CQC report explained · a nursing home
What the CQC found at Asmall Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks, accidents, safeguarding, infection control and medicines were generally managed safely. Two people did not have guides for staff administering their when-required medicines, but the manager acted on issues found during the inspection.
- Effective?
- Good
- People were supported with food, drink, health needs, training and consent. Inspectors observed staff asking permission and found improvements in nutrition management and Mental Capacity Act processes.
- Caring?
- Good
- People were treated with kindness, dignity and respect, and were involved in decisions about their care. Inspectors also heard some concerns about staff awareness and whether people's preferred gender of care worker was always provided.
- Responsive?
- Good
- Care plans reflected people's needs, choices, communication needs and end-of-life wishes. One care file needed completion and not everyone was seen taking part in activities during the inspection.
- Well-led?
- Good
- The home had strong monitoring, audits, meetings and systems for learning from incidents and complaints. People and staff gave positive feedback, although one person said they had not been asked for feedback for some time.
What inspectors found, November 2022
Asmall Hall was rated Good overall; inspectors found kind, safe care and clear improvements since the previous inspection, with some records and activity provision needing attention.
This was an unannounced inspection on 23 September 2022. Inspectors spoke with people living at the home, relatives, staff and professionals. They observed care and checked care files, medicines records, staff files, training records, audits and the building.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks, safeguarding, medicines, infection control and staffing were generally managed well. People were treated with kindness, involved in decisions and supported with their individual needs.
The home had improved from Requires Improvement at the previous inspection, published in January 2020. The provider was no longer in breach of the regulations identified previously. Inspectors still found some smaller shortfalls, including missing guidance for two people's when-required medicines, one care file needing completion and not everyone taking part in activities during the inspection.
Improved safety systems
The home had improved its approach to risk management, accidents, safeguarding and medicines since the previous inspection. Inspectors found the provider was no longer in breach of Regulation 12.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.” from the report
Kind and respectful care
Inspectors observed kind interactions. People were supported to make choices, give consent and maintain their dignity and independence.
“We observed very kind and caring interactions and care support taking place.” from the report
Good staff training
Training, induction, supervision and competency checks were recorded and monitored. Staff had training relevant to people's individual needs.
“Electronic records confirmed the training undertaken by the staff.” from the report
Good food and nutrition support
People gave positive feedback about the food. The home recorded special diets, monitored people's weights and involved health professionals when needed.
“We observed it was a positive dining experience for people.” from the report
Strong management oversight
The home used regular audits, meetings and an electronic monitoring system. Records showed actions taken after checks, complaints and incidents.
“The provider had developed a detailed, excellent electronic system to monitor and support the management and oversight of the service.” from the report
Medicine guidance
needs fixingTwo people did not have written guides to help staff give their when-required medicines. Inspectors said other medicine records were generally up to date.
“However, two people did not have guides to help staff administer 'when required' medicines.” from the report
Care records
needs fixingOne person's care file was not complete when inspectors checked it. The manager acted immediately to complete it.
“They took immediate action to ensure this was completed, this would ensure staff had access to up to date information about people's needs.” from the report
Activities
minorThe home provided activities and had evidence of a wider programme, but inspectors did not see everyone taking part during their visit.
“Not all people were noted to be undertaking activities during the inspection.” from the report
Staffing feedback
needs fixingInspectors saw plenty of staff and staff said numbers were sufficient. However, some people and relatives said the home was not always sufficiently staffed.
“However, not all people and relatives confirmed sufficient staff were in place.” from the report
Communication aids
minorPeople's communication needs were recorded and supported, but one relative said their family member's glasses were often missing.
“One person fedback that their relative's glasses were often missing.” from the report
- 01How do you check that every person's care file is complete and reflects their current needs?
- 02What written guidance is now in place for the two people who need when-required medicines?
- 03How will you make sure my relative has regular activities suited to their interests and abilities?
- 04How do you monitor staffing levels when permanent staff are unavailable and agency staff are used?
- 05How will you make sure glasses, hearing aids and other communication aids are available when people need them?
This was an unannounced inspection covering all five key questions, including infection prevention and control under Safe. This explanation was written from the published report of 11 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, February 2022
Inspected but not rated; inspectors found strong infection control, safe visiting arrangements and a clean home.
This was an announced, targeted inspection on 25 January 2022. Inspectors looked at infection prevention and control, visiting arrangements and whether staffing pressures linked to COVID-19 were affecting care.
The home had infection control policies, testing arrangements and measures for isolation, shielding and social distancing. Staff were using personal protective equipment correctly, and inspectors found the home clean and hygienic.
Relatives spoke positively about visiting. The home checked visitors and professionals before entry, and non-exempt staff and visiting professionals were vaccinated against COVID-19.
The service was inspected but not rated. This means the report does not give a full quality rating for the home or a rated judgement on all five areas.
Infection control
Inspectors found clear infection control guidance, appropriate testing and isolation arrangements, and staff using PPE correctly.
“We were assured that the provider was using PPE effectively and safely.” from the report
Visiting arrangements
Relatives were positive about the visiting process. The arrangements were designed to reduce the risk of infection while allowing visits.
“Relatives we spoke with were very complimentary about the visiting arrangements, which enabled them to safely spend some time with their loved ones.” from the report
Clean environment
The home was clean and hygienic, with cleaning schedules and PPE stations available throughout the building.
“The environment was clean and hygienic throughout and fully stocked PPE stations were provided in the entrance hall and at intervals throughout the home.” from the report
Entry checks
The home had a booking-in system for checking staff and visiting professionals, including their vaccination status where required.
“We noted the booking in system to be robust to ensure thorough checks were conducted before people accessed the home.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current visiting arrangements, and what PPE or booking requirements are still in place?
- 02How do you currently manage COVID-19 outbreaks, testing and isolation?
- 03What are the current staffing levels, and how would staff shortages affect my relative's care?
- 04How do you check vaccination or exemption status for staff and visiting professionals?
- 05When was the home last given a full CQC rating covering caring, effective care, responsiveness and leadership?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it was not a full inspection of all five key questions and the service was not rated. This explanation was written from the published report of 16 February 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.
Every inspection of Asmall Hall
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Inspected but not ratedSafe: Inspected but not rated
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016
Registered with the Care Quality Commission on 19 September 2016.
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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