CQC report explained · a residential care home
What the CQC found at Calder View
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Staffing levels were sometimes lower than required. Medicines processes, recruitment checks and infection control practices needed improvement, although risk assessments were in place and no harm was identified from the issues found.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Requires improvement
- Management checks did not identify all the problems found with medicines, infection control and recruitment. The provider had not completed the requested provider information return, and one incident had not been reported properly.
What inspectors found, November 2022
Requires Improvement; inspectors found some safe care, but medicines, staffing and oversight needed improvement.
This was an unannounced focused inspection on 29 September and 4 October 2022. Two inspectors visited the home, spoke with people, a relative and staff, and checked care, medicines, recruitment and management records.
The home was clean and tidy. People had appropriate risk assessments, medicines stock counts matched records, and people were supported to have visitors. Staff supported people to make choices and worked with other agencies.
However, staffing was sometimes below the required level. Medicines information and records were not always complete or followed correctly. Staff were not wearing masks when inspectors arrived, although this was corrected immediately. One safeguarding incident had not been reported when it should have been.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The home breached Regulation 17 on good governance, and CQC asked the provider for an action plan and said it would continue monitoring the service.
Clean home
Inspectors found the home clean and tidy, with no other infection prevention and control concerns.
“The home was clean and tidy and we found no other IPC concerns.” from the report
Risk assessments
Environmental and personal risk assessments were in place, including fire, legionella and health-related risks.
“Appropriate environmental risk assessments were in place including fire risk assessments and legionella risk assessments.” from the report
Choice and least restriction
People were supported to make choices and care was provided within the principles of the Mental Capacity Act.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Partnership working
Staff worked with the local authority, health professionals and other agencies to support people.
“Staff worked in partnership with the local authority, various other agencies and health professionals to ensure people received appropriate support.” from the report
Staffing and recruitment
needs fixingStaffing was sometimes slightly below the required level. Recruitment files did not contain full employment histories, so CQC recommended a review of recruitment processes.
“Staffing levels were at times slightly lower than required.” from the report
Medicines records and guidance
seriousGuidance for medicines given when needed was not always available. A handwritten medicines record had not been signed by two staff as required by national guidance.
“Information to support staff to safely administer 'when required' medicines was not always available” from the report
Safeguarding reporting
seriousOne incident from January 2022 had not been reported to CQC and safeguarding when it should have been. This happened before the current registered manager took up the post.
“We had seen that a necessary safeguarding referral had been made, however, we also found that an incident from January 2022 had not been notified when needed.” from the report
Management checks
seriousQuality checks did not identify all the problems inspectors found. This was a breach of Regulation 17 and placed people at risk of harm, although inspectors found no evidence that people had been harmed.
“Quality assurance systems were not robust, as they did not identify all of the issues we found.” from the report
Infection control guidance
needs fixingStaff were not wearing masks when inspectors arrived because the home's internal guidance did not match national guidance. The issue was corrected immediately.
“Staff were not wearing masks on our arrival.” from the report
- 01What staffing level is now in place on every shift, and has the additional carer been recruited?
- 02How do you now check that medicines given when needed have clear instructions and that handwritten records are signed correctly?
- 03What changes have been made to medicines audits and management oversight since this inspection?
- 04How do you make sure safeguarding incidents are reported to CQC and the safeguarding authority on time?
- 05What action plan did you send to CQC, and what improvements have been completed?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 12 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, July 2018
Calder View rated Good; inspectors found safe, caring and personalised support, with improvements made since the previous inspection.
Inspectors made an unannounced comprehensive inspection visit on 16 and 17 May 2018. They spoke with people using the home, staff, managers and an advocate. They also checked care plans, recruitment records, medicines records, training, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were positive about the care. Inspectors saw respectful interactions and found that people were involved in their care, meals, activities and daily living skills.
The previous inspection in March 2017 rated the home Requires Improvement because recruitment checks were not robust. Inspectors also made recommendations about medicines and healthy eating. They found these improvements had been completed and found no breaches of the regulations at this inspection.
Improved recruitment
The home had strengthened its recruitment process since the previous inspection. Checks on identity, references, qualifications, employment history and criminal records were completed before staff started.
“Staff recruitment procedures had improved. Robust processes were in place to make sure all appropriate checks were carried out before staff started working at the service.” from the report
Respectful care
People described staff as caring and respectful. Inspectors observed staff responding sensitively to people's needs and requests.
“We observed some tactful and respectful interactions between people using the service and staff.” from the report
Personalised support
Care plans described people's individual needs, preferences, backgrounds and routines. People were involved in planning and reviewing their support.
“People had support plans which identified their individual needs and preferences and how they wished to be supported.” from the report
Building independence
People were supported to develop everyday skills and confidence. This included cooking, laundry, shopping, using public transport and managing medicines.
“People were encouraged and supported to achieve daily living skills such as, involvement with their medicines, using public transport, doing laundry, cooking, baking and cleaning as part of their recovery, skill development and confidence building.” from the report
Choice and control
People were involved in decisions about their care, meals and activities. Staff supported people in the least restrictive way possible.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.” from the report
Windows needed attention
minorSome windows needed repair or replacement. The provider had taken action, but inspectors noted that the work had not yet been completed.
“We noted some of the windows were in need of attention, however we found the provider had taken action to make improvements.” from the report
Some medicines guidance lacked detail
needs fixingSome instructions for medicines given when needed or at variable doses were not specific enough. The team leader updated them during the inspection.
“We noted some protocols were lacking in specific detail.” from the report
Risk review was overdue
needs fixingOne person's risk assessments had not been reviewed within the home's three-month timescale. The team leader reviewed them and improved the electronic alert system during the inspection.
“We noted one person's risk assessments had not been reviewed in accordance with the provider's three monthly timescale.” from the report
Privacy arrangements
minorBecause office space was limited, the registered manager sometimes worked in the lounge. Inspectors also saw an occasion when a person overheard a general discussion, so improvements were needed.
“However, we observed a specific example whereby a person overheard a general discussion, which although not confidential provided a clear indication improvements were needed.” from the report
Tracking residents' suggestions
minorResidents could raise ideas in meetings, but records did not clearly show how suggestions and agreed actions had been followed through. The registered manager agreed to progress this.
“However we noted there was a lack of information to show how ideas, suggestions and agreed outcomes had been actioned.” from the report
- 01Have the windows that needed attention now been repaired or replaced?
- 02How are medicines given when needed or at variable doses recorded, and are the protocols now detailed enough for each person?
- 03How often are risk assessments reviewed, and what system alerts staff when a review is due?
- 04How are residents' suggestions recorded, assigned and checked to show that agreed actions have been completed?
- 05What arrangements are now in place to protect people's privacy when management staff need to work in shared areas?
This was an unannounced comprehensive inspection covering all five key questions, with the home, care provided, records, staff and people's experiences examined. This explanation was written from the published report of 18 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 Calder View
4 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- November 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.