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CQC report explained · a residential care home

What the CQC found at Carden Bank Rest Home

Goodpublished 6 May 2021, 5 years ago

Rated Good: inspectors found the home performing well and meeting their expectations.

The five questions inspectors ask
Safe?
Good
Inspectors found that people received safe care, medicines were given as prescribed, risks were reviewed and there were enough staff. They also found some staff safeguarding training was not up to date.
Effective?
Good
People’s needs were assessed and staff worked with health professionals. Food and dietary needs were considered, although not all key staff training was up to date.
Caring?
Good
People were treated kindly and with dignity. Staff knew people’s likes and dislikes and encouraged them to make choices and remain independent.
Responsive?
Good
Care plans were personalised and people and relatives were involved in reviews. Communication needs, activities, family contact and complaints were considered.
Well-led?
Requires improvement
Quality checks were in place but did not always identify risks or lead to prompt action. Inspectors also found issues with the garden, cleaning-fluid storage, night medicines cover and protective clothing practices.
The latest report, explained

What inspectors found, May 2021

Rated Good overall; inspectors found safe, kind and responsive care, but the home’s leadership and quality checks require improvement.

This was a planned, fully comprehensive inspection on 20 April 2021. Two inspectors spoke with three people living at the home, four relatives and four staff. They also reviewed care records and management records.

The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines, suitable care plans, kind support, access to health professionals and activities that people enjoyed.

Well-led was rated Requires Improvement. Quality checks did not always find problems promptly. Inspectors found unlocked cleaning fluids, a potentially unsafe radiator, rubbish and damaged areas in the garden, and gaps in night staff medicines training. The report says some action was taken during or after the inspection.

This was the first five-question inspection under the new provider, so there was no previous overall rating to compare with. The report says the previous inspection under the new provider had been focused and did not receive an overall rating.

What inspectors praised
  • Safe care and medicines

    Inspectors found that people received safe care and medicines were administered as prescribed. Risks and equipment use were reviewed.

    “People received safe care. Staff understood about safeguarding procedures and when people may be at risk of potential harm.” from the report
  • Kind and respectful staff

    People were happy with the staff. Staff supported people’s privacy, dignity, choices and independence.

    “People were treated in a kind and caring way and they were happy with the support they received from the staff.” from the report
  • Personalised support

    Care plans reflected people’s preferences and communication needs. Activities and contact with family and friends were supported.

    “People felt involved with their care and had care plans which were personalised and detailed.” from the report
  • Access to health support

    Staff worked with other services and professionals when people’s needs changed. People could access healthcare and dietary support.

    “Staff and the registered manager worked with other services and professionals to ensure people received care which met their changing needs.” from the report
What inspectors were concerned about
  • Quality checks missed risks

    serious

    Audits did not identify some safety issues, including an unlocked door where cleaning fluids were stored and a potentially unsafe radiator. The report says immediate action was taken after the inspection.

    “The audits in place had not identified this. Immediate action was taken after the inspection and the registered manager sent us reassurances that a lock had been fitted to the door so it could remain closed.” from the report
  • Garden condition

    needs fixing

    The garden was important to people, but inspectors found rubbish and damaged areas that had not been improved.

    “There was a lot of rubbish and damaged areas which could have been adapted to make the environment better for people now.” from the report
  • Night medicines cover

    serious

    Night staff were not always trained to administer medicines. The manager took action during the inspection, and the report says there was no evidence that people had requested medicines at night.

    “They had taken steps to work to resolving this, however immediate action had not been taken to ensure a staff member was always available at night.” from the report
  • Training records

    needs fixing

    Not all key areas of staff training were up to date, although the manager had an action plan and staff showed they understood their work.

    “Although staff could demonstrate an understanding not all key areas of training were up to date.” from the report
  • Protective clothing practice

    needs fixing

    Inspectors found staff wore more protective clothing than required throughout the day. They said this could increase the risk of cross-contamination if it was not changed between people.

