CQC report explained · a residential care home
What the CQC found at Compton House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2022
Rated Requires Improvement; inspectors found safe staffing during the visit, but recruitment checks and management records were not reliable.
This was an unannounced focused inspection on 11, 12 and 13 September 2022. Inspectors looked at Safe and Well-led because of concerns about staffing and management oversight. They observed care, spoke with nine people and six staff, and checked care, medicines, recruitment and management records.
The home was rated Requires Improvement for Safe and Well-led. Staffing appeared safe during the inspection, and people and relatives said they felt safe. However, three of four staff files had gaps in employment histories. Some care guidance was not followed, and there were concerns about a locked fire exit and infection waste bins.
Management systems were not reliable enough. Some fire checks, medicines counts, daily notes and other records were incomplete or inaccurate. The provider had not always investigated incidents well enough to prevent them happening again. The home remained in breach of Regulation 17, and a new breach was found for recruitment under Regulation 19.
The registered manager and provider acted quickly during and after the inspection. They produced an action plan and made some immediate changes. However, the home had been rated Requires Improvement at the previous inspection too, so inspectors said more improvement was still needed.
Staff available during visit
Inspectors found enough staff during their unannounced out-of-hours visit. Staff appeared available and not rushed.
“During the inspection we observed safe staffing levels and staff appeared unhurried and available to meet people's support needs.” from the report
People felt safe
People said they were happy living in the home. Relatives also told inspectors they felt their family members were safe.
“People confirmed they were happy living at the service and relatives told us they felt people were safe.” from the report
Improved safeguarding
The home had improved how it identified, reported and investigated safeguarding incidents, including unexplained bruising.
“The registered manager had implemented a robust process for identifying, reporting and investigating safeguarding incidents, including unexplained bruising.” from the report
More detailed care plans
Care plans and risk assessments were being updated and had become more detailed and person-centred.
“The updated care plans were very detailed, and person centred.” from the report
Support to increase independence
People were supported to work towards personal goals. Inspectors saw that some goals had led to positive outcomes.
“People were being supported to identify personal goals to increase their independence.” from the report
Recruitment checks
seriousThree of the four staff files checked had gaps in employment histories. This meant the provider could not properly consider whether applicants were suitable to work with vulnerable people.
“For example, we found for three of the four staff files reviewed, there were gaps in employment histories.” from the report
Guidance not always followed
needs fixingStaff did not always follow people's care guidance, including guidance about preferred communication methods.
“We observed occasions where guidance was not being followed. For example, in relation to using people's preferred communication methods.” from the report
Fire safety concern
seriousA fire exit was locked and needed a key to open it. The registered manager took prompt action to put a procedure in place.
“there was a locked fire exit which required a key to open it.” from the report
Inaccurate and incomplete records
seriousSome fire checks, medicines counts, daily notes and recording charts were incomplete or inaccurate. This made it harder for the provider to identify risks and confirm what had happened.
“The provider had not ensured records relating to the management of the home had always been completed or were accurate.” from the report
Incident reviews
needs fixingSome behaviour observation charts were not reviewed promptly or fully. This meant learning and support could be delayed, with a risk that incidents could happen again.
“We were concerned there was a delay in reviewing some BOC's which delayed support for people and staff” from the report
Feedback did not always involve people
needs fixingFeedback forms were generic and did not suit everyone. The home did not always show that it had followed up after people identified actions.
“Where people had provided feedback, there was no evidence of any follow-up with people when actions were identified.” from the report
- 01How have you corrected the gaps in staff employment histories, and how do you check new staff before they start?
- 02How do you make sure agency staff understand each person's communication needs and care guidance?
- 03What checks now confirm that fire exits can be used safely and that weekly fire checks are completed?
- 04How are medicines counts, daily notes and other records checked for accuracy?
- 05How quickly are behaviour incidents reviewed, and how do you make sure lessons are shared with staff?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 24 November 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.
