CQC report explained · a nursing home
What the CQC found at Autumn Vale Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, there were enough staff and medicines were well managed. Risks, accidents, fire safety and infection control were checked and acted on.
- Effective?
- Good
- Staff had relevant training and people had access to health professionals. Inspectors found that people's dietary needs were known, although food and fluid charts were not always completed at the time.
- Caring?
- Good
- People said staff were caring and respectful. Staff supported privacy, dignity, independence, personal choices, faith and relationships.
- Responsive?
- Good
- Care plans reflected people's needs and preferences. People enjoyed activities and outings, and complaints were recorded, monitored and acted on.
- Well-led?
- Good
- People, relatives and staff gave positive feedback about the management team. Audits, meetings and development plans were used to monitor quality and improve care.
What inspectors found, August 2019
Autumn Vale Care Centre is rated Good; inspectors found safe, kind care and strong activities, but food and fluid records were not always completed at the time.
This was an unannounced inspection on 23 July 2019. One inspector and an expert by experience spoke with people, relatives, staff and managers. They observed care and checked care records, medicine records, recruitment files, audits and other documents.
The home provided personal and nursing care for 61 older people, with space for up to 69. Inspectors found enough staff, safe medicines practice, clean surroundings and suitable risk checks. People were treated with kindness, dignity and respect, and were involved in decisions about their care.
People enjoyed the food, activities and outings. Staff worked with health professionals and supported people at the end of life. Inspectors found effective management, complaints handling and quality checks. However, food and fluid charts were not always completed when people ate or drank, and pureed food was not being served using the available moulds.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This was an improvement from Requires Improvement at the previous inspection, published on 24 July 2018.
Enough staff
People received support promptly, and inspectors found that staffing levels met people's needs. Call bell response times were monitored.
“People received support in a timely manner. Call bell analysis was completed by the manager to ensure people were not waiting for extended periods.” from the report
Kind and respectful care
Staff knew people as individuals and supported their dignity, privacy, independence and choices.
“There was a calm and friendly atmosphere at the home. There was relaxed and easy conversation between people and staff with staff being attentive and reassuring people when they required support.” from the report
Activities and inclusion
People took part in activities, outings and social events. Staff supported even people receiving palliative care to attend activities if they wished.
“There were activities going on throughout the inspection. One of these was a singer who visited the home. The event was exceptionally well attended with the majority of people in the home joining in.” from the report
Improved leadership
Inspectors found a clearer management structure and a more open, team-based culture. Quality checks and action plans were being used to improve the service.
“At this inspection the service has improved its rating to Good in all KLOES.” from the report
Medicine safety
Medicines were given as prescribed, records matched stock levels and staff training and competency were checked.
“People received their medicines when needed and confirmed this.” from the report
Food and fluid records
needs fixingFood and fluid charts were not always completed when people ate or drank. Staff completed some records later, and the managers took immediate action after inspectors raised this.
“However, we did note that food and fluid charts were not completed when people ate or drank.” from the report
Presentation of pureed food
needs fixingPureed meals were served using an ice cream scoop instead of the available moulds. Inspectors said this was not best practice for making the food look appetising.
“However, pureed food was still not served using the available moulds but using an ice cream scoop.” from the report
- 01How do you now make sure food and fluid charts are completed when people eat or drink, rather than later?
- 02Are pureed meals now served using the available moulds, and how do you check their presentation?
- 03What changes have been made since the previous Requires Improvement rating, and how are these changes monitored now?
- 04How are staffing levels and call bell response times checked on each unit?
- 05How will you involve my relative and our family in care planning and decisions about activities, food and end of life care?
This was an unannounced comprehensive inspection covering all five key questions, and the report says the previous Requires Improvement ratings improved to Good, while Caring remained Good. This explanation was written from the published report of 14 August 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, July 2018
Autumn Vale Care Centre was rated Requires Improvement; inspectors found kind care but serious inconsistencies in safety, records, staffing and management.