    “This placed people at an increased risk of cross contamination as staff could potentially not change before supporting a second person.” from the report
Questions to ask them, based on this report
  1. 01Have the cleaning fluids remained securely locked, and how do you now check this?
  2. 02What has been done to remove the rubbish and repair the damaged areas in the garden?
  3. 03Is there always a suitably trained member of staff on duty at night who can administer medicines?
  4. 04Which staff training was out of date at the inspection, and has it now been completed?
  5. 05How do you make sure protective clothing is changed between supporting different people?

This was a planned, fully comprehensive inspection covering all five key questions, including infection prevention and control measures. This explanation was written from the published report of 6 May 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.

An earlier report, explained

What inspectors found, December 2020

Carden Bank Rest Home was rated Requires Improvement; inspectors found safe care and stronger management, but only two areas were inspected.

This was an unannounced focused inspection on 12 November 2020. One inspector spoke with people, relatives, staff and a health professional. They observed care and checked care records, medicines, recruitment files and management records.

The home was rated Good for Safe and Good for Well-led. Inspectors found enough safely recruited staff, suitable risk assessments, safe medicines systems and appropriate infection control measures. People appeared comfortable and relaxed with staff.

The overall rating was Requires Improvement. This was because the inspection only checked Safe and Well-led. Ratings for the other areas were carried over from the previous comprehensive inspection, when the service had been rated Inadequate. The report says the new provider had addressed the previous breaches.

What inspectors praised
  • People felt safe

    People appeared comfortable with staff and those spoken with said they felt safe.

    “People were relaxed and comfortable in the presence of staff during the inspection. People we spoke with said they felt safe.” from the report
  • Clear risk planning

    Individual risk assessments gave staff clear instructions, including for mobility and skin care.

    “People had individual risk assessments in place which had been completed with them or in their best interests” from the report
  • Safe medicines support

    Medicines were observed being given safely. Records were accurate and staff had training and competency checks.

    “Medicines administration records (MARs) were accurate and up to date and the provider had introduced new systems to audit medicines records” from the report
  • Improved oversight

    The new provider had introduced audits and monitoring tools to identify risks and track actions.

    “The management team had introduced several new quality monitoring tools that demonstrated how the risks to people using the service were monitored.” from the report
  • Positive staff relationships

    Inspectors saw warm and friendly interactions, and people described staff as kind and respectful.

    “We saw there were warm and friendly interactions between staff and people” from the report
What inspectors were concerned about
  • Support with video calls

    minor

    One relative said it would be helpful for staff to consistently assist with video calls. The manager said the home was looking at planned appointments for these calls.

    “A relative did comment that having staff available to consistently assist with video calls with their loved one would be helpful.” from the report
Questions to ask them, based on this report
  1. 01What is the home's current position on Effective, Caring and Responsive, which were not assessed in this inspection?
  2. 02How do staff now help residents keep in regular contact with relatives by video call?
  3. 03How are risk assessments reviewed when a person's mobility, skin or health needs change?
  4. 04How does the staffing tool show that there are enough staff for people's needs at different times of day and night?
  5. 05What actions have been taken since the inspection to continue the improvements made after the previous Inadequate rating?

This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 17 December 2020 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.

The story over the years

Every inspection of Carden Bank Rest Home

7 rated inspections over 6 years: the service has held its Good rating throughout.

  1. May 2021Goodcurrent ratingup from Requires improvement
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at Carden Bank Rest Home →

  2. December 2020Requires improvementup from Inadequate
    Safe: GoodWell-led: Good

    Read what inspectors found at Carden Bank Rest Home →

  3. August 2019Inadequatestayed Inadequate
    Safe: InadequateWell-led: Inadequate
  4. July 2019Inadequatestayed Inadequate
    Safe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
  5. May 2019Inadequatedown from Good
    Safe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
  6. February 2017Goodstayed Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  7. March 2015Good
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  8. December 2019

    Registered with the Care Quality Commission on 16 December 2019.

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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