CQC report explained · a residential care home
What the CQC found at Crest House Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm. Staffing, recruitment, risk management, safeguarding and medicines were generally safe, although some medicine recording issues were reported under Well-led.
- Effective?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Inspectors did report that staff provided caring, person-centred support.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Inspectors found that people were involved in their care and supported to make choices.
- Well-led?
- Requires improvement
- Quality assurance systems did not always identify environmental problems or medicine-record discrepancies. The provider was in breach of Regulation 17.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found safe, caring support but weaknesses in quality checks.
This was an unannounced focused inspection on 28 November 2022. Two inspectors visited the home and spoke with people, relatives, staff and health professionals. They reviewed care plans, risk assessments, medicine records, recruitment documents and quality records.
The home was rated Good for Safe. Inspectors found enough safely recruited and trained staff. They found that risks were assessed and managed, medicines were generally given safely, and safeguarding concerns were reported appropriately. They also found caring, person-centred support and good involvement of people and relatives.
The home was rated Requires Improvement overall and for Well-led. Quality checks did not always find problems with the environment or medicine records. The provider breached Regulation 17 because it had not effectively assessed, monitored and improved the quality and safety of the service.
Safe staffing
Inspectors found enough staff to meet people's needs, and staff were safely recruited and trained.
“There were enough staff to support people safely.” from the report
Person-centred care
Care plans reflected people's needs and wishes. Staff supported people to make choices and spend their time as they wanted.
“People's care plans were person-centred and written in partnership with people.” from the report
Caring culture
People and relatives spoke positively about staff. Inspectors saw staff spending time with people and responding to their individual preferences.
“The provider and registered manager instilled a caring, person centred culture which the staff team reflected.” from the report
Partnership working
Health professionals said staff communicated well and followed advice. Staff worked with health professionals to support people's health and mobility.
“Professionals who worked with the service told us staff were responsive to people's health needs and communicated well.” from the report
Weak quality checks
seriousThe provider's systems did not reliably identify problems with the environment or medicine records. This resulted in a breach of Regulation 17.
“The provider had failed to assess, monitor and improve the quality and safety of the service provided.” from the report
Medicine records
needs fixingInspectors found two missing staff signatures on one person's medicine record and incorrect dates on another record. They found the medicines had been managed safely, but the checking process had not found these errors.
“We found two gaps on one person's MAR where staff had not signed to say they had given the person the medicine.” from the report
Environmental cleaning
minorSeveral bedroom windows had not been cleaned effectively and there was mildew on window frames. The provider arranged cleaning after inspectors raised this.
“We found several bedroom windows had not been cleaned effectively and there was a build-up of mildew on the window frames.” from the report
- 01What changes have you made to the quality audits since the inspection?
- 02How do you now check that medicine administration records are complete and accurate?
- 03What action was taken to address the mildew and cleaning problems in bedroom windows?
- 04What was included in the action plan requested by CQC, and has it been completed?
- 05How will you show families that the Regulation 17 breach has been addressed?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection when calculating the overall rating. This explanation was written from the published report of 12 January 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, March 2021
Crest House Care Home was inspected but not rated; inspectors found good infection control, with a temporary gap in staff testing.
This was an announced, targeted inspection on 22 February 2021. It looked at infection prevention and control during the coronavirus pandemic, rather than the home's overall quality.
Inspectors found that the home supported social distancing, safe outdoor walks and activities. Staff had training in using personal protective equipment, and the home was clean with enhanced cleaning of frequently touched surfaces.
The home used regular PCR testing for staff and residents. At the time of inspection, regular lateral flow testing for staff had not yet started, although extra precautions were in place. After the inspection, the provider confirmed that this testing was now in place.
The service was inspected but not rated. This means the report does not give a Good, Requires Improvement or Inadequate rating for the home overall.
PPE training and checks
Staff had training in the safe use of PPE. The manager checked their competence each month, and PPE was available throughout the home.
“Staff had received training in the safe use of personal protective equipment (PPE) and the registered manager completed monthly competency checks to ensure staff were using PPE appropriately.” from the report
Cleaning and hygiene
The home had enhanced cleaning schedules and cleaned frequently touched surfaces four times a day. Some flooring and furniture had also been changed to make cleaning easier.
“Frequently touched surfaces such as door handles were cleaned four times a day.” from the report
Social distancing
The home used risk assessments, fixed seating where possible and removed some chairs to create more space in communal areas.
“There was a communal area risk assessment which detailed how staff should support people in communal areas.” from the report
Safe activities
People were supported to take local walks safely. During the pandemic, staff provided sing-alongs, quizzes and reminiscence activities.
“People who chose to go for walks outside the home were supported to do so safely.” from the report
Staff testing was incomplete at the visit
needs fixingRegular lateral flow testing for staff had not yet been implemented when inspectors visited. The home had extra precautions and later confirmed that regular lateral flow testing was in place.
“We were some-what assured that the provider was accessing testing for people using the service and staff.” from the report
- 01When did regular lateral flow testing for staff start, and how is it checked now?
- 02What extra infection control measures were used while regular lateral flow testing was not yet in place?
- 03How often are staff's PPE skills checked, and what happens if a check identifies a problem?
- 04How often are frequently touched surfaces such as door handles cleaned now?
- 05How does the home manage social distancing and safe communal activities when people use the lounge and dining room?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; it did not provide ratings for the other four questions or an overall quality rating. This explanation was written from the published report of 4 March 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 Crest House Care Home
3 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- November 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2016
Registered with the Care Quality Commission on 15 December 2016.
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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.