CQC report explained · a nursing home
What the CQC found at Anville Court Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Safety management was inconsistent. Inspectors found a damaged window that people could access, gaps in safety checks, inconsistent health checks and unclear moving-and-handling information, although medicines and infection control were managed safely overall.
- Effective?
- Good
- This key question was not inspected during this focused visit. The previous ratings for questions not inspected were used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous ratings for questions not inspected were used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous ratings for questions not inspected were used when calculating the overall rating.
- Well-led?
- Requires improvement
- Management audits failed to identify important risks and unclear care records. A complaint had been deleted before it was investigated, and the provider's governance systems did not ensure required improvements were made.
What inspectors found, December 2022
Requires Improvement; inspectors found unsafe gaps in risk checks, care records and management oversight.
This was an unannounced focused inspection. Inspectors visited on 13 and 21 September 2022, spoke with people, relatives and staff, observed care and checked records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found risks linked to a damaged window, missed safety checks, unclear care plans and weak complaint handling.
There were also positive findings. Medicines were managed safely, infection control arrangements were mostly satisfactory, staff recruitment checks were completed and people were supported in line with the Mental Capacity Act.
The overall rating fell from Good at the previous inspection, published on 19 May 2018. The provider was asked for an action plan and the CQC said it would monitor progress.
Medicines
Inspectors found that medicines were received, stored, administered and disposed of safely. Records were complete and storage temperatures were checked.
“Medicines were received, stored, administered and disposed of safely.” from the report
Infection control
The home had effective arrangements for preventing and managing infections, including safe visiting, use of protective equipment and outbreak planning.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Staff recruitment
New staff had appropriate pre-employment checks and a thorough induction, including shadowing experienced staff.
“The registered manager had undertaken appropriate pre employment checks on new staff, such as DBS checks.” from the report
Partnership working
The home worked with health and care professionals when people needed specialist support.
“The provider worked in partnership with other professionals, including the district nursing service, physiotherapy, occupational therapy and local GP's.” from the report
Accessible damaged window
seriousA damaged first-floor window had an ineffective restrictor and was in an unlocked room. People could have accessed it and been at risk of falling from height.
“Although the room was unoccupied, the door was unlocked, and people could access it and were at an increased risk of falls from height.” from the report
Unclear care instructions
needs fixingSome care plans did not give precise instructions for health checks or moving people with a hoist. This could lead to people receiving the wrong support or equipment.
“Some care plans contained detailed instructions for staff, but others lacked essential information such as which sling to use.” from the report
Complaint record deleted
seriousA complaint was voided on the electronic system before it was investigated. This meant the home missed a chance to learn from it and improve.
“a person's complaint had been voided on the provider's electronic care system which had not be investigated.” from the report
Gaps in safety checks
needs fixingRecords showed that safety system checks had not been completed for several weeks while the responsible person was absent. The home said it would arrange cover and train another person.
“Records of checks of safety systems showed a gap of several weeks where no checks had been carried out.” from the report
- 01What action has been taken to permanently repair the damaged first-floor window, and how are people prevented from accessing unsafe areas?
- 02How are safety checks covered when the usual member of staff is absent?
- 03How have care plans been updated to give precise instructions for health checks and for using hoists and slings?
- 04How are complaints recorded, protected from deletion and investigated through to completion?
- 05What progress has been made on the action plan requested after the Regulation 17 breach?
This was a focused inspection of Safe and Well-led only; the other ratings used in the overall calculation carried over from the previous inspection. This explanation was written from the published report of 8 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, May 2018
Anville Court Care Home was rated Good overall; inspectors found safe, kind and responsive care, but the service needed to improve its management checks.
This was an unannounced inspection on 12 April 2018, completed on 17 April 2018. Inspectors followed up concerns about care and spoke with people living at the home, relatives, staff and health professionals. They also checked care plans, medicines records, incidents, staff files and quality audits.
People told inspectors they felt safe and were treated with kindness and respect. Staff understood people's needs, supported medicines safely, sought consent and helped people access healthcare. People had choices about their care, food and activities, and complaints were investigated.
The home was rated Good for Safe, Effective, Caring and Responsive. It was rated Requires Improvement for Well-led because management checks had not always identified problems with the dining experience or ensured that actions were completed promptly.
This was the first inspection since the provider registered the location in July 2017. Inspectors noted improvements under new management, including staffing, cleanliness, activities and links with healthcare services.
People felt safe
People said they felt safe and staff were available when needed. Staff understood how to respond to safeguarding concerns and individual risks.
“People received care from staff they felt safe with and there was sufficient staff to meet and respond to their needs in a safe and timely way” from the report
Kind and respectful staff
Inspectors saw friendly communication and reassurance. Staff respected people's privacy, dignity and choices.
“People were supported by staff who respected their privacy and dignity.” from the report
Personalised support
Staff knew people's preferences and supported a range of activities. People were able to choose how they spent their day.
“Staff were knowledgeable about people's care needs and preferences in order to provide a personalised service.” from the report
Healthcare support
People had access to GPs and other health professionals. Staff were described as proactive in seeking advice and following recommendations.
“They both said they felt people were well cared for.” from the report
Improvements under new management
People, relatives and staff reported improvements under the new management. Inspectors noted better staffing, cleanliness, activities and end-of-life care links.
“People, relatives and staff all complimented the registered manager and the improvements made under the new management.” from the report
Dining arrangements
needs fixingThe lunchtime experience was not always well organised. Some people had to be moved during their meals, while others waited more than 30 minutes before food was served.
“We also noted a number of people needed staff to assist them with their meals, this meant some people were left seated in the dining room for over 30 minutes before their meals were served.” from the report
Quality checks did not always lead to prompt action
needs fixingAudits were in place but were not always robust enough to find problems and ensure they were fixed promptly. This contributed to the issues with dining and medicines records.
“We found that although audits were in place, some needed to be more robust to ensure areas for improvement were consistently identified and actions taken in a timely.” from the report
Missing guidance for some as-required medicines
needs fixingSome people did not have written guidance explaining when as-required medicines should be given. The provider said this would be addressed after the inspection.
“We also found that although people said they received pain medication as required; guidance for PRN 'as required' medication was not in place for some people.” from the report
Signage and orientation
minorThe home was suitable and well decorated, but its uniform decoration and limited signage could make it harder for people to find their way around.
“However, we found that all areas were uniformly decorated and that signage could be improved to help people's orientation within the home.” from the report
- 01What changes have been made to the lunchtime dining arrangements since inspectors found that some people waited over 30 minutes for their meals?
- 02Do all people who may need as-required medicines now have clear written guidance about when those medicines should be given?
- 03How do you check that actions found through audits are completed promptly?
- 04What new signage or layout changes have been made to help people find their way around the home?
- 05How are people and relatives involved in reviewing the quality of food, activities and care?
This was an unannounced inspection covering all five CQC questions over two visits and following up concerns about care; it was the first inspection since the provider registered the location. This explanation was written from the published report of 19 May 2018 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 Anville Court Care Home
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018GoodSafe: GoodWell-led: Requires improvement
- July 2017
Registered with the Care Quality Commission on 27 July 2017.
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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