CQC report explained · a residential care home
What the CQC found at Aynsley Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were generally protected by risk assessments, safe staffing, safeguarding procedures and improved medicines systems. However, homely remedies were not available, staff COVID-19 testing checks were incomplete, and further staff training was needed.
- Effective?
- Good
- This area was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- The manager and staff were described positively, but quality monitoring systems did not reliably identify problems or record completed actions. Records of care were also not always adequate.
What inspectors found, July 2022
Rated Requires Improvement; inspectors found safer care and kind staff, but quality checks and some medicines arrangements were still not reliable.
This was an unannounced follow-up inspection on 21 June 2022. Inspectors checked whether the home had acted on problems found at the previous inspection, focusing on Safe and Well-led. They spoke with people living there, relatives, staff and the manager, and reviewed care, medicines, staff and management records.
The home had improved since its previous inadequate rating. Medicines were generally given safely, there were enough staff, risks were usually assessed and managed, and the home appeared clean. People and relatives said they felt safe and were positive about the care and staff.
Important problems remained. Quality checks did not always find problems or show that action had been completed. There were no homely remedies available, records did not always show the care given, and there was no system to check that staff COVID-19 testing records were complete.
The overall rating and the ratings for Safe and Well-led were Requires Improvement. The home was no longer rated Inadequate or in Special Measures. The other three areas were not inspected during this visit, so their previous ratings were used.
Medicines usually given safely
Medicines records showed that medicines were given as prescribed. Staff administering medicines had training and competency checks.
“Medication administration records (MARs) were completed robustly and showed that medicines were given as prescribed.” from the report
Enough staff
There were enough staff during the inspection, and rotas showed that staffing levels were usually maintained. Most people and relatives said staff were available.
“There were enough staff on duty during the inspection and rotas showed these numbers were regularly maintained.” from the report
Clean environment
The home appeared clean and maintained. Cleaning schedules, infection control training and suitable protective equipment were in place.
“The home appeared clean and well maintained and cleaning schedules were in place to minimise any risk of infections being spread.” from the report
Kind and positive staff culture
People, relatives and staff gave positive feedback about the care, management and atmosphere. Staff were said to know residents well.
“The culture of the service helped ensure good outcomes for people.” from the report
Quality checks did not find or track all problems
seriousAudits missed issues found by inspectors, including staff testing and homely remedies. It was not always clear who knew about actions or whether they had been completed.
“The audits completed did not highlight all the issues identified during the inspection, such as those regarding the oversight of staff testing and lack of homely remedies.” from the report
Continued governance breach
seriousThe provider did not have effective systems to monitor quality and safety. This was a continued breach of Regulation 17.
“Lack of effective systems to ensure the quality and safety of the service is a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
No homely remedies available
needs fixingCommon medicines for minor ailments were not available when people might need them. CQC recommended that the provider review its procedures.
“There were no homely remedies available to people, which meant there was a risk medicines would not be available to people when they needed them.” from the report
Care records were incomplete
needs fixingSome records did not properly show how people had been supported. For example, repositioning records recorded when help was given but not how it was provided.
“Records were not always adequately maintained to evidence care provided to people.” from the report
COVID-19 testing checks
needs fixingThe home recorded staff COVID-19 testing, but did not have a system to check that all staff followed the guidance.
“However, there was no system in place to ensure records were checked to ensure all staff adhered to the guidance.” from the report
- 01What actions are being taken to fix the continued Regulation 17 breach, and how will you show that each action has been completed?
- 02How quickly can homely remedies be made available, and who checks that they remain available when people need them?
- 03How do you now check that all staff complete COVID-19 testing in line with current guidance?
- 04How are care records, including repositioning records, checked to make sure they show the support each person received?
- 05What further staff training has been completed or planned to meet all the needs of people living in the home?
This was a focused follow-up inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 21 July 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, May 2022
Aynsley Care Centre was rated Inadequate and placed in special measures; inspectors found serious problems with safety, medicines, infection control and oversight.
This was an unannounced inspection on 03 December 2021. Inspectors spoke with people living in the home, relatives, managers and staff. They reviewed care records, medicines records, staff recruitment files and management audits.
The home was not consistently safe. Risks were not always assessed or managed properly. Medicines were not always given as prescribed, records were inaccurate, infection control measures were not effective, and some safety checks and repairs were missing. Inspectors also found gaps in care information and staff training.
The home was not well-led. Its monitoring systems did not identify or follow up important problems. The service had no registered manager at the time. The overall rating and the ratings for Safe and Well-led were Inadequate. The provider submitted an action plan and made some changes straight away, but the service was placed in special measures.
People felt safe
People living in the home and relatives told inspectors they felt safe and were happy with the care.
“Feedback regarding care provided was very positive and people told us they felt safe living in the home.” from the report
Positive views of staff
People and relatives described staff as helpful and respectful. Relatives also said staff kept them informed about accidents and incidents.
“I'd recommend it because of the way they talk to residents. They treat my [relative] with respect” from the report
Prompt response during inspection
Managers responded to the inspectors' feedback and took action on some issues during or soon after the inspection.
“The manager and business managers were responsive during the inspection and took timely actions to address concerns raised.” from the report
Unsafe medicines management
seriousMedicines were not always given as prescribed. Storage temperatures, stock balances, administration records and staff competency checks were not reliably managed.
“Records showed that medicines were not always administered as prescribed.” from the report
Risks were not controlled
seriousImportant risks, including smoking, evacuation, diabetes, swallowing difficulties and COVID-19, were not always assessed or recorded well enough. One person received fluids without the required thickener, creating a choking risk.
“One person had been given fluids without them being thickened as required due to swallowing difficulties, placing them at risk of choking.” from the report
Poor infection control
seriousVisiting procedures and cleaning records were not reliable. Inspectors found missing evidence about staff testing, temperature checks and vaccination or exemptions for staff and professional visitors.
“Appropriate infection prevention and control measures were not in place to prevent the spread of infection.” from the report
Weak oversight
seriousAudits did not identify or follow up serious issues. There was no reliable system covering all the risks and safety of the service.
“The systems in place to monitor the quality and safety of the service were not effective.” from the report
Safety checks and repairs
seriousThe home needed repairs and records did not show that all required fire, water and other safety checks had been completed recently.
“There were several repairs needed around the home, one room posed a fire risk due to it being overfilled with boxes and furniture” from the report
- 01What has been done to ensure medicines are stored at safe temperatures, given as prescribed and checked accurately?
- 02How are individual risks now recorded and managed, including swallowing difficulties, diabetes, smoking and emergency evacuation?
- 03What evidence can you show that COVID-19 testing, temperature checks, PPE and vaccination or exemption checks are being completed?
- 04How do you decide how many staff are needed on each shift for the people currently living in the home?
- 05What changes have been made to the audit system, and how do you prove that identified actions are completed?
This inspection rated Safe and Well-led only; no ratings were given for Effective, Caring or Responsive in this report. This explanation was written from the published report of 17 May 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 Aynsley Care Centre
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2022Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- September 2018Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- August 2017Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- March 2013
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 19 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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