CQC report explained · a residential care home
What the CQC found at Appledown
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. There were enough staff, risks were assessed, medicines were given as prescribed and infection control arrangements were satisfactory, although medicine storage temperatures were not routinely monitored.
- Effective?
- Requires improvement
- The kitchen was worn, damaged and difficult to clean in places, and other repairs were needed. Inspectors recommended stronger systems to make sure the environment supports people's wellbeing.
- Caring?
- Good
- This question was not inspected during this focused visit.
- Responsive?
- Good
- This question was not inspected during this focused visit.
- Well-led?
- Good
- Managers provided effective leadership and support. They carried out audits, involved people and relatives, and worked with health professionals.
What inspectors found, December 2023
Appledown was rated Good overall; inspectors found safe, caring support, but the service was not always effective and needs improvement to its environment.
This was an unannounced, focused inspection on 3 October 2023. Inspectors looked at Safe, Effective and Well-led. They spoke with people, staff, managers and relatives, and checked care, medicines, training, staffing and other records.
The home was rated Good for Safe and Well-led. People felt safe, there were enough trained staff, medicines were given as prescribed, and managers understood people's needs. Staff supported people to make choices, stay independent and access health care.
Effective was rated Requires Improvement, down from Good at the previous inspection. Inspectors found the kitchen was worn and difficult to clean in places. The temperature where medicines were stored was also not routinely monitored. Some repairs were made after the inspection, with a kitchen replacement planned for summer 2024.
The overall Good rating includes ratings carried over for areas not inspected during this visit. The report says the home will continue to be monitored.
People felt safe
People and relatives said they felt safe and well cared for. Staff understood their safeguarding responsibilities and investigated concerns with the local authority.
“People were protected from all forms of abuse and discrimination by the dedicated staff team.” from the report
Enough trained staff
Staffing levels were planned around people's needs and community activities. Recruitment checks were completed and staff training was kept up to date.
“Staff were recruited safely. All necessary pre-employment checks had been completed to ensure prospective staff were suitable for employment in the care sector.” from the report
Support for independence
Staff supported people to make choices, take part in activities and voluntary work, and live as independently as possible.
“Staff valued and promoted people's independence and individuality.” from the report
Caring culture
Inspectors found staff knew people well, understood their communication needs and responded positively when people asked for help.
“The culture of the service was caring and compassionate and the staff team were focused on supporting people to live their own lives.” from the report
Kitchen and other repairs
needs fixingThe kitchen worktops and flooring were damaged, and some areas were difficult to clean. A rusty radiator and a broken lockable cupboard also needed attention. Inspectors recommended stronger systems for managing the environment.
“The service's kitchen was tired and in need of replacement.” from the report
Medicine storage temperatures
needs fixingPeople received their medicines correctly, but the temperature of the storage area was not routinely checked. Inspectors recommended getting guidance on how to monitor this.
“However, the temperature of the area in which medicines were stored was not routinely monitored.” from the report
- 01Has the planned kitchen replacement for summer 2024 been completed, and what temporary improvements were made?
- 02How are medicine storage temperatures checked now, and where are those checks recorded?
- 03Have the rusty bathroom radiator and broken lockable cupboard been replaced or repaired?
- 04How will you make sure the home environment supports people's wellbeing and helps them develop new skills?
- 05What recent feedback have people and relatives given about the care and support?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected, and ratings for areas not inspected were carried over from the previous inspection. This explanation was written from the published report of 7 December 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 2018
Rated Good; inspectors found caring, personalised support and major improvements since the previous inspection.
This was a planned, announced comprehensive inspection on 5 and 6 November 2018. Inspectors spoke with all six people living in the home, two relatives, staff and health and social care professionals. They reviewed care and medicines records, staff files, training records and quality checks.
The home was providing personal care for six people with learning disabilities. Inspectors found enough staff, safer premises, safe medicines systems and staff who understood people's needs. People were treated with kindness and respect, involved in decisions, and supported to follow their interests and stay connected with others.
The overall rating was Good. Safe, Effective, Caring, Responsive and Well-led were all rated Good. This was an improvement from Requires improvement at the October 2017 inspection, when four regulations had been breached. Inspectors said those previous breaches had been addressed.
More staff support
Staffing levels had increased during the day and at night. This gave people more individual support and more chances to go out and follow their interests.
“These staff changes meant people had more individual support, and could pursue a wide range of individual interests, and go out more at weekends.” from the report
Kind and respectful care
Staff built warm relationships with people and supported them in ways that reflected their preferences and life histories.
“People were supported by staff that were caring, compassionate and treated them with the utmost dignity and respect.” from the report
Personalised activities
People were supported with hobbies, work, volunteering and community activities. They helped plan meals and activities at house meetings.
“People were supported to pursue their interests and hobbies and did meaningful work.” from the report
Improved quality checks
The home had strengthened its monitoring systems, including checks on training, staffing, the environment and care quality. Inspectors found evidence that checks led to improvements.
“Quality monitoring systems had improved, with examples of continuous improvements made in response to audits, observation of practice and regular checks of the environment.” from the report
Upper-floor window safety
needs fixingWindow restrictors were not fitted to second- and third-floor windows during the inspection. The provider later told CQC that restrictors would be fitted to all upper-floor windows.
“However, there were no window restrictors fitted on the second and third floor rooms.” from the report
Care plans were difficult to use
minorCare plans contained useful detail but were large and unwieldy. Inspectors recommended adding easy-read summary plans so information would be more accessible to people.
“However, care records were rather large and unwieldy.” from the report
End-of-life wishes not recorded
minorThe home had not provided end-of-life care, and no one had recorded advance decisions about resuscitation or preferred funeral arrangements. Inspectors encouraged the manager to discuss and record people's and relatives' views.
“None of the people who lived at the service had expressed any advanced decisions about resuscitation, or preferred funeral arrangements.” from the report
- 01Have window restrictors now been fitted to all second- and third-floor windows, and how is their safety checked?
- 02Can we see the easy-read summary care plans recommended by inspectors?
- 03How are people's wishes about resuscitation and funeral arrangements discussed and recorded?
- 04How are staffing levels matched to each person's assessed needs, including one-to-one or two-to-one support in the community?
- 05How are people's choices about activities, meals and daily routines recorded and reviewed?
This was an announced comprehensive inspection covering the premises and care, following the previous Requires improvement rating and four breaches found in October 2017. This explanation was written from the published report of 28 December 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 Appledown
4 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 30 September 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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