CQC report explained · a nursing home
What the CQC found at Amesbury Abbey Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by hot water safety valves, regular equipment and fire checks, safeguarding procedures and risk plans. Inspectors found a shortfall because some 'as required' medicines did not have clear protocols.
- Effective?
- Good
- This area was not covered by this focused inspection. The previous rating was used when calculating the overall rating.
- Caring?
- Good
- This area was not covered by this focused inspection. The previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This area was not covered by this focused inspection. The previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The provider had improved its quality checks and monitoring systems. Although there was no registered manager, interim arrangements and additional managers gave the home management cover.
What inspectors found, September 2020
Rated Good; inspectors found safer care and improved management, but some 'as required' medicines lacked clear instructions.
Inspectors visited on 26 August, 3 September and 4 September 2020. They reviewed care, medicine and recruitment records, spoke with people, relatives, staff and professionals, and checked how the home was managed.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that hot water outlets had been made safe, safety checks were completed, people received their medicines as prescribed, and infection control arrangements were in place.
Inspectors recommended that all 'as required' medicines should have clear instructions for staff. There was no registered manager, but an interim manager and other managers provided cover. The home had improved from Requires Improvement at the previous inspection and was no longer in breach of regulations.
Hot water made safe
Safety valves regulated hot water temperatures, and the temperatures were checked regularly.
“The provider had placed safety valves on hot water taps where people, staff and visitors had access.” from the report
Good infection control
The home was clean, cleaning records had no gaps, and staff had training and equipment for infection prevention and control.
“People were living in a clean service with systems in place to make sure all areas were cleaned thoroughly.” from the report
Enough staff and safe recruitment
Inspectors found enough staff to meet people's needs and saw that recruitment checks had been completed.
“The service had used agency staff to fill gaps in rotas but recruitment had been successful.” from the report
Quality checks
The provider used audits and monthly reports to identify and track improvements.
“Any improvement needed was identified and action was taken in a timely way.” from the report
People felt safe
People and relatives told inspectors they felt safe, and staff knew how to report safeguarding concerns.
“People and relatives told us they were safe at the service.” from the report
Medicine instructions
needs fixingSome 'as required' medicines did not have a clear protocol telling staff when and how to give them. Inspectors made a recommendation for this to be corrected.
“There were some 'as required' medicines that did not have a protocol in place to help staff know when to administer this type of medicine.” from the report
No registered manager
minorThe home did not have a manager registered with the CQC at the time of inspection. Inspectors found interim management cover, and the provider was looking for a suitable registered manager.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01Have all 'as required' medicines now got clear protocols, and how do you check staff follow them?
- 02When do you expect to appoint a registered manager?
- 03How do you make sure safety checks for hot water, fire systems, emergency lighting and equipment are completed and acted on?
- 04How are people's views and relatives' concerns recorded and followed up?
- 05What were the ratings and any concerns in the previous comprehensive inspection for Effective, Caring and Responsive?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 18 September 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, June 2019
Rated Requires Improvement; inspectors found an ongoing risk of scalding and weak action to manage it.
This was an unannounced, focused inspection on 21 May 2019. One inspector checked whether the home had acted on an earlier concern about very hot water. They tested 31 basins, reviewed water temperature records and eight risk assessments, and spoke with the manager and provider.
Inspectors found hot water above the recommended safe temperature in 21 en-suite facilities and three communal bathrooms. Temperatures ranged from 46.3 to 79.4 degrees centigrade. Monitoring was taking place, but action was not always taken when dangerous temperatures were recorded.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. This was a fall from Good at the previous inspection in January 2019. The report says the home breached Regulations 12 and 17.
Risk checks were in place
The home had completed assessments about people's risk of scalding. However, inspectors found that the precautions recorded were not effective enough.
“People had been assessed in relation to their risk of scalding” from the report
Some safety work had started
Thermostatic valves had been fitted to eight basins, and further work was being planned after the inspection.
“Thermostatic valves to control the water at a safe temperature had been installed to eight hand wash basins.” from the report
High scalding risk
seriousHot water was above the recommended safe temperature in 21 en-suite facilities and three communal bathrooms. One basin reached 79.4 degrees centigrade.
“The temperature of the water identified during this inspection was above this and ranged from 46.3 to 79.4 degrees centigrade.” from the report
Checks did not lead to action
seriousThe home recorded water temperatures, but did not always act when they were dangerously high. A basin recorded at 79.4 degrees centigrade had also been very hot in earlier checks.
“Records showed the temperature of the hot water was being monitored. However, action had not always been taken when excessive temperatures were identified.” from the report
Poor oversight of improvements
needs fixingThe provider and manager did not know the order or timescale for fitting the valves. This meant the work was not being managed in a clear and timely way.
“The provider or manager were not aware of the order in which they would be fitted or by when.” from the report
- 01Have all the en-suite basins and communal bathrooms now been fitted with thermostatic valves?
- 02What are the current recorded water temperatures in residents' rooms and communal bathrooms?
- 03How quickly does staff act when a water temperature is too high, and who checks that this has happened?
- 04How are individual scalding risks assessed now, rather than using the same precautions for everyone?
- 05Has the new manager completed registration with the Care Quality Commission?
This was a focused inspection of Safe and Well-led, prompted by the earlier hot water safety concern; the other question ratings were not given in this report. This explanation was written from the published report of 27 June 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 Amesbury Abbey Care Home
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2019Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- January 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2014
Registered with the Care Quality Commission on 30 April 2014.
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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