CQC report explained · a residential care home
What the CQC found at Echelforde
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks, safeguarding, staffing, recruitment, medicines and infection control were generally managed well, although one person's risk assessments had not been updated until the inspection.
- Effective?
- Good
- People's needs were assessed and staff had suitable training and support. Nutrition, healthcare, the environment and consent were managed well, although one person's mental capacity and best-interests decisions had not been recorded until inspectors raised this.
- Caring?
- Outstanding
- Staff showed exceptional kindness, warmth and respect. People were supported to make choices, remain independent and take part in their care and daily life.
- Responsive?
- Good
- Care plans were detailed and personalised, and people had a wide range of activities and community links. Complaints were handled through an accessible process, and there had been no complaints since the previous inspection.
- Well-led?
- Good
- Inspectors found visible leadership, an open culture and systems for checking quality and learning from problems. People, relatives and staff said the home had improved under the current management.
What inspectors found, February 2020
Rated Good overall, with Outstanding care; inspectors found kind, person-centred support and a few records that needed updating.
This was an unannounced inspection over two days. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care plans, medicines records, recruitment files and other records.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were rated Good. Caring improved from Good to Outstanding since the previous inspection in June 2017.
Inspectors found people were safe, treated with warmth and respect, and supported to stay independent. The home offered personalised care, activities and community links. A small number of risk and decision-making records had not been updated, but these were addressed during the inspection.
Exceptionally caring staff
People and relatives consistently described staff as kind and compassionate. Inspectors saw staff using their knowledge of people's personalities and interests to reduce distress and support well-being.
“People told us they received outstanding care from staff who demonstrated kindness and compassion and valued people's uniqueness.” from the report
Independence and dignity
People were encouraged to do what they could for themselves and were involved in decisions about their care. Staff respected people's choices about their daily routines.
“People were encouraged in a distinctive way to be as independent as possible and to be involved in decisions about their care.” from the report
Personalised activities
The home offered varied activities and strong links with community groups. People could join outings and group events, or choose to spend time in their own way.
“The home had innovative links with community groups and offered a wide range of stimulating activities.” from the report
Learning and improvement
The home reviewed incidents, carried out audits and acted on problems. Inspectors found evidence that the current manager had made and sustained improvements since the previous inspection.
“The registered manager had introduced and sustained improvements at the home since the last inspection.” from the report
Risk records needed updating
needs fixingFor one person, risk assessments about behaviour had not been updated to guide staff. The manager updated them on the first day of the inspection, but families should ask how this is now checked.
“We found for one person their risk assessments had not been updated to guide staff on aspects of their behaviour to reduce risk to themselves or others.” from the report
Capacity decisions were not recorded
needs fixingFor one recently admitted person, mental capacity assessments and best-interests decisions had been discussed but not recorded. This was corrected during the inspection.
“For one person recently admitted to the home we found MCA assessments and best interests' decisions had been discussed but not recorded.” from the report
Pain records were still being developed
minorThe home was arranging for pain assessments to be included in its new electronic medicines records. Families may wish to ask how pain is currently assessed and recorded.
“The home was in the process of organising for pain assessments to be included in the new electronic medicines' records.” from the report
Occasional weekend staffing pressure
minorThe report found enough staff overall, but two staff members said it could sometimes be difficult to find agency cover when colleagues were absent at short notice at weekends.
“However, two staff members said occasionally if staff were off work at short notice at weekends it could be difficult to get agency staff.” from the report
- 01How do you now make sure every person's risk assessment is updated when their behaviour or needs change?
- 02How are mental capacity assessments and best-interests decisions recorded for new residents?
- 03How are pain assessments recorded in the electronic medicines system while this work is being completed?
- 04What happens at weekends if staff are absent at short notice and agency cover cannot be found?
- 05How do you check that the improvements made since the previous inspection continue over time?
This was an unannounced inspection covering all five CQC questions, with the previous ratings reviewed and Caring improved from Good to Outstanding. This explanation was written from the published report of 11 February 2020 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 2017
Rated Good; inspectors found safe, kind and responsive care, with improvements since the previous inspection.
This was an unannounced inspection on 19 April 2017. Inspectors spoke with people living at the home, relatives and staff. They observed care and reviewed care plans, medicines, staff records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training and good support for people's health and nutrition.
Staff were described as kind, respectful and attentive. Care plans reflected people's needs and preferences. Activities had increased, including outings and visits from community groups. Complaints were investigated and people's views were used to improve the home.
The previous inspection found breaches relating to safe moving and handling, consent, confidentiality and incomplete care plans. Inspectors found that the provider had acted to address these concerns.
Safe care
Staff used the equipment set out in people's care plans when helping them transfer. People and relatives said they felt safe.
“Staff provided care in a safe way and ensured that appropriate equipment was used where necessary to support people.” from the report
Kind and respectful staff
Inspectors saw staff treating people warmly, protecting their dignity and responding to their comfort and emotional needs.
“Staff were kind and caring and treated people with respect.” from the report
Food and healthcare
People had a choice of food, snacks and drinks. Staff monitored health needs and made referrals when people needed specialist support.
“People's healthcare needs were monitored effectively and people were supported to obtain treatment if they needed it.” from the report
Personalised activities
The home offered activities, outings and visits from entertainers and community groups. Staff also visited people in their rooms to reduce isolation.
“The range of activities available to people had increased since our last inspection.” from the report
Open management
People, relatives and staff were encouraged to give feedback. The home showed that it acted on suggestions and monitored areas for improvement.
“There was an open culture in which feedback was encouraged and used to improve the service.” from the report
Use of agency staff
minorThe report says vacancies meant agency staff were used on some shifts. The manager was trying to recruit permanent staff, but ask how continuity is managed now.
“Due to vacancies on the staff team, agency staff were employed on some shifts.” from the report
- 01How many permanent staff are currently in place, and how often are agency staff used?
- 02How will you make sure staff use the correct moving and handling equipment for my relative?
- 03How will my relative and family be involved in mental capacity and best-interest decisions?
- 04How will you record and review my relative's care plan, life history, interests and changing needs?
- 05Which activities and one-to-one support would be available if my relative did not want to join group activities?
This was an unannounced comprehensive inspection covering all five CQC questions and checking whether improvements had been made since the previous inspection. This explanation was written from the published report of 10 June 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 Echelforde
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- December 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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