CQC report explained · a nursing home
What the CQC found at Astor Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2019
Rated Good; inspectors found safe, kind and personalised care, with a few minor gaps around dementia support and records.
This was an unannounced inspection carried out over 8 and 11 April 2019. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care, medicines and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, well-managed medicines and care that was kind and tailored to people's needs.
The home had improved since the previous inspection, when it was rated Requires Improvement and had three breaches of regulations. At this inspection, the provider was no longer in breach.
Kind and respectful staff
People and relatives described staff as kind, warm, friendly and respectful. Staff knew people well and supported their dignity and independence.
“People and relatives told us staff were kind and treated them well.” from the report
Personalised care
Care plans included people's personality, preferences, likes, dislikes and previous experiences. Staff had clear information about how each person should be supported.
“Care was planned to take into account people's personality, behaviour, likes, dislikes and previous experiences.” from the report
Creams and lotions records
minorRecords showing when staff had applied creams and lotions were still inconsistent. The registered manager was monitoring this closely.
“Records about when staff had applied people's creams and lotions was still varied, but the registered manager monitored this closely.” from the report
Dementia-friendly food choices
needs fixingPeople were asked verbally about food choices, which inspectors said did not best suit people living with dementia. The registered manager said they would look into better practice.
“They were verbally asked their choices which did not best suit the needs of people with dementia.” from the report
Bedroom signage
minorSome bedroom doors did not have visual signs to show whose room it was. The registered manager said this would be reviewed.
“Some bedroom doors had not visual signs to indicate whose room it was.” from the report
Activities information
minorActivities had improved after a period when staff sickness limited what was available. Relatives were not always sure what activities and events were planned.
“Relatives told us they were not always sure what was planned.” from the report
- 01How are you checking that creams and lotions are applied and recorded every time?
- 02How do you offer food choices in a way that works well for people living with dementia?
- 03What visual signs are now used to help people identify their bedrooms?
- 04How do you make sure activities continue when staff are absent or off sick?
- 05How are relatives told in advance about planned activities and events?
This was an unannounced planned inspection covering all five CQC questions, following the previous Requires Improvement rating. This explanation was written from the published report of 6 July 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.
What inspectors found, April 2018
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, consent and management checks were not reliable enough.
This was an unannounced inspection on 19 and 21 February 2018. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicine records, recruitment files, complaints and quality checks.
People generally felt safe and said there were enough staff. Inspectors found safe recruitment, appropriate safeguarding referrals, suitable food and regular access to health professionals. However, some medicines were not given as prescribed, including eye drops, tablets and a skin cream.
Care was rated Good because staff were patient, respectful and considerate. Responsiveness was also Good, although some care plans lacked detail and there was no activities worker in post. Effective and well-led care were rated Requires Improvement because consent and best-interest decisions did not always follow the law, and management audits had missed or not dealt with problems.
The overall rating was Requires Improvement. This was worse than the previous Good rating in December 2015. There was no registered manager at the inspection, although a new manager had been in post for about four weeks.
People felt involved
People and relatives said they were involved in care decisions and reviews where appropriate.
“People and relatives we spoke with told us they were involved in care decisions.” from the report
Staff training
Records showed good completion of mandatory training, with supervision and appraisals taking place.
“Records indicated there had been good uptake of mandatory training.” from the report
Food and dietary support
People were happy with the meals and drinks. Staff and kitchen workers knew about individual dietary needs, including pureed and diabetic diets.
“We observed the food to be appetising, well cooked and hot.” from the report
Medicines were not always safe
seriousInspectors found that medicines were not always given as prescribed. This included missed doses and incomplete records, creating a risk that people did not receive the right treatment.
“We found some people were not receiving their medicines as directed by the doctor or the pharmacist.” from the report
Consent decisions were not always lawful
seriousSome relatives signed consent forms without the right legal authority. Best-interest decisions did not always show that the least restrictive option had been considered, and staff did not always understand the process.
“We found the service was not always working within the requirements of the MCA, with regard to consent, capacity and best interests decisions.” from the report
Quality checks missed problems
seriousAudits did not identify the medicine and consent issues found by inspectors. Actions recorded in care file audits had also not always been completed.
“This meant quality audits were not undertaken robustly and where checks had taken place action was not always taken to address the issues identified.” from the report
Some care plans lacked detail
needs fixingSome plans did not explain clearly enough how staff should provide particular personal care or respond when a person became anxious.
“Some care plans did not always contain detail to assist staff to deliver personal care.” from the report
No activities worker in post
minorPeople said there could be more activities. Some events were provided, but the activities worker vacancy had remained unfilled.
“At the time of the inspection there was no activities co-ordinator employed at the home.” from the report
- 01How are you now checking that every medicine, including creams and eye drops, is given at the prescribed time and dose?
- 02What process do you use to check who has legal authority to give consent for a person's care?
- 03How do you record and review best-interest decisions, including whether the option chosen is the least restrictive?
- 04Who now checks the quality audits, and how do you make sure identified actions are completed promptly?
- 05What activities are currently available, and has the activities worker post been filled?
This was an unannounced inspection covering the home, the care provided and all five CQC question areas; inspectors reviewed four care records and 20 medicine administration records. This explanation was written from the published report of 11 April 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 Astor Court
3 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 14 October 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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23 live-in carers within about an hour of Northumberland
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,190 a week. 20 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.