CQC report explained · a residential care home
What the CQC found at Appletree House Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks, safeguarding, medicines, staffing and infection control were generally managed safely. Some communal floor and wall coverings and hand rails were difficult to clean, and fire safety actions were still being addressed.
- Effective?
- Good
- People received suitable food, drink, healthcare support and staff training. The home supported people to make choices and followed the Mental Capacity Act and deprivation of liberty procedures.
- Caring?
- Good
- Inspectors saw warm and positive relationships. People were treated with kindness, dignity and respect and were involved in decisions about their care.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People could take part in activities, keep in touch with relatives and raise complaints or concerns.
- Well-led?
- Good
- Quality checks and records had improved, and the new electronic care system supported more organised care. People, relatives and staff gave positive feedback about the management and the changes made.
What inspectors found, November 2022
Rated Good; inspectors found safe, kind and personalised care, with some outstanding issues about the building.
This was an unannounced follow-up inspection on 17 October 2022. One inspector reviewed records, checked the premises and watched care in communal areas. They spoke with eight people, four staff and five relatives, and reviewed care, medicine and recruitment records.
All five areas were rated Good: safe, effective, caring, responsive and well-led. People said they felt safe and were treated kindly. Inspectors found that risks and medicines were managed safely, staffing was sufficient, and care plans gave staff detailed guidance about people's needs and preferences.
The home had improved since the previous inspection, which was rated Requires Improvement overall. Previous breaches and registration conditions were no longer in place at this inspection. Inspectors did note that some communal surfaces were difficult to clean, the furnishings looked tired, and there was only one bath and no shower.
Safe care and medicines
Inspectors found that risks were assessed, medicines were administered safely and accidents were followed up appropriately.
“People received their medicines safely. Since the last inspection improvements had been made to the way medicines were managed.” from the report
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors observed compassionate support and warm, friendly interactions.
“People were supported in a respectful and dignified way. We observed staff were very compassionate when supporting people.” from the report
Personalised care
Care plans reflected people's health needs, preferences, independence and spiritual needs. People were involved in planning and reviewing their care.
“Support plans were personalised and provided guidance to staff on the level of care and support each person needed, and in the way they preferred.” from the report
Food and drink
People had choices at mealtimes, specialist diets were provided and drinks and snacks were readily available.
“People had unlimited access to cold beverages from a drink station in the dining room and we observed people were frequently offered hot drinks and snacks.” from the report
Improved management
The home had stronger quality monitoring and more accurate records than at the previous inspection.
“Quality assurance processes and governance audits were robust and actions arising were followed up.” from the report
Communal surfaces
minorSome floors, walls and hand rails were difficult to wipe clean and sanitise. Inspectors signposted the provider to resources to improve its approach.
“Floor and wall coverings and hand rails in some communal areas were difficult to wipe clean and sanitise.” from the report
Bathing facilities
needs fixingThe home had one bath and no shower. Some people said a shower would be helpful, and the manager said a downstairs wet room was planned.
“The service has one bath and no shower facilities.” from the report
Building condition
minorInspectors described some decoration and furnishings as tired. A programme of redecoration, repairs and improvements had started.
“We observed the decoration and furnishing were tired.” from the report
Fire safety actions
needs fixingThe provider was still addressing actions from a recent fire safety inspection. Personal evacuation plans were in people's care records.
“The provider was addressing actions arising from a recent fire safety inspection to ensure people were safe in the event of a fire.” from the report
- 01Has the planned downstairs wet room now been installed, and what bathing options are available meanwhile?
- 02Have all actions from the recent fire safety inspection been completed, and can you explain the evacuation arrangements for my relative?
- 03What work has been completed to replace or improve the communal floor, wall and hand rail coverings?
- 04How do you maintain safe staffing levels while there are care staff vacancies and occasional agency use?
- 05How are care plans and electronic records checked to make sure they remain accurate and up to date?
This was an unannounced follow-up inspection covering all five key questions, including infection prevention and control, after the previous inspection found breaches. This explanation was written from the published report of 4 November 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, September 2021
Rated Requires Improvement; inspectors found unsafe risk and medicines practices, and rated leadership Inadequate.
This was an unannounced focused inspection on 7 June 2021. The inspectors spoke with people, staff and relatives, reviewed care and medicines records, and checked infection control and management systems.
The home was rated Requires Improvement overall. Safe was rated Requires Improvement because risks were not always assessed or managed, medicines were not stored and recorded safely, and some infection control arrangements increased the risk of COVID-19 spreading.
Well-led was rated Inadequate. The systems for checking quality and keeping records accurate had not found or fixed important problems. The home had been rated Requires Improvement at the previous inspection and had not made enough improvement. This was the fourth consecutive inspection with that rating.
Inspectors also found kind and respectful staff, enough staff to meet people's personal care needs, and systems to protect people from abuse. The other three key questions were not inspected during this visit, so their earlier ratings were carried forward.
Kind staff
People and relatives described staff as kind, caring, friendly and respectful. Inspectors observed positive relationships between staff and people.
“People were treated with kindness and compassion and staff were friendly and respectful.” from the report
Enough staff
Inspectors observed enough staff on duty to meet people's personal care needs. Recruitment checks were also carried out safely.
“Our observations were there were enough staff on duty to meet people's personal care needs.” from the report
Safeguarding
Staff knew how to recognise and report possible abuse. Safeguarding training and refresher arrangements were in place.
“Systems and processes protected people from the risk of abuse.” from the report
Mental capacity processes
The home had improved its processes for assessing capacity and recording best-interest decisions. It was no longer in breach of the consent regulation from the previous inspection.
“At this inspection enough improvement had been made and the provider was no longer in breach of Regulation 11.” from the report
Risks not properly assessed
seriousSome care plans did not explain how staff should manage serious risks, including seizures, diabetes, choking and head injuries. This could mean staff missed signs of deterioration or did not provide consistent care.
“There was an increased risk that people could be harmed.” from the report
Medicines management
seriousMedicines were found on an open shelf and in an unlocked fridge. Records for controlled medicines and as-needed medicines contained discrepancies, creating a risk that medicines might not be properly accounted for or recorded.
“There was a failure to ensure the proper and safe management of medicines.” from the report
Unsafe or unsuitable environment
needs fixingInspectors found threadbare stair carpets, soiled garden furniture and an open penknife in the manager's office. Seagulls also affected the use of some patio doors and bedroom ventilation.
“The provider had not always ensured the premises were safe for people to use and free of potential hazards.” from the report
- 01What risk assessments and care plans are now in place for people with seizures, diabetes, choking risks or recent head injuries?
- 02How are medicines now stored, returned to the pharmacy and recorded, including controlled medicines and as-needed medicines?
- 03What changes have been made to visiting arrangements, cleaning schedules and ventilation since the inspection?
- 04How do managers check that care plans and daily records are accurate and kept up to date?
- 05What conditions were proposed for the provider's registration, and what progress has been made on the required action plan?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 25 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.
Every inspection of Appletree House Residential Care Home
6 rated inspections over 7 years: the service has held its Good rating throughout.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Appletree House Residential Care Home →
- September 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at Appletree House Residential Care Home →
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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