CQC report explained · a residential care home
What the CQC found at CCT Community Enablement Team LTD, Enablement Care
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were enough staff overall and people were protected from abuse. However, risk assessments, evacuation plans and medicines records were not always complete or safe, and individual incidents were not always analysed.
- Effective?
- Requires improvement
- Staff did not receive consistent training or supervision. Mental capacity assessments and best-interest decisions were missing for some important care decisions, although people were supported with food, healthcare and individual activities.
- Caring?
- Good
- This question was not inspected during this visit. Inspectors recorded that some staff supported people with kindness and patience, but a positive person-centred culture was not always evident.
- Responsive?
- Good
- This question was not inspected during this visit. The report says people's preferences were included in some care plans and people had personalised rooms and choices about communal areas.
- Well-led?
- Requires improvement
- Management and quality checks were not consistently effective. Audits missed problems with care planning and monitoring charts, staff meetings had not taken place since October 2022, and recording sometimes showed a blame culture.
What inspectors found, August 2023
Requires Improvement; inspectors found caring aspects of support, but gaps in training, care records, medicines management and consent created safety risks.
This was an unannounced focused inspection on 31 May 2023. Inspectors looked at Safe, Effective and Well-led because of concerns about staffing, training and management. They spoke with people, relatives, staff and a health professional, and checked care, staff and management records.
The home had enough staff overall and people were protected from abuse. Staff usually gave prescribed oral medicines safely, followed infection control measures and supported people with food and health appointments. However, some medicines were not managed safely, risk records were incomplete and incidents were not always reviewed properly.
Staff training and supervision were not consistent. Some mental capacity assessments and best-interest decisions were missing. Checks by managers did not always find problems with care plans, consent or monitoring charts. Inspectors found breaches of the rules about staffing and consent.
The overall rating changed from Good to Requires Improvement. The ratings for Safe, Effective and Well-led were Requires Improvement. Caring and Responsive were not inspected, so their previous ratings were carried forward. The provider was asked for an action plan and will be monitored.
Enough staff overall
Inspectors found there were enough staff to meet people's needs, and staffing levels were reviewed using people's individual dependency levels.
“There were enough staff to meet people's needs.” from the report
Safeguarding arrangements
Most staff had safeguarding training and understood how to report concerns. The home had a safeguarding policy in place.
“Systems were in place to protect people from the risk of abuse.” from the report
Kind medicine support
Inspectors saw oral medicines being given safely, with patience and clear communication.
“This was done with kindness and patience communicating each step with the person.” from the report
Food and healthcare support
People had meal and drink choices, their dietary needs and weights were monitored, and referrals were made to health professionals when needed.
“People were supported to maintain a healthy balanced diet.” from the report
Partnership working
The home worked with outside professionals, including dietitians, speech and language therapists and mental health and social work teams.
“The provider worked in partnership with external professionals to help meet people's outcomes.” from the report
Incomplete risk records
seriousSome people's risks were not fully assessed or recorded. One person's care plan was out of date, another person had no risk assessment for distress, and some evacuation plans were inaccurate.
“People's care plans and risk assessment were inconsistent, some people's risks were assessed whilst others were not identified.” from the report
Medicines not always managed safely
seriousThere were no written instructions for medicines given only when needed. Open medicine boxes were not dated, and patch application sites were not recorded on body maps.
“Medicines were not always managed safely.” from the report
Training gaps
seriousStaff training had several gaps, including first aid, dementia awareness and equality and diversity. Staff did not always receive regular supervision.
“Staff did not receive ongoing consistent training.” from the report
Consent and mental capacity
seriousThe home did not always assess people's ability to make particular decisions or record best-interest decisions. This included decisions about being cared for in bed and using bed rails.
“People's mental capacity was not always assessed to make particular decisions.” from the report
Management checks missed problems
needs fixingAudits did not always identify missing monitoring charts and care planning problems. A required repositioning chart was missing until after the inspection.
“Systems to assess and monitor the service were not always effective.” from the report
Incidents and culture
needs fixingThe home recorded accidents and incidents, but did not always analyse repeated incidents to reduce the risk of them happening again. Some records about distress and anxiety suggested a blame culture.
“A positive culture was not always evident with specific recording of incidents in relation to periods of distress and anxiety.” from the report
- 01What has been done to complete staff training in first aid, dementia awareness, equality and diversity and other required subjects?
- 02How are as-needed medicines now supported by written instructions, and how are medicine boxes and transdermal patches checked?
- 03Have all residents had the required mental capacity assessments and best-interest decisions recorded, including for bed rails and care in bed?
- 04How are care plans, risk assessments, repositioning charts and personal evacuation plans checked for accuracy and kept up to date?
- 05What changes have been made to review repeated incidents and to hold regular staff meetings?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 9 August 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, April 2021
Enablement Care was inspected but not rated; inspectors found PPE and safety arrangements in place, but incident records needed improvement.
This was an unannounced, targeted inspection on 23 March 2021. It followed concerns about personal protective equipment and the safety and quality of care. The inspector spoke with two people and four staff, and reviewed information from other sources.
Inspectors found enough PPE, and staff were observed using it. Staff took part in regular COVID-19 testing and had training in infection control and PPE. Care plans, risk assessments, fire safety checks and equipment servicing were also in place.
Some improvement was needed in how incidents were recorded and in deciding whether incidents met local authority safeguarding thresholds. The overall service and Safe rating were not changed because this inspection only examined specific concerns. The previous rating was Good, published on 11 January 2020.
PPE and infection control
There were sufficient PPE supplies, and staff were observed using PPE. Staff also took part in regular COVID-19 testing and had infection control training.
“We saw there were sufficient supplies of PPE available at multiple points within the care home.” from the report
Safe care planning
Care plans and risk assessments were in place for people's needs. Monthly checks were used to make sure these remained current.
“Risk assessments were in place for people's care needs and staff told us they provided care in line with these.” from the report
Equipment and fire safety
The home had checks to reduce fire risks, and equipment such as hoists had been serviced.
“Checks to help reduce risks associated with fire were in place and equipment such as hoists had been serviced.” from the report
Incident records and safeguarding decisions
needs fixingThe home needed to improve how it recorded incidents and how it decided whether an incident met local authority safeguarding thresholds.
“Actions were taken to ensure people's safety. However, some improvements were required to the way incident records were made and the assessment of whether incidents met with the local authority safeguarding thresholds.” from the report
- 01How are incidents now recorded, reviewed and followed up?
- 02How do you decide whether an incident should be referred to the local authority safeguarding team?
- 03How do you make sure PPE remains available and staff continue to use it correctly?
- 04How often are care plans and risk assessments checked, and what happens when they need updating?
- 05When is the next comprehensive inspection expected, given that this visit did not assess all areas?
This was a targeted inspection of specific concerns about PPE and safe care; the full Safe question and the other key questions were not assessed, so the previous ratings carried over. This explanation was written from the published report of 16 April 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.
Every inspection of CCT Community Enablement Team LTD, Enablement Care
2 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at CCT Community Enablement Team LTD, Enablement Care →
- April 2021Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at CCT Community Enablement Team LTD, Enablement Care →
- January 2020GoodSafe: GoodEffective: GoodWell-led: Good
- December 2018
Registered with the Care Quality Commission on 10 December 2018.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
75 live-in carers within about an hour of Nottinghamshire
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. 63 can care for a couple. 10 years' experience on average.
“Ernest is an amazing professional carer who delivers care from the heart.”
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.