CQC report explained · a nursing home
What the CQC found at Azalea Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, medicines, staffing and infection control were generally managed safely. They found no evidence of harm from the concerns that prompted the inspection.
- Effective?
- Good
- People had good support with nursing care, healthcare appointments, eating and drinking. However, some care records were incomplete and staff did not support three people with their meals in line with best practice.
- Caring?
- Good
- This question was not separately rated in the report. Inspectors described staff as kind and caring, and people and relatives were generally happy with their care.
- Responsive?
- Good
- This question was not separately rated in the report. Inspectors found that care plans covered people's needs and wishes, and that the home offered activities and ways for people and relatives to give feedback.
- Well-led?
- Good
- Inspectors found effective management oversight, audits and daily leadership meetings. The management team acted promptly when inspectors raised problems.
What inspectors found, March 2023
Rated Good; inspectors found safe, kind and well-managed care, but identified gaps in pain plans, care records and mealtime support.
Inspectors visited the home without notice on 10 February 2023. Inspection activity continued until 15 February. They spoke with people, relatives and staff, visited all four units, observed mealtimes and reviewed care, medicines, recruitment and management records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found that medicines, staffing, risk management and infection control were generally managed safely. People received good nursing care and staff were described as kind and caring.
The inspection was prompted by concerns about a serious injury and the care of people with tracheostomies. Inspectors found no evidence that people were at risk of harm from these concerns. They did find some problems with pain management plans, care records and support at three mealtimes, which the management team said they would address.
Safe medicines
Medicines were stored, administered and recorded safely overall. Staff were trained and assessed as competent before giving medicines.
“Other than the above example, staff followed best practice in administering and recording medicines.” from the report
Good nursing care
Inspectors found good support with nursing needs and good wound care. They saw evidence that pressure ulcers and other wounds improved with treatment.
“Wound care in the home was good and there was a clinical lead who oversaw all wound treatment plans.” from the report
Kind and respectful staff
Staff supported people in a respectful, person-centred way. Inspectors saw people being offered choices and supported to remain as independent as possible.
“We observed staff respecting people's wishes to be independent and supporting them in a respectful way whilst still ensuring their safety.” from the report
Strong management oversight
The home had clear management roles, regular audits and daily leadership meetings. The management team responded quickly when inspectors raised issues.
“There were effective systems in place to oversee the running of the home and quality of care provided.” from the report
Staff training and support
Staff had completed required training and received additional support for specialist needs, including tracheostomy care and dementia support.
“Staff were suitably trained and supported to carry out their duties effectively.” from the report
Pain plans
needs fixingTwo people's pain care plans did not give enough guidance. On the inspection day, one person was in pain and did not receive pain relief before personal care as advised by their GP.
“There was not enough information in the pain management care plans for 2 people to advise staff how to effectively manage their pain.” from the report
Incomplete care records
needs fixingSome records did not consistently show that care and observations had been completed. The manager said the care had been provided but not recorded.
“Records of care and treatment were not consistently completed.” from the report
Mealtime support
needs fixingInspectors saw three examples where people were not supported with their meals in line with best practice. The manager planned additional staff training.
“We saw three examples where staff did not support people with their meal in line with best practice.” from the report
Some dirty carpets
minorTwo people were unhappy about dirty carpets. The home was already replacing flooring as part of a refurbishment programme.
“2 people told us they were not happy with their carpets as they were dirty” from the report
- 01How have you improved the two pain management care plans, and how do you check that people receive pain relief before personal care when this is needed?
- 02What checks now make sure repositioning, oxygen levels, respiration rates and signs of pain are recorded consistently?
- 03What training was given after inspectors saw three examples of poor mealtime support, and how is staff practice now monitored?
- 04Which flooring has been replaced since the inspection, and when will the remaining refurbishment work be completed?
- 05How do you make sure staff supporting people with tracheostomies follow the emergency procedure and have up-to-date training?
