CQC report explained · a residential care home
What the CQC found at Crescent House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2019
Rated Good; inspectors found safe, kind and personalised care, with some records and authorisations still being developed.
This was an unannounced inspection of the whole home on 15 October 2019. Inspectors spoke with 14 people, six relatives, seven staff members and a visiting health professional. They reviewed care and medicines records, staff recruitment and supervision files, and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, received their medicines as prescribed, and had their risks assessed. Staff knew people well and supported their dignity, independence, health needs and personal choices.
The home offered varied activities and spaces, including one-to-one activities for people living with dementia and outdoor access to ponies. Managers used audits, complaints, incidents and near misses to improve the service. The report also noted that some DoLS applications were awaiting authorisation and that end-of-life preferences were still being recorded in more detail.
Staff know people well
People received care from a consistent group of staff who understood their needs and preferences.
“People received care from a consistent group of staff who knew people well.” from the report
Personalised care
People and relatives were involved in care planning. Staff supported people in ways that reflected their routines, interests and past lives.
“People's care was planned and delivered in a person-centred way.” from the report
Activities and social contact
The home provided tailored activities, including one-to-one support for people living with dementia. Inspectors found that activities helped reduce isolation and maintain interests.
“No-one suffers from isolation now [activities staff] is here. They [staff] are now organising trips outside the home.” from the report
Approachable management
People, relatives and staff described managers as visible, supportive and easy to approach. Managers acted on feedback and incidents.
“The atmosphere is lovely. All the management are approachable.” from the report
DoLS applications awaiting authorisation
needs fixingThe home had applied for DoLS authorisations, but the local authority had not yet authorised them at the time of the inspection. The report does not say that this led to a breach.
“The compliance manager showed they had applied for DoLS authorisations, but these had not yet been authorised by the local authority.” from the report
End-of-life records still developing
minorStaff followed people's wishes and supported families, but the home was still developing fuller records about how people wanted to be supported at the end of their lives.
“The provider was developing ways of recording what was important to people including information about how they wanted to be supported towards the end of their lives.” from the report
- 01What is the current position of any DoLS applications for my relative, and what arrangements are in place while authorisation is awaited?
- 02How will you record and regularly review my relative's wishes for end-of-life care?
- 03How will you make sure my relative receives activities suited to their interests, abilities and communication needs?
- 04How will my relative and our family be involved in updating the care plan?
- 05How quickly would you respond if we raised a concern or complaint?
This was an unannounced planned inspection of the care home covering all five CQC questions, and all five ratings remained Good from the previous inspection. This explanation was written from the published report of 20 November 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, April 2017
Rated Good; inspectors found safe, kind and personalised care, but activities and some monitoring needed improvement.
This was an unannounced inspection over two days, on 2 and 3 November 2016. Inspectors spoke with people living in the home, relatives, staff and health professionals. They looked at care records, recruitment, training, medicines and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People generally felt safe and well cared for. Staff understood people's needs, medicines were managed safely, and people had access to healthcare and suitable food.
There were some shortfalls. People did not always have enough social contact or activities, and staff said they were often very busy. Monitoring of falls and some people's weights was not always effective, but the provider took action during or before the inspection to improve these areas.
People felt safe
People and relatives generally had confidence in the staff's ability to keep people safe. Staff knew how to report abuse or other concerns.
“People felt safe in the home and relatives said they had no concerns about people's safety.” from the report
Safe medicines support
Medicines were obtained, stored, given and disposed of safely. Staff were trained and checked for competence.
“People were supported to take their medicines as prescribed. Medicines were obtained, stored, administered and disposed of safely.” from the report
Kind and respectful care
Staff had warm relationships with people and respected their privacy, dignity, choices and independence.
“Staff supported people in a kind and caring way and involved them as much as possible in day to day choices and arrangements.” from the report
Personalised care plans
Care plans described people's needs, preferences and how they wanted to be supported. People were involved in decisions where possible.
“Care plans were written in a person centred approach and detailed how people wished to be supported.” from the report
Access to healthcare
People's health was monitored and they were supported to see doctors and other health professionals when needed.
“People had prompt access to health care support, as the doctor attended the home weekly as well as visiting people for acute health problems when needed.” from the report
Not enough activities
needs fixingPeople, relatives and staff said there was not always enough time or provision for activities and conversation. The provider responded by reviewing and increasing staffing levels.
“People told us and we saw that there was not always enough social interaction and activity available to ensure that sufficient mental stimulation was available to people living in the home.” from the report
Follow-up after falls
seriousMonitoring after one person's further falls had not led to enough action to reduce the risk of harm. The provider put new safety measures and formal falls monitoring in place during the inspection.
“Sufficient action had not been taken following these falls; meaning that appropriate measures had not been put in place to reduce the risk of harm to the person.” from the report
- 01What activities and one-to-one social contact are available now, following the increase in staffing?
- 02How quickly are call bells answered, including at night, and how is this monitored?
- 03What changes were made after the concerns about repeated falls?
- 04How do you make sure people are weighed as often as their nutrition assessments require?
- 05How is each person's consent to their care recorded and kept up to date?
This was an unannounced two-day inspection that assessed the overall service and gave ratings for all five CQC questions. This explanation was written from the published report of 22 April 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 Crescent House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
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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