CQC report explained · a residential care home
What the CQC found at 196 High Street
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
CareTech Community Services Limited - 196 High Street was rated Inadequate and placed in special measures; inspectors found serious problems with personalised care, activities, repairs and management.
This was an unannounced inspection on 12 July and 01 August 2023. One inspector reviewed care records, medicine records, staff files and management records. They observed care and spoke with people, staff, relatives and a professional.
The home supported six people during the inspection, with six others away on holiday. Inspectors found kind and compassionate care from some staff, safe medicines management, suitable safeguarding procedures and good links with health professionals.
However, care plans were not always up to date or personalised. People did not always receive activities they enjoyed, and information was not always provided in a format they could understand. Repairs, fire safety issues and other environmental risks were not dealt with promptly.
The overall rating was Inadequate. Safe, Effective and Caring were rated Requires Improvement. Responsive and Well-led were rated Inadequate. This was a fall from Good at the previous inspection, published on 22 August 2018.
Medicines
Inspectors found that medicines were administered as prescribed and records were completed correctly.
“Medicines were managed safely. We reviewed the medicines administration records (MAR) for 2 people who used the service and saw these were completed correctly” from the report
Safeguarding
Staff understood how to recognise and report abuse. There were also checks to reduce the risk of financial abuse.
“Staff knew how to protect people from the risk of abuse and knew how to escalate any safeguarding concerns.” from the report
Health support
People were supported to access healthcare, including specialist services. The home had a structured way to pass concerns to health professionals.
“The service worked with specialist health services such as the speech and language therapists and acted on their recommendations.” from the report
Kind staff
Inspectors found that some staff were very kind and concerned about people's welfare.
“People received care from staff who were individually very kind and caring.” from the report
Unsafe repairs and fire risks
seriousFire doors did not close correctly, trip hazards had not been dealt with and the lift was condemned. One person's risk assessment had not been updated for using the stairs.
“Systems had not been established to assess monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report
Poorly maintained building
seriousThe home needed modernisation. Bathroom leaks and other repairs remained outstanding, affecting people's use of facilities.
“The failure to ensure the premises and equipment were properly maintained and suitable for the intended purpose is a breach of Regulation 15” from the report
Care was not personalised
seriousSome care plans contained information that was no longer true, and staff did not always know people's interests or preferences. This increased the risk that people's needs would not be met.
“The lack of person-centred care plans placed people at an increased risk of not having their needs met.” from the report
Too few meaningful activities
needs fixingPeople were not consistently supported to take part in activities they enjoyed, such as swimming, music, outings and watching football. Staff said time, staffing and resources were barriers.
“The support provided to people to participate in activities that were important to them was ineffective.” from the report
High agency staff use
needs fixingThe home was struggling to recruit permanent staff. Inspectors found that some agency staff did not have the skills to support people in a caring and dignified way.
“The provider was using a high number of agency staff, whilst agency staff had the necessary training, permanent staff spoke about the negative impact this had on the day to day running of the home.” from the report
Weak management oversight
seriousAudits failed to identify important problems, incidents were not properly investigated and repairs took too long. The report said this placed people at risk of harm.
“A lack of good governance and effective management meant there was no evidence of learning.” from the report
- 01Which fire doors, trip hazards and other safety risks from the report have now been repaired, and when were they completed?
- 02How many permanent and agency staff currently work at the home, and how do you make sure agency staff understand each person's needs?
- 03How have each person's care plans been updated to reflect their current needs, preferences and interests?
- 04What regular activities are now available, including music, swimming, outings and weekend activities?
- 05What improvements have been made in response to the CQC action plan, and what evidence can you show that managers now check and learn from incidents and complaints?
This inspection looked at all five key questions, including risks linked to a serious injury incident, but it did not examine the circumstances of that incident itself. This explanation was written from the published report of 28 September 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, December 2020
Inspected but not rated; inspectors found strong infection-control arrangements, with some further development signposted.
This was an unannounced targeted inspection on 25 November 2020. It looked only at infection prevention and control because of the coronavirus response.
Inspectors found the home was clean and hygienic. Visitors were screened, required to use personal protective equipment, and given handwashing facilities and alcohol gel. People and staff were taking part in routine testing.
The home was rated 'Inspected but not rated' overall and for safety. This means the visit checked infection-control arrangements, rather than giving a full quality rating for the home.
Clean and hygienic home
Cleaning schedules were completed methodically, and senior staff carried out regular infection-control audits. Issues found were dealt with promptly.
“Cleaning schedules were in place, which were methodically completed throughout the service.” from the report
Controls for visitors
Visitors were screened, had their temperatures checked and were required to use protective equipment. Handwashing facilities and alcohol gel were available.
“Visitors were screened and had their temperatures checked by on arrival.” from the report
Testing and risk checks
People and staff had joined the routine testing scheme. Inspectors found that health, safety and wellbeing risks had been thoroughly assessed.
“People and staff had engaged with the routine testing scheme. Risks to people and staff in relation to their health, safety and wellbeing had been thoroughly assessed.” from the report
Pandemic planning
The provider had pandemic policies and procedures, including a contingency plan for the home.
“The registered manager had developed a robust contingency plan for the service.” from the report
Some further development needed
minorInspectors signposted the provider to resources to develop its infection-control approach. The report does not say that this led to a breach or enforcement action.
“We have also signposted the provider to resources to develop their approach.” from the report
- 01What infection-control resources did inspectors ask you to use, and what changes have you made since the inspection?
- 02How are visitors currently screened and checked before entering the home?
- 03How do you make sure people and staff take part in routine testing?
- 04How often are cleaning and infection-control audits completed, and what happens when an issue is found?
- 05What is your current plan for managing an infection outbreak?
This was an unannounced targeted inspection of infection prevention and control only; the report did not rate Effective, Caring, Responsive or Well-led. 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.
Every inspection of 196 High Street
3 rated inspections over 8 years: the service has slipped, from Good to Inadequate.
- September 2023Inadequatecurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- December 2020Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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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