This inspection focused on the concerns that prompted it and rated Safe, Effective and Well-led; Caring and Responsive were not separately rated in this report. This explanation was written from the published report of 23 March 2023 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, November 2021
Azalea Court was rated Good; inspectors found kind, safe care, but medicine supply and oversight problems needed attention.
This was an unannounced focused inspection on 27 and 28 October 2021. Inspectors reviewed safe, effective and well-led care because concerns had been raised about nursing needs, staffing and staff morale. They spoke with people, relatives, staff and a healthcare professional, observed care and reviewed records.
The overall rating was Good. People were seen receiving caring support, and inspectors found suitable safeguarding, risk management, infection control, staffing and recruitment arrangements. Staff were trained and people’s care, health, nutrition and consent needs were generally well managed.
Inspectors found six examples where people had not received medicines as prescribed because supplies had not been ordered in time or were out of stock. They found no evidence that people had been harmed, but the home’s checks had not identified the problem quickly enough. A recommendation was made to improve medicine oversight.
Kind and respectful care
Inspectors observed care that was compassionate, person-centred and respectful. People and relatives said staff understood their needs and involved them in decisions.
“Throughout the inspection we observed people to be supported by care staff with care and compassion.” from the report
Good infection control
The home was clean and had processes for cleaning, COVID-19 safety, protective equipment and visiting. Inspectors found the service had managed infection risks well.
“People were protected from the risks associated with the spread of infection. The service was clean and well maintained.” from the report
Trained staff
Staff received induction, regular training, supervision and appraisal. Specialist training was also provided for people’s particular needs.
“Staff received appropriate induction, training and support and applied learning effectively in line with best practice.” from the report
Personalised care planning
Care plans recorded people’s needs, choices and preferences. Staff knew people well and worked with healthcare professionals when support was needed.
“Care plans in place detailed people's needs and preferences. Staff knew people and their care needs well.” from the report
Medicines were not always available
seriousInspectors found six examples where people did not receive medicines as prescribed because supplies were out of stock or had not been ordered promptly. The provider acted during the inspection, and no harm was found, but this could put people at risk.
“However, during this inspection we identified six examples of where people had not received their medicines as prescribed.” from the report
Medicine checks missed problems
needs fixingThe home’s audits did not always identify or record medicine supply problems. Inspectors recommended stronger medicine governance and oversight.
“There was a lack of management oversight of this issue which led to certain people not receiving their medicines as prescribed.” from the report
Staffing pressure reported
needs fixingSome staff said there were often too few staff, especially on certain shifts. Inspectors saw enough staff during the visit, and managers said they were reviewing staffing levels.
“We are short staff majority of the time. There is supposed to be five depending on who the staff are that's a good day, but a majority of the time its four, it does set us back” from the report
Mixed views about food
minorMost people spoke positively about the food, but some people felt it lacked flavour or was not prepared as they wanted. Managers were given this feedback for consideration.
“The food is often too salty or too sweet. On Saturday I asked for a bacon sandwich and it was not cooked fully and there was no tomato sauce” from the report
- 01What changes have been made to medicine ordering, stock checks and audits since the inspection?
- 02How do you make sure medicines are available when people need them, including when there are supply problems from the pharmacist?
- 03What staffing levels are planned for each shift, and what happens when the home is short-staffed?
- 04What action has been taken in response to people’s mixed feedback about the food?
- 05Have satisfaction surveys now been sent to people, relatives and stakeholders, and what did the results show?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were used. This explanation was written from the published report of 27 November 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.
Every inspection of Azalea Court
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2021GoodSafe: GoodEffective: GoodWell-led: Good
- September 2020Inspected but not ratedSafe: Inspected but not rated
- March 2020Goodstayed GoodSafe: Requires improvementEffective: GoodWell-led: Good
- April 2018Goodstayed GoodSafe: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- May 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.
- August 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 14 March 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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