CQC report explained · a residential care home
What the CQC found at Amadeus
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm through safeguarding systems, risk assessments and accident monitoring. Staff were safely recruited, medicines were managed safely and infection control arrangements were in place.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Good
- Management and quality checks had improved since the previous inspection. Records contained more detail, audits were in place and managers used feedback and partnership working to improve care.
What inspectors found, December 2022
Amadeus rated Good; inspectors found safe care and stronger management systems, but this was a focused inspection.
Inspectors visited on 9 and 14 November 2022 without giving notice. They spoke with people, relatives, staff and health professionals. They observed care and a meal, and checked care files, staff records, medicines records and management checks.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found suitable safeguarding, risk management, staffing, recruitment, medicines and infection control arrangements.
This inspection followed a Requires Improvement rating in November 2020. The provider had made the improvements required after a breach about quality monitoring and was no longer in breach. The other three areas were not inspected during this visit, so their previous ratings were used for the overall rating.
Safe staffing
Inspectors found enough staff with suitable training and checks. Staff deployment gave them enough time to support people safely.
“The provider ensured there were enough staff, with the right training and skills, to meet people's needs.” from the report
Medicines management
Staff had medicines training and competence checks. Support plans, risk assessments and records for creams were in place.
“Staff managed people's medicines safely; they completed appropriate training and had their competence assessed to ensure they administered medicines safely.” from the report
Improved oversight
The provider improved records and introduced audits covering safeguarding, medicines, accidents and incidents. Inspectors said improvements were acted on promptly.
“Action had been taken following the last inspection to improve records relating to areas such as safeguarding, auditing, medicines and accidents and incidents.” from the report
Open communication
Relatives said managers kept in regular contact. People felt able to raise concerns and expected to be listened to.
“People felt comfortable raising concerns with the manager and were confident they would be listened to.” from the report
Working with professionals
The home worked with health and social care organisations to meet people's needs and obtain advice and training.
“There was evidence of joined-up work between the provider and other professionals to meet the needs of people using the service.” from the report
Manager registration pending
minorThere was no registered manager in post at the time of the inspection. A new manager had applied to register, but CQC was still assessing the application.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01Has the manager's application to register now been decided?
- 02How often are medicines audits completed, and how are any problems followed up?
- 03How does the home check that staffing levels and staff training continue to meet each resident's needs?
- 04What lessons have been identified from recent accidents, incidents or near misses?
- 05What were the ratings for Effective, Caring and Responsive at the previous inspection?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 6 December 2022 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, November 2020
Amadeus was rated Requires Improvement because care was safe and kind, but records, audits and management oversight were not reliable enough.
Inspectors visited on 2, 15, 16 and 18 September 2020. They spoke with people, relatives and staff, observed care, and checked care, medicines, staffing and management records. They also reviewed infection control arrangements during the coronavirus pandemic.
The home was rated Good for Safe and Caring. People said they felt safe and were treated with dignity and respect. Staffing, medicines, safeguarding and infection control were generally managed safely.
The home was rated Requires Improvement for Well-led. Records about safeguarding, accidents and incidents were disorganised, and learning and actions were not always recorded. Several audits and staff supervisions were overdue.
The overall rating fell from Good at the previous inspection in 2017 to Requires Improvement. This was a focused inspection of Safe, Caring and Well-led, so the other areas were not inspected and their previous ratings were used.
People felt safe
People told inspectors they felt safe and said staff looked after them well.
“People told us they felt safe and spoke positively about the care and support they received.” from the report
Kind and respectful care
Staff were warm and friendly, respected privacy and dignity, and supported people to make choices.
“Staff cared for people in a warm and friendly manner.” from the report
Infection control
The home had strengthened its infection control arrangements during the pandemic. Staff used protective equipment correctly and supplies were good.
“Staff used personal protective equipment (PPE) appropriately and supplies were good; staff had received training regarding the use of PPE.” from the report
Safe staffing and medicines
Staffing levels were sufficient for people's needs, and medicines were administered safely by trained staff whose competence had been checked.
“Staffing levels were sufficient to meet people's care needs.” from the report
Family communication
Relatives said communication had been maintained during the pandemic, including support for people to stay in contact using technology.
“People, staff and relatives were involved with the service.” from the report
Incomplete records and learning
seriousRecords about safeguarding, accidents and incidents were disorganised and did not always show outcomes or actions to prevent a repeat. Inspectors could not be sure the home consistently learned from mistakes.
“Learning wasn't always identified following accidents and incidents.” from the report
Weak quality checks
seriousSeveral audits had not been completed since the start of the pandemic. The provider had not made adequate arrangements to maintain oversight while managers were providing care.
“Quality assurance systems were not robust and learning was not always identified.” from the report
Risk assessments not always updated
needs fixingSome risk assessments were not consistently updated, which could make it harder to manage changing risks.
“Documentation, such as risk assessments, had not been consistently updated to help mitigate future risks.” from the report
Medication stock records
minorMedicine stock was recorded using descriptions rather than exact numbers. Inspectors recommended following NICE guidance for these checks.
“However, stock was recorded as 'appropriate level' or 'hoarding' rather than numerically.” from the report
Overdue staff reviews
needs fixingStaff appraisals and formal supervision were out of date, although staff said they received informal support during the pandemic.
“Staff appraisals and supervisions were out of date.” from the report
- 01What action have you taken to make sure safeguarding, accident and incident records include outcomes and steps to prevent a repeat?
- 02Are all quality audits and risk assessments now up to date, and who checks them?
- 03How do you maintain management oversight when managers are also working care shifts?
- 04Are staff appraisals and supervisions now being completed on time?
- 05Are medicine stock checks now recorded numerically in line with the recommendation?
This was a focused inspection of Safe, Caring and Well-led, including infection control; Effective and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 12 November 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.
Every inspection of Amadeus
4 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Requires improvementdown from GoodSafe: GoodWell-led: Requires improvement
- October 2017Goodstayed GoodSafe: GoodCaring: GoodWell-led: Good
- April 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- June 2013
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.
- January 2011
Registered with the Care Quality Commission on 28 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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