken to complete choking risk assessments for people whose needs changed?
- 02How are handwritten medicines records checked and signed now?
- 03What formal audits are now carried out for medicines, infection control and care plans?
- 04How are concerns and complaints recorded and reviewed for repeated patterns?
- 05How are you planning for people's changing needs, including dementia, falls, skin care and end-of-life care?
This was an unannounced inspection of the overall service covering all five key questions, and it was the first inspection since the change of ownership on 5 January 2016. This explanation was written from the published report of 20 July 2017 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 Alston Court Residential Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Alston Court Residential Home →
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Alston Court Residential Home →
- January 2016
Registered with the Care Quality Commission on 5 January 2016.
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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