What inspectors found, April 2022
Rated Requires Improvement; inspectors found caring staff and safe medicines practice, but concerns about staffing, risk guidance, records and management oversight.
Inspectors visited on 2, 4 and 7 March 2022 without giving notice. They spoke with six people, six relatives, 17 staff and four visiting professionals. They also observed care and checked care plans, medicines, staff files and management records.
The home supported people with autism and learning disabilities. Inspectors found kind and respectful interactions, good infection control, suitable healthcare support and medicines that were generally managed safely. However, some safety guidance was not followed, staffing relied heavily on agency workers, and activities were not provided consistently.
Care plans and mental capacity records were not always accurate or personalised. Meal choices and healthy alternatives were not consistently supported. Management checks had not identified or fixed several problems, including poor records and delayed learning from incidents.
The overall rating fell from Good at the previous inspection, published in April 2019, to Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. The report identified a breach of Regulation 17 on good governance and said the provider must submit an action plan.
Kind relationships
Inspectors saw relaxed, friendly and respectful interactions. Permanent staff knew people's communication styles and preferences well.
“They genuinely care for the residents and know them well” from the report
Medicines
Staff generally followed safe systems for prescribing, storing and giving medicines. Reviews also considered the risk of over-medication.
“People were supported by staff who were trained and followed systems and processes to prescribe, administer and store medicines safely.” from the report
Infection control
The home was clean and staff followed infection control measures. Suitable arrangements were used during a recent Covid-19 outbreak.
“Overall, staff followed effective infection, prevention and control measures to keep people safe.” from the report
Health support
People were supported with health checks, vaccinations, dental care and access to health professionals. Relatives said staff acted promptly when people became unwell.
“The service promoted good health and wellbeing outcomes for people, including supporting people to have an annual health check with their local GP.” from the report
Risk guidance not always followed
seriousInspectors saw people eating without the support described in their choking risk plans. This created an increased risk of harm.
“We observed this person eating their breakfast, whilst the staff member was encouraging this person to eat slowly and not place too much food in their mouth at once, the person had not been given a drink.” from the report
Heavy use of agency staff
needs fixingStaff turnover was high, with many vacancies and frequent agency cover. Inspectors saw agency staff who did not always know people well enough to provide meaningful support.
“There had been a large turnover in managers and staff, for example, 38 staff had left the service within the last 12 months and there remained 19 vacancies for support workers.” from the report
Food choices
needs fixingRecords showed repetitive meals and little evidence that staff encouraged healthier alternatives. Meals served did not always match the planned menus.
“More needed to be done to ensure that people were being involved in choosing and planning their meals and that they were being supported to maintain a healthy and varied diet.” from the report
Weak management checks
seriousThe home's systems did not reliably identify or fix problems with care, safety and records. This was the report's breach of Regulation 17.
“The systems in place to assess and monitor and improve the service were not effective.” from the report
Activities not consistent
needs fixingPeople had activity timetables, but records and observations showed limited evidence that these activities happened regularly. Some people spent long periods on laptops or tablets instead.
“More still needed to be done to ensure that people were adequately supported to take part in their chosen social and leisure interests on a regular basis.” from the report
- 01How do you now check that each person's choking and other risk guidance is followed on every shift?
- 02How many permanent staff currently work at the home, and how are agency workers introduced to each person's communication and support needs?
- 03What has changed to make sure people choose varied, healthy meals and receive suitable alternatives when they do not eat?
- 04How are care plans, mental capacity assessments and best-interest decisions now checked for accuracy and family or advocate involvement?
- 05How do you record and monitor each person's activities, community access and progress towards their personal goals?
This inspection focused on Safe, Effective and Well-led; the report says ratings for key questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 28 April 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Compton House
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015
Registered with the Care Quality Commission on 31 July 2015.
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
26 live-in carers within about an hour of Hampshire
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 £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.