CQC report explained · a residential care home
What the CQC found at Draycombe 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
- Some risks had not been properly assessed, some equipment safety checks had not been completed, and some staff training was outstanding. People said they felt safe, and the manager arranged risk assessments and equipment checks during the inspection.
- Effective?
- Requires improvement
- This key question was not inspected in this focused inspection. Its rating was not given in this report.
- Caring?
- Good
- This key question was not inspected in this focused inspection. The report nevertheless says people received kind and compassionate care and were treated with respect.
- Responsive?
- Good
- People were supported with personalised care, communication, independence and activities they enjoyed. The home had improved support for people to take part in the community.
- Well-led?
- Requires improvement
- The systems for checking the quality and safety of the home were not effective. The manager also lacked knowledge in some areas of responsibility for assessing safety.
What inspectors found, September 2023
Rated Requires Improvement; inspectors found kind, responsive care, but safety checks and quality monitoring were not reliable.
This was an unannounced focused inspection. The inspector visited on 13 July 2023 and returned to review further safety records. They spoke with people and staff, observed care, looked around the home, and checked care, medicine, staffing, training and safety records.
People said they felt safe and received kind care from staff who knew them well. The home had improved support for community activities since the previous inspection. People were supported with medicines, health care, communication and decisions about their lives.
However, some risks had not been properly assessed. Some equipment safety checks had not been completed, and some staff training was incomplete. The home also did not have effective systems to monitor safety and quality. The registered manager arranged some checks and risk assessments during the inspection, but the home remained in breach of two regulations.
The overall rating remained Requires Improvement. Safe and well-led were rated Requires Improvement, while responsive was rated Good. This was the second consecutive inspection with an overall Requires Improvement rating.
Kind and respectful care
People received kind, compassionate and personalised care from staff who knew them well. Staff respected people's privacy, dignity, choices and communication needs.
“People received kind and compassionate care from staff who knew them well.” from the report
Community activities
People had returned to activities such as local clubs, family visits and local amenities. This was an improvement since the previous inspection.
“People told us they enjoyed the activities they followed in the community.” from the report
Support with medicines
Staff were trained to manage medicines safely and followed systems for administering, recording and storing them.
“People were supported by staff who followed systems and processes to administer, record and store medicines safely.” from the report
Staffing and safeguarding
Inspectors found enough staff to meet people's needs. Staff understood how to recognise and report abuse, and recruitment checks were carried out.
“People were protected from abuse because staff understood how to identify and report any concerns.” from the report
Risks were not fully assessed
seriousSome risks to people's health, safety and welfare had not been assessed, or the assessments were not strong enough. Inspectors said this placed people at risk of harm.
“People were not protected against the risk of harm and infection because some risks had not been assessed and some risk assessments were not robust.” from the report
Safety checks were missed
seriousSome checks on equipment and the premises had not been completed. The manager arranged the required checks during the inspection.
“Some checks on the safety of equipment had not been carried out.” from the report
Weak quality monitoring
seriousThe home's systems did not identify the problems with risk assessments and safety checks. The manager also lacked knowledge in some areas of responsibility.
“The provider had failed to operate effective systems to ensure the quality and safety of the service.” from the report
Some staff training incomplete
needs fixingSome staff had not completed training about keeping people safe. The manager had arranged for the required training to be completed.
“Some staff had not completed training around how to ensure people were safe.” from the report
- 01Which risk assessments were missing or not robust, and when were they completed?
- 02Have all equipment and premises safety checks now been completed, and how often will they be repeated?
- 03Which staff had not completed safety training, and has all required training now been completed?
- 04What new system will check that risks, equipment safety and service quality are monitored consistently?
- 05How will you maintain the improved programme of community activities for each person?
This was a focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected, and their ratings were not given in this report. This explanation was written from the published report of 22 September 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, June 2022
Draycombe House was rated Requires Improvement; care was safe and kind, but community access, person-centred support and management systems were not good enough.
This was the first inspection since the current service was registered. Inspectors visited on 8 April 2022 and gathered further views until 11 May. They spoke with all five people living in the home, staff and relatives, observed care, looked around the home and checked care, medicine, staffing and management records. They also gathered feedback about the personal care provided to two people living in the community.
The home was rated Good for Safe and Caring. People felt safe, received their prescribed medicines and were supported by staff who knew them well. Inspectors saw kind, respectful care. People were supported with healthcare, communication, privacy and independence.
The home was rated Requires Improvement for Effective, Responsive and Well-led. People living in the home had not regularly returned to activities in the community after COVID-19 restrictions eased. Their views about this had not been properly gathered or acted on. This affected their quality of life and meant the care was not always centred on their needs and wishes.
The overall rating Requires Improvement means the home was not consistently meeting the standard expected. The provider was required to send an action plan, and CQC said it would monitor progress with the provider and local authority.
Kind and respectful care
People were supported by staff who knew them well. Inspectors found a friendly atmosphere and saw staff protecting people's privacy and dignity.
“People were supported by staff who knew them well and who were kind, respectful and caring.” from the report
People felt safe
People said they felt safe and staff understood how to recognise and report abuse. Risk assessments guided staff in keeping people safe.
“Everyone told us they were confident the service was safe, and people were protected from the risk of abuse.” from the report
Medicines and healthcare
People received medicines as prescribed and were supported to attend healthcare appointments, checks and vaccinations.
“People received their medicines as they needed and as their doctors had prescribed.” from the report
Support for independence
Staff helped people build skills through everyday tasks such as cooking, washing up and changing their beds.
“People were supported to carry out tasks in the home to gain skills and promote their independence.” from the report
Limited community activities
seriousPeople living in the home had not been supported to regularly return to activities in the community after restrictions eased. Inspectors found this reduced choice and affected people's quality of life.
“People were not supported to be involved in their community.” from the report
Feedback was not acted on
seriousPeople and staff had raised concerns about the lack of community activities, but the provider had not treated these concerns as a formal complaint or used them to improve the service.
“The provider had not gathered and acted on people's feedback about the lack of community access and how this impacted on their quality of life.” from the report
Staffing for social needs
needs fixingThere were enough staff to keep people safe, but usually only one staff member was on duty in the home. Activities could be interrupted when staff had to provide care elsewhere.
“However, there were times activities were interrupted because the staff member on duty had to leave an activity to support a person with their care.” from the report
Some training updates overdue
needs fixingSome staff training updates were overdue because of problems caused by the pandemic. The manager had an action plan to address this.
“Although staff had completed training, some training updates were overdue due to issues caused by the pandemic.” from the report
- 01How often can each person currently take part in activities in the local community?
- 02How are people's individual choices and goals for community activities recorded and reviewed?
- 03What staffing arrangements are now in place so community activities do not have to be interrupted?
- 04What action has been taken in response to the Regulation 10(1) and Regulation 17(1) breaches?
- 05How are people, relatives and staff now asked for feedback, and how is the home checking that concerns lead to improvements?
This first inspection looked at all five key questions, the care home and the personal care agency, with the main concerns relating to people living in the care home. This explanation was written from the published report of 14 June 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.
Every inspection of Draycombe House
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementdown from GoodSafe: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021
Registered with the Care Quality Commission on 25 February 2021.
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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.