CQC report explained · a residential care home
What the CQC found at Ciderstone House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Safe was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Effective?
- Good
- Staff understood the Mental Capacity Act, supported people to make choices and used least restrictive approaches. Staff had suitable training, and people had access to food, health checks and other health services.
- Caring?
- Good
- Caring was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- Responsive was not inspected in this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Managers had clear systems for checking quality, managing risk and improving the service. Families, staff and professionals gave positive feedback about communication, support and the changes made since the previous inspection.
What inspectors found, February 2023
Rated Good; inspectors found effective, well-led support, with the overall rating improved from Requires Improvement.
The inspection was unannounced and took place on 31 January 2023. One inspector met everyone living at the home, observed care, spoke with managers, and checked support and service records. Feedback was also sought from staff, families and professionals.
The inspection found that staff supported people to make choices, stay healthy and access the local community. Staff had suitable training and people’s support plans and risk assessments were reviewed. The home had a positive, person-centred culture and management systems were used to improve the service.
This report inspected only Effective and Well-led. Both were rated Good. The other three question ratings were carried over from the previous inspection, and these ratings were used to calculate the overall Good rating.
Choice and independence
Staff supported people to make their own decisions and used the least restrictive approach possible. People were also supported to access local shops, activities and other community resources.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Trained staff
Staff had the knowledge and skills needed for their roles. New staff completed a full induction and did not work alone until they could do so safely.
“All staff completed a comprehensive induction and did not work unsupervised until they and their manager were confident, they could do so safely.” from the report
Health support
People’s health needs were monitored and staff worked with health and social care professionals. Records showed regular reviews, health checks and medical appointments.
“Regular monitoring and reviews were carried out with people using the service and relevant professionals to ensure people's health needs continued to be met.” from the report
Improved leadership
Management had improved the culture and had systems to identify risks and drive improvement. The previous recommendation about responding to complaints had been acted on.
“The service had clear and effective governance, management and accountability arrangements in place.” from the report
Positive relationships
Families and professionals reported better communication and more consistent support. The report described people as receiving kind, compassionate and person-centred care.
“People received kind and compassionate care and were supported in a person-centred way.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings for Safe, Caring and Responsive, which were not inspected in this visit?
- 02How are people’s support plans and risk assessments reviewed when their needs or preferences change?
- 03How will you support my relative to make choices and take part in local activities?
- 04How are health appointments, annual health checks and follow-up actions recorded?
- 05What changes have been made to the complaints process since the previous inspection?
This was a focused inspection of Effective and Well-led only; the other ratings carried over from the previous inspection and were used to calculate the overall rating. This explanation was written from the published report of 24 February 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, May 2021
Rated Requires Improvement; inspectors found safe, kind care, but people’s choices, complaints handling and quality checks needed improvement.
This was an unannounced comprehensive inspection on 18 and 23 March 2021. Inspectors observed care, spoke with relatives and staff, and reviewed care, medicines, incident and management records. None of the people living at the home could give verbal feedback.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safe medicines systems, kind care, personalised plans and activities that reflected people’s interests.
The home was rated Requires Improvement for Effective and Well-led. People were not always involved in decisions about their care, one person’s DoLS conditions were not met, and quality checks did not identify all the problems found. Some relatives were also unhappy with how complaints and communication were handled.
The overall rating was Requires Improvement. The previous rating under the former provider was also Requires Improvement, published on 14 January 2020. Inspectors said the new provider had improved training, premises safety and medicines management, but further improvements were still needed.
Enough staff
Inspectors found enough staff to meet people’s needs. Staff supported people calmly and did not leave them waiting long for help.
“We saw there were enough staff to support people and people did not have to wait long for assistance when needed.” from the report
Kind and respectful care
Staff were observed treating people kindly and respecting their privacy and dignity. People were supported to make everyday choices.
“We observed staff treated people with kindness and respect. We witnessed many positive interactions between staff and people they supported.” from the report
Personalised support
Care plans described people’s histories, preferences, communication needs and routines. Staff could explain how they supported individuals.
“People's care files included information about their personal histories and what was important to them.” from the report
People’s choices and legal rights
seriousThe home did not consistently follow the Mental Capacity Act. A special diet was arranged without evidence of the person’s involvement, a capacity assessment or a best-interest meeting. One person’s DoLS conditions were also not met.
“There was no evidence of the person being involved in this decision; no mental capacity assessment, no involvement of healthcare professionals and no best interest meeting had taken place in order to make this decision.” from the report
DoLS conditions
seriousInspectors recommended that the home meet specific conditions in a DoLS authorisation promptly. Families should ask what action has been taken since the inspection.
“We recommend the provider meet specific conditions stipulated in DoLS authorisation in a timely manner.” from the report
Quality checks
needs fixingThe provider’s audits did not always identify concerns or ensure they were addressed. This contributed to the Requires Improvement well-led rating.
“Other systems such as audits remained ineffective and failed to address concerns identified during this inspection.” from the report
Communication and complaints
needs fixingSome relatives were unhappy with the responses to complaints and with the frequency of communication. The provider did not always explain what had changed after problems were raised.
“Changes introduced to address the issues raised were not always communicated to people's relatives.” from the report
- 01What has been done to ensure every person is involved in decisions about their care and that best-interest decisions are properly recorded?
- 02How are the specific DoLS conditions being met now, and how is this checked?
- 03How do you make sure relatives receive clear updates after they raise a complaint?
- 04What changes have been made to the quality audits since this inspection?
- 05How do you support each person to make choices and receive care in the least restrictive way?
This was an unannounced comprehensive inspection covering all five key questions and infection control; inspectors reviewed care records for four people, and none of the people living at the home could provide verbal feedback. This explanation was written from the published report of 7 May 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 Ciderstone House
4 rated inspections over 6 years: the service has slipped, from Outstanding to Good.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Requires improvementstayed Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- March 2020
Registered with the Care Quality Commission on 31 March 2020.
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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44 live-in carers within about an hour of Swindon
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 £990 to £1,280 a week. 34 can care for a couple. 12 years' experience on average.
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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.