CQC report explained · a nursing home
What the CQC found at Apollo House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were receiving medicines as prescribed and risks were generally better managed. However, kitchenette doors were not always secured and some staff were unsure about external safeguarding and whistleblowing procedures.
- Effective?
- Requires improvement
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Requires improvement
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Requires improvement
- This question was not inspected during this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- Management systems and audits had improved, and staff described a supportive culture. Further work was needed to embed improvements, make care records consistent and ensure environmental risks were managed reliably.
What inspectors found, December 2022
Apollo House rated Requires Improvement; inspectors found improved medicines and risk systems, but some safety and oversight problems remained.
This was an unannounced focused inspection. Inspection activity ran from 26 October to 3 November 2022, with visits on 26 and 31 October. Inspectors spoke with people, a relative and staff, and reviewed care records, medicines records, recruitment files and management records.
The home had improved since the previous inspection. People received their medicines as prescribed, staffing levels were suitable during the inspection, and records of risks, injuries and care tasks had improved. Infection control arrangements were also found to be effective.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. Some kitchen doors were not always secured, some staff were unsure about external safeguarding and whistleblowing procedures, and electronic and paper care records were not always cross-referenced.
Medicines
Medicines systems had improved. Staff were trained and people received their medicines as prescribed.
“People received their medicines as prescribed from trained staff.” from the report
Staffing
Inspectors saw enough staff to meet people's needs, and people said staffing was sufficient.
“During the inspection we observed there were enough staff deployed to meet people's needs and people's call bells were answered quickly.” from the report
Infection control
The home appeared clean, and infection prevention arrangements, including PPE and visiting arrangements, were found to be suitable.
“We were assured that the provider was using PPE effectively and safely.” from the report
Supportive culture
Staff said managers listened to concerns and worked with them to provide care.
“Staff told us they felt supported by the management team and felt they all worked well together to provide people's care.” from the report
Safeguarding reporting
needs fixingSome staff did not know how to use external safeguarding and whistleblowing reporting routes. The provider was asked to improve staff awareness and confidence.
“Some staff were unsure how to follow external safeguarding and whistleblowing reporting procedures.” from the report
Incomplete cross-referencing
needs fixingCare was recorded in both electronic and paper systems, but these records were not always linked together. Inspectors said this could affect continuity of care.
“People's care was recorded on electronic and paper records, which were not always cross referenced to provide a complete record of the care provided.” from the report
- 01What immediate checks are now in place to make sure all kitchenette doors remain secured?
- 02How are staff being trained and tested on external safeguarding and whistleblowing procedures?
- 03How are care plans being reviewed to include enough detail about physical intervention during personal care?
- 04How do you make sure electronic and paper care records are cross-referenced and give a complete record of care?
- 05What evidence can you show that the improvements identified at this inspection have been sustained?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 23 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, June 2021
Rated Requires Improvement; inspectors found serious gaps in safety, care records, medicines and management, with warning notices issued.
This was the home’s first comprehensive inspection. Inspectors visited without notice on 22 April 2021, spoke with people, relatives, staff and other professionals, and checked care, medicines, staff files and management records.
All five areas were rated Requires Improvement. Inspectors found unexplained injuries were not always investigated, risks and healthcare needs were not always recorded or managed, and care records had gaps. They also found problems with medicines records, staff training, activities and oversight of the home.
There were some positive findings. Most staff were described as kind and respectful. Infection control measures such as testing, PPE and visitor checks were in place, and complaints had been answered within the provider’s stated timescale. The home had sent an action plan, but CQC said it would continue to monitor the service.
Kind and respectful staff
People said most staff treated them kindly and with respect. Inspectors also found staff could describe ways to protect privacy and dignity.
“However, people told us most staff were kind and respectful to them.” from the report
Infection control measures
The home was carrying out COVID-19 testing and using PPE. Visitors were tested before entering, although inspectors also found gaps in cleaning records.
“Visitors were required to complete a test before entering the service. Staff wore appropriate personal protective equipment (PPE) and received training in infection control.” from the report
Mental capacity processes
Where people lacked capacity, decision-specific assessments and best-interest decisions had been completed. DoLS applications had also been submitted to the local authority.
“Where people lacked capacity, decision specific mental capacity assessments had been completed and best interest decisions had been made with all the relevant people being involved.” from the report
Complaints process
People, relatives and staff knew how to complain. The complaints inspectors reviewed had been answered appropriately and within the provider’s timescale.
“The complaints seen had been responded to appropriately and in a timely manner.” from the report
Unexplained injuries
seriousFive people had unexplained bruises that were not recorded or investigated. This meant the home could not establish what had happened or reduce the risk of abuse.
“we found five people had unexplained bruises which had not been recorded and we found no evidence of investigations being completed to identify the cause of these injuries.” from the report
Incomplete care and risk records
seriousCare plans and risk assessments did not always contain the information staff needed. Records of repositioning, fluids, oral care, continence and skin checks also had gaps.
“These failures put people at risk of harm.” from the report
Health and diabetes support
seriousStaff did not always follow diabetes care plans or record blood sugar checks at the required times. Information about epilepsy and changes in people’s health was also incomplete.
“This put people at risk of complications associated with unstable diabetes.” from the report
Medicines records
seriousStaff did not consistently record why 'as required' medicines were given or whether they worked. CQC found this was a breach of safe care and treatment requirements.
“staff did not consistently record the reason for giving the medicine or the effectiveness of the medicine once administered.” from the report
Limited activities
needs fixingPeople and staff said there were few activities, with watching films described as the only regular option. People reported that this could be boring.
“No activities, the only one is watching films.” from the report
Heavy use of agency staff
needs fixingStaffing levels were suitable during the inspection, but the home was using many agency staff while recruiting permanent staff. People said staff kept changing, and staff said there was not enough time for activities.
“Staff do respond but staff keep changing.” from the report
- 01What action has been taken to investigate unexplained bruising, and how are new injuries now recorded and reviewed?
- 02How do you check that care plans and risk assessments are complete and reflect each person’s current health needs?
- 03How are diabetes, epilepsy, pressure damage, hydration and other health risks monitored and escalated?
- 04How do you make sure staff record the reason, time and outcome when giving 'as required' medicines?
- 05What is the current balance between permanent and agency staff, and what activities are now available each week?
This was the first comprehensive inspection of the newly registered home and covered all five CQC questions; an earlier infection prevention and control inspection was published on 30 November 2020 but was not rated. This explanation was written from the published report of 2 June 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 Apollo House
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- June 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- August 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2020
Registered with the Care Quality Commission on 17 August 2020.
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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