CQC report explained · a residential care home
What the CQC found at Apna Ghar Residential 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
- Inspectors found unsafe medicines management, incomplete risk assessments, unsafe oxygen storage, unguarded radiators and gaps in recruitment checks. Infection prevention and control arrangements were satisfactory.
- Effective?
- Requires improvement
- The home was not always following the Mental Capacity Act when restrictions or physical intervention were used. Staff also lacked training in de-escalation and physical intervention.
- Caring?
- Good
- This key question was not inspected during this focused visit, so no new rating was given.
- Responsive?
- Good
- This key question was not inspected during this focused visit, so no new rating was given.
- Well-led?
- Requires improvement
- There were no effective audits or checks, and the provider had not identified problems with medicines, recruitment, risks or staff training. There was also no formal system for feedback from people and relatives.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found serious gaps in medicines, risk management, staff training and oversight.
This was a focused inspection on 2 February 2023. One inspector spoke with two people, one relative and three staff members. They reviewed one care file, one recruitment file, medicines records and other documents.
The home was not always safe or effective. Risks such as unguarded radiators, oxygen storage, window safety and distress were not properly assessed. Medicines records and stock did not always match, and staff had not had medicine competency checks.
The home had no effective checks or audits to find and fix these problems. Inspectors identified breaches about consent, safe care, good governance and staffing. The overall rating changed from Good at the previous inspection, published in 2018, to Requires Improvement.
Enough staff
Inspectors found there were enough staff to meet people's needs and support healthcare appointments and outings.
“There were sufficient numbers of staff to meet people's needs. There were sufficient numbers of staff to ensure people were able to go out as and when they wanted to.” from the report
Clean and maintained
The home was clean and well maintained. Infection prevention arrangements were considered suitable.
“The service was clean and well maintained. Staff had received training in infection control.” from the report
Cultural needs
The home supported people's cultural and faith needs, and staff spoke several languages.
“The service continued to be homely, based around the cultures and faith of the people living there and was specific to people's needs.” from the report
Access to healthcare
People were supported to attend healthcare appointments and take part in activities supporting their physical and mental health.
“People had regular appointments with the dentist and opticians.” from the report
Positive relationships
Inspectors saw people appearing comfortable with staff. A relative said their loved one was keen to return.
“People were happy, smiling and chatting with staff seemingly at ease.” from the report
Unmanaged safety risks
seriousRisks involving falls, hot radiators, oxygen cylinders, fire safety and people's distress had not been properly assessed or reduced. This increased the risk of harm.
“Risks to people had not been assessed and mitigated, for example exposed radiators or if window restrictors were required.” from the report
Medicines not fully controlled
seriousMedicine stock did not match records, guidance for some medicines was incomplete and staff had not completed competency checks.
“People's medicines were not always well managed. Some people had 'as and when' medicines.” from the report
Unlawful restrictions
seriousThe home had not properly considered legal requirements when physical intervention or other restrictions were used. Inspectors found these restrictions had not been included in the relevant assessments.
“The registered person failed to put in to practice the requirements of the MCA.” from the report
Weak oversight
seriousThe provider had no audits or checks to identify problems and had not found the issues raised by inspectors.
“There were no checks and audits carried out on the service to seek to improve the service or identify any issues.” from the report
Staff training
needs fixingStaff did not always have the skills to support people during distress. They had not received de-escalation training, and there was no practical training for physical intervention.
“Staff did not always have the skills and knowledge to support people when in distress.” from the report
Recruitment records
needs fixingEmployment gaps had not been explored and references were missing. Start dates were not recorded, so the provider could not show that all checks were completed before staff started.
“People were supported by staff who had not always been recruited safely.” from the report
- 01What has been done to make sure medicine stock matches the administration records every time?
- 02Have all staff now completed medicine competency checks, de-escalation training and any required physical intervention training?
- 03How are risks from radiators, windows, oxygen cylinders and fire safety now assessed and checked?
- 04How are restrictions and physical interventions recorded, legally authorised and reviewed under the Mental Capacity Act?
- 05What regular audits and checks are now in place, and can families see the home's improvement action plan?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected in this visit and the overall rating used the previous ratings for those areas. This explanation was written from the published report of 15 March 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, June 2018
Rated Good; inspectors found safe, kind and personalised care, with fire safety improvements still being completed.
This was a planned, announced comprehensive inspection on 3 May 2018. The inspector spoke with two people, staff and the registered manager, observed care and lunch, and reviewed care plans, risk assessments, medicines records, staff files and quality checks.
The home supports three Asian adults with mental health difficulties. Inspectors found enough staff, suitable training, safe medicines processes and regular risk reviews. People had access to health professionals and staff understood changes in their mental health.
People were treated with kindness, dignity and respect. Care was personalised, people's languages and cultures were respected, and people were supported to make choices, stay independent and take part in activities.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. This was unchanged from the previous inspection on 1 March 2016.
Enough staff
Staffing levels meant people could receive one-to-one support, go out and have changes in their wellbeing noticed quickly.
“There were enough staff to support people.” from the report
Kind and personal care
Staff knew people's histories, preferences and communication needs. They used this knowledge to build positive relationships.
“Staff treated people with kindness and understanding in their day to day lives.” from the report
Support for independence
People were encouraged to manage parts of daily life, speak for themselves with health professionals and take part in activities and community groups.
“Staff continued to encourage people's independence at home and in the community.” from the report
Good mental health support
Staff recognised changes in people's usual behaviour and knew when to seek medical or mental health support.
“Staff knew how to contact the out of hours mental health crisis team if there were significant changes in people's mental health and had done so in a timely manner.” from the report
Open management
The manager was involved in day-to-day care, sought people's views and used checks and meetings to monitor and improve the home.
“The registered manager was fully involved in the running of the service and monitoring its quality.” from the report
Fire safety work
needs fixingA Fire Officer visit and an external fire risk assessment had identified areas needing improvement. Some work had been completed, but removing timber hallway cladding was still underway at the inspection.
“A visit from the Fire Officer in February 2018 and an external fire risk assessment had highlighted areas where improvements were needed.” from the report
- 01Has all the fire safety work identified in February 2018, including removal of the hallway timber cladding, now been completed?
- 02How many staff are on duty during the day and at night, and how is one-to-one support maintained when people go out?
- 03How are changes in a person's mental health identified, recorded and referred to health professionals?
- 04How are medicines checked to make sure they continue to be given at the right time and in the right way?
- 05How will the home support my relative's language, cultural, faith and activity preferences?
This was a comprehensive inspection covering all five key questions, and the ratings remained Good from the previous inspection in March 2016. This explanation was written from the published report of 8 June 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 Apna Ghar Residential Home
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 1 March 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.
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
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.