CQC report explained · a residential care home
What the CQC found at Care Home for Special Needs
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2020
Rated Requires Improvement; inspectors found kind, person-centred care, but safety checks and quality monitoring were not reliable enough.
This was a planned inspection on 6 March 2020. One inspector visited the home, spoke with the two people living there, staff, the provider and a relative, and reviewed care, medicine and management records.
The home was rated Good for Effective, Caring and Responsive. People were supported by kind staff who knew their needs and preferences. They had choices, meaningful activities and access to health services.
Safe and Well-led were rated Requires Improvement. Inspectors found problems with medicine recording, checking water temperatures, fire exit arrangements, staff competency checks and formal audits. The overall rating remains Requires Improvement, as it was at the previous inspection.
Kind relationships
People had positive relationships with staff who knew them well. Staff treated people with respect and compassion.
“People received help and support from a kind and compassionate staff team with whom they had positive relationships with.” from the report
Personalised support
Care plans reflected people's preferences, communication needs and what was important to them. People were involved in decisions about their care.
“Support plans were very person centred and included information about what was important to the person.” from the report
Choice and independence
People were supported to make choices and remain as independent as possible, including through everyday tasks and activities.
“People were supported to be as independent as possible.” from the report
Activities and community links
People took part in activities suited to their interests and could attend events outside the home.
“People led active and meaningful lives and were supported to follow their interests and participated in activities which were socially relevant and suitable to them.” from the report
Quality checks were not effective
seriousThe home did not have reliable formal audits to identify and correct problems. This was a breach of Regulation 17.
“There were insufficient systems in place to monitor and improve the quality of the service.” from the report
Fire exit arrangements
seriousAn evacuation route led onto a flat roof without a secure method of escape. The fire risk assessment had not been updated to reflect the arrangements.
“One evacuation route was onto a flat roof. This did not have any railings or method of escape.” from the report
Medicine records
needs fixingOne evening dose was not signed as given for 11 days. The evidence suggested the medicine had been given, but the recording system was not reliable.
“One evening dose of medicine had not been signed as given for 11 days.” from the report
- 01What action have you taken to make sure every medicine dose is recorded correctly?
- 02How has the fire exit onto the flat roof been made safe, and has the fire risk assessment been updated?
- 03How are water temperatures now measured and recorded?
- 04How do you check that staff are competent to administer medicines?
- 05What formal audits are now used to identify and fix problems in the home?
This was a planned inspection covering all five CQC questions; the report says Safe and Well-led remained Requires Improvement while Effective, Caring and Responsive remained Good. This explanation was written from the published report of 18 April 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.
What inspectors found, April 2019
Care Home for Special Needs was rated Requires Improvement; inspectors found kind, personalised care but weaknesses in safety checks and management oversight.
This was an unannounced, comprehensive inspection on 4 March 2019. One inspector spoke with both people living there, visitors and staff, observed care, and checked care records, staff records, medicines information, premises checks and quality monitoring.
The home supported two people, although it could accommodate up to four. Inspectors found people were treated kindly, involved in their care and supported to be independent. Their needs, choices, activities and healthcare were generally well supported.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe and well-led were rated Requires Improvement because some safety checks, risk records, training updates and management records were not kept up to date. The report says several records and checks were updated after the inspection.
Kind and respectful care
People and relatives said staff were kind and friendly. Inspectors saw that staff treated people with dignity and used their knowledge of each person to provide individual support.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
People helped shape their care and daily activities. Staff supported independence, communication needs and personal choices.
“The care was planned and delivered based on people's needs and preferences.” from the report
Activities and community links
People enjoyed activities in the home and locally, including the garden facilities, discos, theatre visits and holidays.
“People were encouraged to go to a local disco and attend events in the local area which they enjoyed including visiting the theatre and pantomimes.” from the report
Open staff culture
Staff said the manager was supportive and approachable. Inspectors found an open culture and staff who felt valued.
“Staff felt valued and the culture was open and honest.” from the report
Safety checks and evacuation route
seriousRequired health and safety checks, including weekly fire equipment checks, had not always been completed. One evacuation route led onto a flat roof without railings or a method of escape, and this needed review with fire authorities.
“One evacuation route was onto a flat roof. This did not have any railings or method of escape.” from the report
Medicines training and checks
needs fixingStaff medicines training was out of date. Homely remedies had not been checked with a doctor, and medicines records were not signed by two staff as expected by good practice.
“Staff training had not been refreshed to make sure their knowledge was current.” from the report
Limited management oversight
needs fixingWhen staff were unavailable, the home continued to provide daily care but did not have enough contingency arrangements to ensure all checks and records were completed. Some audits were not recorded.
“Since Christmas 2018 not all staff had been available which had impacted on the running of the service.” from the report
Incomplete risk and care records
needs fixingSome associated risks were missing from assessments. Allergies were not recorded consistently, and one person's food consistency information was unclear after a professional reassessment.
“The registered manager had not always considered all associated risks when a risk had been identified.” from the report
- 01Have all fire safety and other environmental checks been completed at the required frequency since the inspection?
- 02What has been decided about the evacuation route onto the flat roof, and what would happen if it had to be used?
- 03Are all staff now up to date with medicines training, and have homely remedies been checked for interactions with prescribed medicines?
- 04What cover is available if staff are unavailable, and how do you make sure care records, audits and safety checks are still completed?
- 05Have all risk assessments, allergy records and food consistency instructions been reviewed and updated?
This was an unannounced comprehensive inspection covering all five CQC questions; the previous overall rating was Good, published on 11 March 2016. This explanation was written from the published report of 30 April 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.
Every inspection of Care Home for Special Needs
3 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- April 2020Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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