CQC report explained · a residential care home
What the CQC found at Cassandra House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found kind, person-centred care, but medicines, risk records and quality checks were not always reliable.
The inspection was unannounced and took place on 16 January 2024. Two inspectors and an Expert by Experience spoke with people, relatives and staff. They reviewed care records, medicine records, staff recruitment files and management records, and observed care and infection control.
The home was rated Requires Improvement overall, with Safe and Well-led also rated Requires Improvement. Medicines were mostly managed safely, but some records and arrangements were incomplete. Risk assessments, care plans and records of accidents and incidents were not always up to date or detailed enough.
Inspectors saw kind and respectful interactions. People said they felt safe, staff knew them well, staffing levels met assessed needs, and people were supported to access healthcare. The home had a positive culture, but its audits and systems did not always identify problems or ensure improvements were completed.
The previous rating was Good, published on 17 October 2017. The CQC found a breach of Regulation 17 on good governance and will ask for an action plan before monitoring progress.
Kind, respectful care
Inspectors saw compassionate interactions. People and relatives said staff treated people with dignity and respect.
“We observed kind and caring interactions between people and staff during the inspection.” from the report
People felt safe
People told inspectors they felt safe. Staff understood how to recognise and report abuse, and safeguarding arrangements were in place.
“People told us they felt safe at the service.” from the report
Suitable staffing
Recruitment checks had been completed, and inspectors found staffing levels matched people's assessed needs.
“Staffing levels were sufficient to meet the needs of people living at the service.” from the report
Positive culture
The home was described as welcoming and supportive. Staff understood the home's values and people were involved in their care.
“The home was welcoming, and the atmosphere was warm and supportive.” from the report
Healthcare links
The home worked with health and social care professionals, including GPs and therapists, to support people's health and wellbeing.
“The provider worked closely with several community health and social care professionals to ensure people maintained their health and wellbeing.” from the report
Medicines records
seriousRecords about medicine preferences, prescribed patches, refrigerated medicines and thickeners were incomplete. Documentation for one person's covert medicines was not in place.
“Medicine practices were not always in line with best practice guidelines.” from the report
Risk and care records
needs fixingRisk assessments and care plans did not always reflect people's current needs or give enough detail about the care provided.
“Care plans were not always fully complete or lacked relevant details about people's care needs.” from the report
Learning from incidents
needs fixingThe home recorded incidents and accidents, but did not consistently analyse them for patterns, trends or lessons that could prevent them happening again.
“There was minimal evidence to support the monitoring and analysing of accidents, incidents or falls.” from the report
Quality checks
seriousAudits did not always identify problems found by inspectors, and improvement actions were not always followed up and signed off.
“Where improvements to the service had been identified through quality auditing, action was not always taken in a timely way.” from the report
Some premises areas
minorSome parts of the home needed refurbishment to allow more effective cleaning.
“Some areas of the care home required refurbishment to enable more effective cleaning.” from the report
- 01What changes have been made to medicine records, including records for prescribed patches, refrigerated medicines, thickeners and covert medicines?
- 02How are you making sure risk assessments and care plans are updated when people's needs change?
- 03How are accidents, incidents, falls and safeguarding concerns now analysed for patterns and lessons?
- 04How will you make sure audits identify problems and that improvement actions are completed and signed off?
- 05Which areas of the home need refurbishment to support effective cleaning, and what is the timetable for this work?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not rated in this inspection. This explanation was written from the published report of 13 February 2024 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, October 2022
Cassandra House was inspected but not rated; inspectors were assured about infection controls, but some damaged surfaces needed attention.
This was an announced, targeted inspection on 23 September 2022. It focused on infection prevention and control, including the effect of COVID-19-related staffing pressures.
Inspectors were assured that the home managed visiting, admissions, personal protective equipment, infection risks and outbreaks safely. The home also reviewed previous COVID-19 outbreaks and used what it learned to improve practice.
The inspection did not give an overall rating or a rated score for Safe. Inspectors were only somewhat assured about the building's layout and hygiene because some doors, handrails and walls were damaged or chipped.
Infection control
Inspectors were assured that the home had measures to prevent and manage infections, including safe visiting, admissions and use of protective equipment.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Learning from outbreaks
The home reviewed previous COVID-19 outbreaks and used the findings to improve its future arrangements.
“The provider had used reflective practice to review outbreaks of COVID-19 and used the findings to develop and improve practice.” from the report
Safe visiting arrangements
The home had clear visiting signs and hand-washing facilities at the entrance. Visits were supported in line with government guidance.
“People were supported to have visits from family and friends in a safe manner in line with government guidance.” from the report
Damaged building surfaces
needs fixingSome doors, handrails and walls were damaged or chipped. The registered manager knew about this and planned a programme of decoration.
“This was due to some areas of the building requiring attention such as doors, handrails and walls that were damaged or chipped.” from the report
- 01Have the damaged or chipped doors, handrails and walls now been repaired?
- 02What is the timetable for the planned programme of decoration?
- 03How are you managing staffing pressures linked to COVID-19, and have they affected people's care?
- 04How do you make sure visits take place safely without disrupting other people living in the home?
- 05What arrangements are now in place for any future infection outbreak?
This was a targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it did not rate the service overall or assess the other four key questions. This explanation was written from the published report of 5 October 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.
Every inspection of Cassandra House
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- February 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2022Inspected but not ratedSafe: Inspected but not rated
- October 2017Goodstayed GoodSafe: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 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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16 live-in carers within about an hour of East Riding of Yorkshire
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 £1,030 to £1,420 a week. 14 can care for a couple. 7 years' experience on average.
“She was always 'just present enough': attentive, available, kind and engaging, but without ever over-stepping any boundary”
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
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.