This was an unannounced inspection on 3 May 2018, followed by an announced visit on 10 May because inspectors found concerns on the first day. They spoke with people, relatives, staff and health professionals, observed care, and reviewed nine people's care records.
The home was rated Good for Caring. People said staff were kind, respectful and knew them well. Staff supported people's dignity, privacy, food and access to health professionals.
The home was rated Requires Improvement overall and in Safe, Effective, Responsive and Well-led. Inspectors found unsafe moving and handling on some occasions, incomplete risk and care records, gaps in mental capacity and liberty safeguards, limited activities, and weak leadership checks. Managers took action during the inspection, but inspectors said many problems had not been found by the home's own audits.
Kind and respectful staff
People described staff as kind and respectful. Inspectors saw calm, personal support when people were upset or needed help.
“People were cared for in a kind and compassionate way by staff who knew them well and were familiar with their needs.” from the report
Dignity and privacy
Staff knocked before entering rooms and supported people discreetly with personal care and changing clothes.
“Care was provided in a way that promoted people's dignity and respected their privacy.” from the report
Medicines generally managed safely
Inspectors found that people received medicines as prescribed and that medicines were stored securely, although they also found some medicines-record concerns.
“People's medicines were generally managed well in the home and people received their medicines as required.” from the report
Access to health professionals
People were supported to see professionals such as GPs, district nurses, dieticians, chiropodists and mental health specialists when needed.
“People had access to health and social care professionals as needed.” from the report
Managers acted during the inspection
Managers corrected several issues during the inspection, including moving and handling arrangements, pressure mattress settings and some liberty safeguard applications.
“Although the manager took swift action to make improvements and mitigate the risks to people's health and wellbeing” from the report
Unsafe transfers and equipment use
seriousInspectors saw people being moved without the equipment required in their assessments. One person was placed at significant risk of falling and injury.
“The actions of this unit lead clearly placed the person at significant risk of falling and injury.” from the report
Incomplete risk and incident records
seriousBruising and skin tears were not always fully recorded or investigated. Staff were not always told about incidents so they could prevent a repeat.
“Incidents were not consistently documented, investigated or shared with staff in a way that would enable them to learn from the incident” from the report
Mental capacity safeguards
seriousSome decisions were not supported by the required records or authorisations. This included covert medicines, bed rails and leaving the building.
“We found that DoLs authorisations had not been submitted for those people who had their medicines administered covertly.” from the report
Care plans did not reflect people
needs fixingCare plans were often task-focused and did not clearly explain people's preferences or how they wanted support. Some reviews repeated the same wording without showing people's involvement.
“Care plans contained tick box entries and pre- populated text fields which meant that staff selected the area of support people required help with” from the report
Limited activities and outdoor access
needs fixingActivities were not consistent, especially for people who stayed in their rooms. The gardens and paths were poorly maintained and were not safely accessible.
“Social activity and inclusion was limited and not consistent across the home.” from the report
Unsettled leadership
needs fixingThe home had employed three managers since registering under the new provider. Staff morale was low, and audits had failed to identify several issues found by inspectors.
“Autumn Vale lacked leadership from a consistent manager having employed three managers since the service registered in May 2017.” from the report
- 01What has been done to ensure every person's moving and handling assessment is followed, and how is staff practice checked?
- 02How are pressure mattress settings checked and recorded for each person who needs one?
- 03How are incidents such as choking, bruising and falls investigated and shared with all relevant staff?
- 04Have all Mental Capacity Act assessments and Deprivation of Liberty Safeguards applications been completed for people receiving covert medicines or using bed rails?
- 05What regular activities, resident meetings and family meetings are now available, especially for people who spend much of the day in their rooms?
This was a full inspection of all five areas, covering care and the premises; it was the first inspection of the home under the new provider, and the second visit checked action taken after concerns found on the first day. This explanation was written from the published report of 24 July 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 Autumn Vale Care Centre
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017
Registered with the Care Quality Commission on 8 May 2017.
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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