CQC report explained · a nursing home
What the CQC found at Annabel House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Infection control, staffing levels, risk assessments and medicines management were found to be safe, although recruitment was still in progress for vacant posts.
- Effective?
- Good
- People's care achieved good outcomes and supported choice and control. Staff received induction, training and supervision, and people were supported with food, drinks and healthcare.
- Caring?
- Good
- Staff were kind, caring and respectful. People were involved in decisions about their care and supported to remain as independent as possible.
- Responsive?
- Good
- Care plans reflected people's histories, interests and preferences. Activities, visits and one-to-one support were available, but some information displayed in the home was not always accurate or accessible.
- Well-led?
- Good
- The home was described as well managed, with an open culture and regular audits. Governance had improved and the provider was no longer in breach of Regulation 17, although recruitment and care plan audits needed further development.
What inspectors found, September 2021
Rated Good; inspectors found safe, kind and personalised care, with some information needing to be made more accessible.
This was an unannounced follow-up inspection on 17 and 20 August 2021. Inspectors spoke with three people, six staff and eight relatives. They reviewed care records, medicines records, staff recruitment files and management systems.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were described as happy and safe. Inspectors found the home clean and well maintained, with kind staff, safe medicines systems and care plans based on people's preferences.
The home had improved since the previous inspection. COVID-19 testing systems and records had been strengthened, and the earlier breach of Regulation 17 was no longer in place. Inspectors made a recommendation about showing information in ways that are easier for people to understand.
Kind and respectful staff
People and relatives described staff as kind, attentive and respectful. Inspectors observed people being treated with dignity and supported in a calm, happy atmosphere.
“People were supported by staff who were kind, caring and knew them well.” from the report
Improved safety systems
The home had improved its COVID-19 testing systems, records and checks since the previous inspection. Risk information and safety records were also more organised.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Personalised care
Care plans included people's histories, interests, routines and preferences. Staff used this information to support choice, independence and individual ways of receiving care.
“Care plans directed staff how to support people in a person-centred way.” from the report
Safe medicines management
Medicines were stored and administered safely. Records were accurate, allergies were recorded and checks were in place for medicines needing extra security.
“Medicines that required additional storage in line with legal requirements were stored appropriately and systems for stock checks were in place.” from the report
Information was not always accessible
minorThe dining-room noticeboard did not always show accurate information about items such as menus, dates and times. Inspectors recommended making information, including the complaints procedure, easier for people to understand.
“The noticeboard in the dining room which displayed information such as the menu, date and time was not always accurate.” from the report
Some audits needed development
minorRecruitment audits did not yet check people's right to work or name changes. Care plan audits had also been identified for further development.
“Recruitment audits did not review people's right to work or name change.” from the report
- 01How do you now make menus, dates, times and the complaints procedure accessible to each person?
- 02How do you check that recruitment audits include right-to-work and name-change checks?
- 03What further changes have been made to care plan audits since this inspection?
- 04How many vacant staff posts are there now, and how are safe staffing levels maintained while recruitment continues?
- 05Is the manager now registered with the CQC, or what progress has been made with registration?
This was an unannounced follow-up inspection covering all five key questions; Safe and Well-led had improved from Requires Improvement, while Effective, Caring and Responsive received their first ratings at this inspection. This explanation was written from the published report of 14 September 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 2021
Inspected but not rated overall; inspectors found safe, kind care, but COVID-19 testing and oversight required improvement.
This was an unannounced focused inspection on 11 and 25 February 2021. It followed concerns about COVID-19 testing and isolation. Inspectors spoke with people, relatives and staff, and reviewed care, medicine, recruitment, testing and management records.
Inspectors found that staff COVID-19 testing was not reliable or consistent. Published guidance after a positive result had not been followed, creating a potential risk of harm. The home made immediate changes during the inspection, including systematic testing, recording and oversight.
The home was clean and calm. People were happy, staff knew them well, medicines were managed safely and staffing levels were considered safe. However, some planned audits had not been completed and provider audits were absent.
The service was rated Requires Improvement for Safe and Well-led. There was no overall rating because all five areas had not yet been inspected.
Clean environment
The home was described as clean and tidy. Inspectors were assured about its layout, hygiene practices and use of protective equipment.
“The home was clean and tidy.” from the report
Safe staffing and recruitment
Staffing levels were considered safe, and recruitment checks included criminal record checks, employment history and references.
“Recruitment procedures were followed.” from the report
Medicines managed well
Medicines were stored, administered and recorded safely. Monthly medicine audits identified areas for improvement.
“Medicines were stored, managed and administered safely.” from the report
Kind atmosphere
People were happy, and inspectors saw positive interactions. Staff knew people well and worked together as a team.
“The service had a friendly and calm atmosphere.” from the report
COVID-19 testing
seriousThe staff testing system was ineffective and inconsistent. People and staff were placed at potential risk, and guidance after a positive result was not followed.
“People and staff had been placed at risk of potential harm due to ineffective and inconsistent systems in place for COVID-19 testing for staff.” from the report
Weak governance
seriousThere were no provider audits, and some manager audits due between July 2020 and February 2021 had not been completed. This resulted in a breach of Regulation 17.
“This was a breach of Regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014” from the report
Allergy information on medicine records
minorKnown allergies were not shown on the printed medicine records for three people. The deputy manager said this would be addressed.
“We highlighted where for three people their known allergies were not showing on the printed MAR.” from the report
Care recording
needs fixingSome daily notes were difficult to read and events were not always timed. The home began trialling electronic recording during the inspection.
“Information in daily notes were not always easy to read and events were not always timed.” from the report
- 01How do you now make sure every staff COVID-19 test is completed, recorded and checked?
- 02What happens if a staff member has a positive COVID-19 result, and how do you follow the relevant guidance?
- 03Which provider and manager audits were missed, and have they now all been completed?
- 04How do you check that known allergies appear correctly on each person's printed medicine record?
- 05What has happened with the trial of electronic daily recording, and how do you make sure events are timed and easy to read?
This was a focused inspection of Safe and Well-led after a targeted inspection of COVID-19 risks; the other three key question ratings were not given and the service had no overall rating. This explanation was written from the published report of 14 April 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.
Every inspection of Annabel House Care Centre
6 rated inspections over 6 years: the service has improved, from Inadequate to Good.
- September 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2021Inspected but not ratedSafe: Requires improvementWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2016Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- October 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Requires improvement
- July 2019
Registered with the Care Quality Commission on 16 July 2019.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
23 live-in carers within about an hour of North Somerset
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 £1,050 to £1,320 a week. 19 can care for a couple. 12 years' experience on average.
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.