CQC report explained · a residential care home
What the CQC found at Creda House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always securely stored or recorded correctly, and some storage temperatures were too high without action being taken. Incident and safeguarding records did not always show that concerns were reported or lessons were learned.
- Effective?
- Requires improvement
- Medicine management did not always follow guidance. Inspectors otherwise found that people's needs, communication preferences and support plans were assessed and that people had access to healthcare.
- Caring?
- Good
- This key question was not inspected during this visit. The report describes staff as knowing people well, promoting dignity and supporting people in a person-centred way.
- Responsive?
- Good
- This key question was not inspected during this visit. The report says people were supported with choices, activities, relationships and individual communication preferences.
- Well-led?
- Requires improvement
- Quality checks did not identify important medicine, incident-recording and environmental problems. The provider had also failed to send some required notifications to CQC.
What inspectors found, November 2022
Creda House rated Requires Improvement; inspectors found risks in medicines, safeguarding records and quality checks, although staff knew people well.
This was an unannounced focused inspection by two inspectors. They visited on three dates and reviewed information, records, policies and training documents. They observed staff supporting people, and spoke with staff, relatives and the registered manager.
The home was not always safe. Medicine keys and a medicine stock cupboard were not secured properly. Medicine records were inconsistent, and some storage temperatures were above the recommended level without action being taken. Inspectors also found that incident records did not always show whether concerns had been reported or what lessons had been learned.
People's care was generally person-centred. Staff knew people well, supported their communication preferences and used the least restrictive approach. Relatives gave positive feedback, and people were supported with activities, relationships, healthcare and meal preparation.
The overall rating fell from Good to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. This was a focused inspection, so Caring and Responsive were not inspected and their previous ratings were carried forward.
Staff knew people well
Staff could explain people's risks, communication needs and ways of responding to emotional distress. Relatives said people were supported safely and well.
“Staff knew people well and were responsive to their needs.” from the report
Person-centred support
Care plans included people's communication preferences, equality and diversity needs, positive behaviour support guidance and daily choices.
“People were supported in a person-centred way.” from the report
Choice and least restriction
People were supported to make choices, maintain important relationships and take part in activities. Staff described using less restrictive options first.
“People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Support from relatives and professionals
Relatives were involved in care planning, and people were supported to attend healthcare appointments and work with health professionals.
“Relatives told us, and records showed that people had access to relevant professionals when needed and been involved in peoples care plans.” from the report
Medicine security and records
seriousMedicine cupboard keys were left in the door, the stock cupboard had no lock and electronic administration records were inconsistent. Some medicine storage temperatures were above the recommended level without action.
“People's medicines were not always managed and stored safely.” from the report
Safeguarding and incident records
seriousThe home could not assure inspectors that incidents had always been reported as required. Records of injuries and emotional distress lacked enough detail to support learning and prevention.
“The service's failure to identify potential abuse placed people at potential harm.” from the report
Quality checks missed problems
seriousAudits did not identify the medicine, incident-recording and environmental issues found during the inspection. This meant managers did not have reliable oversight of risks.
“Quality monitoring systems had not identified issues highlighted during the inspection” from the report
Maintenance and personalisation
needs fixingSome areas were bare, damaged or worn, and parts of the home needed repair and redecoration. Inspectors said the environment did not always reflect people's preferences.
“some parts of the service were quite bare, with no pictures on the walls, lacked personalisation and areas of the service required maintenance and repair.” from the report
Infection control on the first day
needs fixingSome staff were not wearing face masks as required by current guidance. This was corrected immediately, but some damaged surfaces could not be kept hygienically clean.
“On the first day of the inspection some staff were not wearing face masks and told us these were only worn during personal care.” from the report
- 01How have you secured the medicine cupboards and ensured medicine administration records are complete?
- 02How are medicine storage temperatures now checked, and what happens when they are outside the recommended range?
- 03How do you record, report and review injuries, emotional distress and safeguarding concerns?
- 04What changes have you made to quality audits so they identify medicine, incident-recording and environmental problems?
- 05What repairs and redecoration have been completed, and how have people's preferences been used to personalise the home?
This was an unannounced 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 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, July 2019
Creda House was rated Good; inspectors found safe, kind and personalised care, with effective management and no identified breaches.
This was the first inspection since the home registered in March 2018. It was a planned, announced visit on 20 June 2019. One inspector reviewed records, spoke with the person living there, staff and managers, and checked care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that staff knew the person well, supported their choices and independence, and helped them take part in activities at home and in the community.
Inspectors found safe medicines support, up-to-date risk assessments, suitable staffing and good links with health and social care professionals. They also found systems for checking quality, responding to concerns and making improvements.
Personalised support
Staff knew the person well and planned support around their preferences, interests and daily choices.
“There was a homely feel to the service and it was apparent that staff knew the person very well.” from the report
Safety and risk management
The person's risks were assessed and reviewed, with clear guidance for staff on how to keep them safe.
“Risk assessments were comprehensive and up to date to ensure staff acted consistently to protect people from harm.” from the report
Family involvement
Relatives were involved in developing care plans and could raise questions or concerns with the management team.
“We saw the person and their relatives had been involved in developing their care plans.” from the report
Quality oversight
The management team used audits and other checks to monitor care, medicines and the running of the home.
“Quality assurance processes were in place to monitor the quality of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you keep care personalised if more people moved into the home or used it for respite?
- 02What changes were made to medicines administration after the local authority inspection, and how do you check that these changes remain effective?
- 03How are care records and medicines audits followed up when inconsistencies are found?
- 04How would you record and review a person's wishes about end of life care if this became relevant?
- 05How will you support a new resident to take part in activities and maintain their independence?
This was a planned inspection following registration and covered all five CQC questions, but only one person was living at the home at the time. This explanation was written from the published report of 31 July 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.
Every inspection of Creda House
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- November 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2019GoodSafe: GoodEffective: GoodWell-led: Good
- March 2018
Registered with the Care Quality Commission on 12 March 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.
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