CQC report explained · a residential care home
What the CQC found at Applewood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention and control. This included visitors, admissions, personal protective equipment, testing, cleaning, ventilation and outbreak management.
- Effective?
- Good
- This area was not covered by this targeted inspection.
- Caring?
- Good
- This area was not covered by this targeted inspection.
- Responsive?
- Good
- This area was not covered by this targeted inspection.
- Well-led?
- Good
- This area was not covered by this targeted inspection.
What inspectors found, January 2021
Inspected but not rated; inspectors were assured about infection prevention and control during the coronavirus outbreak.
This was an unannounced, targeted inspection on 5 January 2021. It looked only at infection prevention and control because the home had been affected by coronavirus outbreaks.
Inspectors were assured that the home used personal protective equipment safely, arranged testing, cleaned regularly and managed visiting, admissions, social distancing and outbreaks. They also found people were supported to stay in touch with relatives and receive stimulation.
The home was not given an overall quality rating. The Safe question was marked 'Inspected but not rated', so this report does not provide ratings for the other areas of care.
Safe visiting arrangements
The home limited indoor visits during the outbreak and put safer arrangements in place when visits resumed, including booked appointments and health checks.
“The provider had in place effective measures, to ensure when visits resumed, these were safe.” from the report
Purpose-built visiting space
Staff created a visiting pod that could be cleaned, alongside garden visiting areas.
“Staff had designed and built a cleanable visiting 'pod' for visits within the service, for the safety of people, staff and visitors.” from the report
Contact with relatives
People were supported to keep in touch with relatives by telephone and the internet, with four iPads available.
“People were well supported by staff to have telephone and internet contact with their relatives.” from the report
Infection control practice
Inspectors were assured about the use of protective equipment, testing, cleaning, ventilation and outbreak management.
“We were assured that the provider was using PPE effectively and safely.” from the report
Monitoring people's health
Staff monitored oxygen levels during the outbreak and reported them to a virtual ward, supporting early action when people deteriorated.
“Staff monitored and reported people's oxygen levels to a 'virtual ward,' which enabled the early detection of deterioration in people and rapid intervention and treatment.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, including personal protective equipment, testing, cleaning and ventilation?
- 02How are visits arranged now, and are the visiting pod and garden areas still available?
- 03How will my relative keep in touch with family if indoor visits are restricted?
- 04What arrangements are used when someone is admitted, including isolation and monitoring for signs of illness?
- 05What are the home's current ratings or evidence for Effective, Caring, Responsive and Well-led, which this inspection did not cover?
This was an unannounced targeted inspection of infection prevention and control during a coronavirus outbreak; the service was inspected but not rated overall and the other care questions were not covered. This explanation was written from the published report of 16 January 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.
What inspectors found, February 2019
Rated Good, down from Outstanding; inspectors found safe, kind and personalised care, with staffing changes affecting morale and time for individual attention.
This was an unannounced, comprehensive inspection on 24, 25 and 28 January 2019. The inspector spoke with people living at the home, relatives, staff and health professionals. They also observed care and checked care plans, medicines, recruitment records, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from avoidable harm, received medicines safely, and had their health, nutrition and hydration needs supported.
Staff were described as kind, respectful and responsive. Care plans reflected people's lives, wishes and preferences. Activities, family contact and end of life care were also viewed positively.
The rating fell from Outstanding at the previous inspection in May 2016. This followed a change of manager, the departure of experienced staff and a period of lower morale. The new home manager was rebuilding the team, but there was not yet a registered manager in post.
Kind and respectful care
People were treated with compassion and their dignity was protected. Staff knew people well and used their life stories to support conversations and reassurance.
“People experienced positive, caring relationships with staff who treated them with kindness, respect and compassion.” from the report
Personalised support
Care plans included people's life histories, preferences, interests, communication needs and end of life wishes. People and families were involved in planning care.
“People actively contributed to the planning of their care.” from the report
Responsive healthcare
The home worked with GPs and other health professionals and made prompt referrals when people's needs changed. Staff followed professional guidance.
“We have good communication with the staff here, who make timely referrals when required,” from the report
Activities and family links
People were supported to take part in group and one-to-one activities, maintain friendships and stay in contact with relatives.
“Where people chose not to participate in group activities the activities team ensured they received individual one to one sessions,” from the report
Improving leadership
The new home manager had created a supportive culture and used audits, feedback and complaints to drive improvement.
“Quality assurance systems were in place to monitor the quality of service being delivered, which were effectively operated by the management team.” from the report
Staffing pressure and turnover
needs fixingA previous manager had left, followed by several experienced care staff. Staff said they sometimes had less time for meaningful conversations and highly personalised care, although inspectors found staffing sufficient for safe care.
“However, staff consistently told us that since our last inspection in May 2016 the level of staffing had meant that the amount of time they had to deliver highly personalised care had diminished.” from the report
No registered manager in post
needs fixingThe home manager was applying to become the registered manager, but this process was not complete when inspectors visited.
“Applewood did not have a registered manager in post.” from the report
Dementia training needed refreshing
minorThe impact of earlier dementia training had reduced because of staff turnover and changes in the people living at the home. The manager planned to repeat the training.
“At this inspection due to the turnover of staff and change of people using the service, the impact of this training had been diluted.” from the report
- 01How many experienced care staff have left since the inspection, and how have staffing levels and continuity changed?
- 02How do you make sure people receive enough one-to-one time and meaningful conversation when staff are busy?
- 03Has the manager completed the process to become the registered manager?
- 04Was the dementia training repeated, and how is staff understanding checked now?
- 05How are night staffing levels reviewed when two staff are needed to support someone?
This was an unannounced comprehensive inspection covering all five key questions, so all five ratings were assessed at this visit. This explanation was written from the published report of 28 February 2019 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 Applewood Care Home
2 rated inspections over 3 years: the service has slipped, from Outstanding to Good.
- January 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- February 2019Gooddown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Good
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 January 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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