CQC report explained · a nursing home
What the CQC found at Ampersand
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2023
Requires Improvement overall; inspectors rated safety Inadequate and found medicines, risk management, infection control and recruitment were not reliable.
This was an unannounced follow-up inspection on 17 and 18 May 2023. Two inspectors and an Expert by Experience spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The home was rated Inadequate for Safe and Requires Improvement for Well-led. Inspectors found that medicines were not always given as prescribed, risk assessments lacked important information, some areas were not clean, and recruitment checks and staffing deployment were not robust.
People and relatives said staff were kind, respectful and friendly. Staff understood how to report abuse, and the home worked within the principles of the Mental Capacity Act. However, the home remained in breach of regulations and had been rated Requires Improvement for four consecutive inspections.
Kind and respectful staff
People and relatives described staff as kind, friendly and respectful. People said staff helped them and made them feel safe.
“They are all very nice and very respectful. They always call me by my name” from the report
Safeguarding awareness
Staff understood what abuse could mean and knew how to report concerns. Safeguarding concerns had been reported appropriately.
“Staff had received safeguarding training and knew how to escalate concerns to outside organisations” from the report
Mental capacity practice
Inspectors found that people were supported to make choices where possible. Where people lacked capacity, decisions were made in their best interests and in the least restrictive way.
“People were supported to have maximum choice and control of their lives” from the report
Positive atmosphere
Inspectors saw a calm atmosphere, and people and relatives spoke positively about the management and the home.
“There was a calm, relaxed atmosphere at the service.” from the report
Medicines were not reliably managed
seriousInspectors found that patches were not used according to prescriber's instructions and medicine quantities did not always match the records. Daily medicine balances had not been recorded, so it was not possible to establish when errors happened.
“The provider has failed to manage medicines safely. This placed people at risk.” from the report
Risks were not fully assessed
seriousSome risk assessments were missing or lacked important, person-specific information. This included risks linked to infection, falls, anticoagulant medicines, catheters, evacuation and flammable creams.
“Risk assessments did not always have information staff needed to keep people safe.” from the report
Cleanliness and infection control
seriousSome areas were not clean and inspectors noticed a smell of stale urine. Infection risks relating to one person had not been assessed or managed.
“Some areas of the service were not clean. There was a smell of stale urine in one part of the service.” from the report
Recruitment checks and records
seriousThree staff files had gaps in employment history, and the application forms did not collect all the information required. This meant the home could not demonstrate that recruitment was robust.
“Staff recruitment records showed gaps in three members of staff employment history.” from the report
Staff availability
needs fixingAlthough the rota appeared sufficient, inspectors found that staff were not always deployed effectively. People sometimes waited for help, including in areas away from the main floor.
“I can ring my call bell and it could be 10 to 15 minutes before anyone comes.” from the report
Weak management checks
seriousAudits had not identified several of the problems found during the inspection. Care records were difficult to read, and daily records did not always explain what personal care had been offered.
“Systems in place to audit the quality of the service were not robust or sufficient to alert the provider of concerns and issues within the service.” from the report
- 01What has changed to make sure every person receives medicines exactly as prescribed, including skin patches?
- 02How are you now checking that each person's risk assessment contains complete and person-specific information?
- 03What evidence can you show that all areas are clean and infection risks are being assessed and controlled?
- 04How are staff deployment and response times to call bells being monitored?
- 05How have recruitment records been corrected, and how do you now check that new staff are suitable to work here?
This was a focused follow-up inspection of Safe and Well-led; the Effective, Caring and Responsive ratings were carried over from the previous inspection. This explanation was written from the published report of 2 August 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, December 2020
Inspected but not rated; inspectors were assured that the home had safe infection prevention and control arrangements.
This was a targeted inspection on 11 December 2020. Inspectors checked infection prevention and control arrangements because of coronavirus outbreaks in care homes. The visit was announced.
Inspectors found individual COVID-19 risk assessments for residents. Staff movement between areas had been reduced, and communal spaces had been rearranged to support social distancing.
The inspectors were assured about visitors, shielding, admissions, personal protective equipment, testing, cleaning, outbreak management and the infection control policy. The home was inspected but not rated, so this report does not give an overall quality rating.
Personal risk planning
Residents had individual COVID-19 risk assessments to identify vulnerabilities and plan safe support.
“People living at the service had individual COVID-19 risk assessments.” from the report
Reduced staff movement
Staff deployment was changed to reduce movement between different areas of the home.
“Staff deployment had been modified to minimise the need for staff to move between different areas of the service.” from the report
Safer shared spaces
The layout of communal areas had been changed to help people keep apart where possible.
“The layout of communal areas had been adapted to help with social distancing.” from the report
Inspectors raised no specific concerns in this report.
- 01How are residents' individual COVID-19 risk assessments reviewed and updated?
- 02How do you now limit staff movement between different areas of the home?
- 03What are the current rules for visitors and how do you manage infection risks during visits?
- 04How do you arrange testing for residents and staff?
- 05How often is the infection prevention and control policy reviewed?
This was a targeted inspection of infection prevention and control practices only; the home was inspected but not rated and the other care questions were not covered. This explanation was written from the published report of 24 December 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 Ampersand
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: InadequateEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- September 2020Inspected but not ratedSafe: Inspected but not rated
- October 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2017Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 11 July 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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91 live-in carers within about an hour of Medway
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,250 a week. 78 can care for a couple. 10 years' experience on average.
“Usha rapidly became 'one of the family' and is sorely missed.”
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.