CQC report explained · a residential care home
What the CQC found at 121 Station Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staffing had improved and inspectors found enough staff to meet people's needs. Medicines were given as prescribed, but recording of creams was not always consistent, and one relative raised concerns about occasional cleanliness.
- Effective?
- Good
- Staff had relevant training and people were supported with food, drink and healthcare. Not all records showed that mental capacity assessments and best-interest decisions had been regularly reviewed.
- Caring?
- Good
- Staff were kind and caring, respected privacy and dignity, and encouraged people to make choices and remain independent. Inspectors saw calm and sensitive responses when people became distressed.
- Responsive?
- Good
- People received personalised care and had more access to activities than at the previous inspection. Their communication needs, preferences, routines and interests were recorded and supported.
- Well-led?
- Good
- The manager had returned to the role and improvements had been made in staffing, training and oversight. However, audits had not always identified gaps in care records, so a new audit tool had been introduced.
What inspectors found, June 2019
Consensus Support Services Limited - 121 Station Road was rated Good; inspectors found kind, safe and person-centred care, with some care records and maintenance needing attention.
This was an unannounced inspection over 23 and 24 April 2019. One inspector visited the home, spoke with people, relatives and staff, observed care, and reviewed three people's care records and management documents.
Inspectors found improvements since the previous inspection. Staffing was better, people had more activities, safety checks had been completed, and the manager had returned to the role. People were supported by kind staff who respected their choices, privacy and independence.
Some records did not fully show that care had been reviewed. Audits had not always found these gaps. There were also concerns about damaged plasterwork, occasional cleaning standards and inconsistent recording of creams. The overall rating and all five question ratings were Good.
Kind relationships
Inspectors found that staff were kind, caring and attentive. People appeared relaxed and staff responded sensitively to distress.
“People were supported by staff that were kind and caring and enjoyed spending time in their company.” from the report
More activities
Access to activities had improved since the previous inspection. People took part in outings, hobbies and activities of their choice.
“People were supported to access activities of their choosing and to engage in their hobbies and interests.” from the report
Health support
Staff recognised when people needed healthcare and helped arrange appointments and support from health professionals.
“Staff recognised when people needed healthcare support and co-ordinated appointments with professionals such as the GP, speech and language therapist, dietician, physiotherapist and community learning disability nurses.” from the report
Choice and independence
People were offered choices, supported to make their own decisions and encouraged to develop independent living skills.
“We observed staff support people to be independent, such as by making their own drink.” from the report
Care records
needs fixingQuality checks had not always found gaps in people's care records. The home introduced a new audit tool to identify and address these gaps.
“Quality assurance systems and processes did not always identify gaps in people's care records.” from the report
Mental capacity records
needs fixingSome records did not show that mental capacity assessments and best-interest decisions had been reviewed regularly. The manager said these had been reviewed after the inspection.
“Not all records we reviewed evidenced assessments and decisions had been regularly reviewed to ensure they remained reflective of people's needs.” from the report
Medicine recording
needs fixingPeople received their medicines as prescribed, but the recording of creams being applied was inconsistent. The manager said this would be addressed.
“The most recent audit identified inconsistency in recording of creams being applied” from the report
Home condition and cleanliness
minorInspectors found damaged plasterwork in some areas. One relative also said the home sometimes looked grubby.
“We found there were areas in the building where the plasterwork had been damaged by manoeuvring wheelchairs and equipment.” from the report
- 01What changes has the new audit tool made to care records, and how do you check that these changes are lasting?
- 02Are all mental capacity assessments and best-interest decisions now reviewed and kept in people's care files?
- 03How do you make sure creams and other medicines are recorded every time they are given or applied?
- 04What work has been completed to repair the damaged plasterwork and improve the areas that looked tired?
- 05How do you make sure people have regular access to the activities listed in their care plans?
This was an unannounced inspection covering all five CQC questions and both the care and premises; the previous rating was Requires Improvement, published on 23 May 2018. This explanation was written from the published report of 14 June 2019 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 2018
Requires Improvement; inspectors found kind care and good medicines practice, but staffing, activities and management needed improvement.
This was an unannounced inspection on 4 and 6 April 2018. Inspectors spoke with people, staff, relatives and a regular visitor. They observed care, checked three care records and three staff recruitment records, and reviewed training, audits, complaints and other records.
The home was safe in some important areas. Staff knew people well, followed safeguarding procedures and gave medicines safely. However, staffing levels were not always enough to support people's wider needs. Fire alarm and water temperature checks were also not recorded consistently.
People received kind and respectful care. Their care plans were detailed, their health needs were assessed and families were involved. However, activities and time out were sometimes missed because of staff shortages. There was no registered manager, and changes in managers had affected the stability of the home and its monitoring systems.
The overall rating was Requires Improvement. Effective and caring were rated Good. Safe, responsive and well-led were rated Requires Improvement. The home had deteriorated in some areas since the previous inspection in April 2016, when it was rated Good overall.
Kind and respectful care
Inspectors saw positive relationships between people and staff. Staff understood people's different ways of communicating and respected their dignity, choices and relationships.
“People received care from staff that knew them well and were kind, compassionate and respectful.” from the report
Detailed care planning
People's needs were assessed before they moved in. Care plans gave staff information about individual needs, preferences and support, and were reviewed regularly.
“The care plans contained all the relevant information that was needed to provide the care and support for the individual and gave guidance to staff on each individual's care needs.” from the report
Safe medicines practice
Medicines were stored securely and given according to people's prescriptions. Staff competency checks and medicines audits were carried out.
“People received their medicines, as prescribed, in a safe way and in line with the home's policy and procedure.” from the report
Safeguarding and risk management
Staff understood how to report concerns. Individual risks such as pressure damage and poor nutrition were assessed, with measures put in place to reduce them.
“Staff understood their roles and responsibilities in relation to keeping people safe and knew how to report concerns if they had any.” from the report
Staffing was not consistent
seriousThe home did not always have the agreed number of staff. Basic care was provided, but staff were sometimes too stretched to support people safely with activities, outings and other wider needs.
“Staffing levels were not always being consistently maintained to ensure that people received care timely and safely.” from the report
Activities and outings were missed
needs fixingSome people were left for long periods without interaction or activities. Planned individual activities could not always happen because there were not enough staff.
“We observed people left for long periods without any interaction with staff or any activities to undertake.” from the report
Unstable management
needs fixingThere had been several managers and no registered manager since September 2016. This affected staff confidence, staffing arrangements and the stability of the home.
“There had been a number of manager's in post, none of whom had completed the process of applying to become the registered manager.” from the report
Checks were not always recorded
needs fixingSome health and safety monitoring was inconsistent. Weekly fire alarm tests were not recorded and water temperature checks had not been recorded since November 2017.
“Fire alarm tests had not been recorded each week and water temperature checks had not been recorded since November 2017.” from the report
- 01What staffing levels are in place now during the day and at night, and how do you cover sickness and annual leave?
- 02How will you make sure each person receives their planned one-to-one time, activities and outings?
- 03Who is the registered manager now, and how long have they been in post?
- 04How are fire alarm tests, water temperature checks and other safety audits recorded and checked?
- 05What has been done to bring staff training refreshers and supervision up to date?
This was an unannounced inspection covering all five key questions, with the inspection team observing care, speaking to people and others, and reviewing care, staffing and management records. This explanation was written from the published report of 23 May 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.
Every inspection of 121 Station Road
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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