CQC report explained · a residential care home
What the CQC found at 1 William Street
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2018
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors visited unannounced on 17 October 2018. Two inspectors spoke with one person, three relatives, four care staff and the registered manager by telephone. They also observed care and checked care, medicines, recruitment and quality records.
The home supported five people with learning disabilities or autism, and could accommodate up to six people. Inspectors found enough trained staff, safe medicines systems, suitable risk plans and a clean environment.
Care was adapted to people's communication needs, choices, health needs and interests. Staff were described as kind and respectful. People and relatives were involved in care planning, activities and giving feedback.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. It had been rated Requires Improvement at the previous inspection because of safeguarding and notification failures, but inspectors found these legal breaches had been corrected.
Personalised support
Care plans included people's interests, relationships, preferences and communication needs. Staff adapted routines and activities to help people feel less anxious and take part in daily life.
“People received personalised care that was responsive to their needs.” from the report
Good involvement
People and relatives were involved in care planning and reviews. The home used individual meetings and accessible methods to help people share their views.
“People, relatives and staff were engaged and involved in the development of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you assess whether one staff member at night remains enough if my relative's needs change?
- 02How will you make sure my relative's medicines, including any as-required medicines, are recorded and reviewed safely?
- 03How will you communicate with my relative and support them to make choices if they cannot use speech or written words?
- 04How often will my relative's care plan and risk assessments be reviewed, and how will we be involved?
- 05How can my relative or our family raise a concern or complaint, and how will the home show us what action was taken?
This was an unannounced inspection of the whole service and all five CQC question areas; inspectors also checked whether improvements had been made since the previous inspection. This explanation was written from the published report of 15 November 2018 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, November 2017
Overall rating Requires Improvement; inspectors found kind, personalised care but safety and management checks were not reliable enough.
Inspectors visited without warning on 31 August 2017. They spoke with people, a relative, staff and the registered manager. They observed care, checked two care records and reviewed staff, medicines, staffing and quality records.
The home provided care for up to six people with learning disabilities. Inspectors found good care in the areas of effectiveness, kindness and responsiveness. People were supported with their health, food choices, decisions, dignity, activities and relationships.
However, the home was not consistently safe or well-led. Potential abuse and neglect had not always been referred to safeguarding authorities. There were concerns about night staffing, out-of-hours management support, medicines records and reporting incidents to the CQC.
The overall rating Requires Improvement means the home was not consistently meeting the required standard in important areas. The home had met legal requirements at the previous inspection in September 2015, but this inspection found two breaches of regulations.
Kind and respectful care
Inspectors saw positive relationships between people and staff. People were treated with dignity, supported to make choices and helped to be as independent as possible.
“People were treated with dignity and respect and their right to privacy was promoted.” from the report
Health and staff skills
People's health and wellbeing were monitored, and they were supported to access professionals when needed. Staff had training to meet people's individual needs.
“People's health needs were effectively monitored and managed and staff were suitably skilled to meet people's individual care needs.” from the report
Personalised support
People helped plan and review their care. Staff supported them with activities linked to their interests and preferences.
“People were involved in the planning and review of their care.” from the report
Food choices
People could choose what they ate and drank. Specialist diets were provided in an inclusive and well-presented way.
“People were supported to eat meals that met their individual preferences.” from the report
Safeguarding referrals
seriousAt least four incidents of potential abuse or neglect had not been referred to the local safeguarding team. The report says this left people at risk of harm.
“This showed that the registered manager and provider did not follow safeguarding procedures to report incidents of potential abuse and neglect as required.” from the report
Night-time safety and emergency support
needs fixingThere was concern about supporting one person safely at night when only one staff member was available. On one occasion, a night worker could not reach the on-call manager or provider after repeated attempts.
“This meant we could not be assured that this person was in receipt of safe care and support during the night when only one staff member was available.” from the report
Medicines records
needs fixingSome medicines stock figures and administration records were inaccurate. This meant people could not always be assured that medicines had been given as prescribed.
“These inaccuracies meant people who used the service could not always be assured that they had received their medicines as prescribed.” from the report
Weak quality monitoring
seriousChecks were carried out, but some did not find the problems identified by inspectors. The home also failed to report some notifiable incidents to the CQC.
“However, some of the checks had not identified some of the concerns we found.” from the report
- 01How are all suspected abuse or neglect incidents now referred to the local safeguarding team?
- 02How many staff are available at night when a person needs two staff to move safely?
- 03How can night staff reach a manager or provider immediately during an incident or emergency?
- 04What checks now confirm that medicines stock and administration records are accurate?
- 05What action was taken after the inspection, and how is it being checked by the home and provider?
This was an unannounced inspection covering all five areas of quality and the overall rating, following the previous inspection in September 2015. This explanation was written from the published report of 14 November 2017 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 1 William Street
3 rated inspections over 3 years: the service has held its Good rating throughout.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 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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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 £1,190 a week. 93 can care for a couple. 9 years' experience on average.
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“She maintained a great environment for mum both with the tidiness and cleanliness of the house and Mum and with her caring and understanding attitude.”
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