CQC report explained · a residential care home
What the CQC found at Esther Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, regular risk reviews and safe medicines management. They also found suitable infection prevention arrangements and staff who understood safeguarding.
- Effective?
- Good
- Not assessed in this focused inspection.
- Caring?
- Good
- Not assessed in this focused inspection, although inspectors observed positive interactions between people and staff.
- Responsive?
- Good
- Not assessed in this focused inspection.
- Well-led?
- Good
- Inspectors found clearer electronic care records, quality checks and an open culture where people, relatives and staff could share their views. This rating improved from Requires Improvement at the previous inspection.
What inspectors found, April 2022
Rated Good; inspectors found safe care and stronger leadership, but three of the five key questions were not assessed.
This was a focused inspection on 31 January 2022. One inspector reviewed records, watched how staff supported people, spoke with people, the provider and staff, and checked medicines, staffing, recruitment and infection control.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe medicines practices, suitable risk assessments and good safeguarding arrangements. People were supported to be independent and to take part in activities and community visits.
Leadership had improved since the previous inspection, when Well-led was rated Requires Improvement. Electronic care records were clearer and easier for staff to use. The inspection did not assess Effective, Caring or Responsive, so those areas were not given new ratings.
Staff understood people
Staff knew people's risks, communication methods and signs of distress. They supported people to be as independent as possible while keeping them safe.
“Staff knew people well and told us when people were not able to verbally communicate they used people's body language and nonverbal cues to communicate with them.” from the report
Enough staff
Inspectors found enough staff for people's needs, including one-to-one support for activities and community visits.
“The service had enough staff to support people. This included one-to-one support for people to take part in activities and community visits.” from the report
Safe medicines
Medicines were stored securely, records checked were accurate, and staff had training and competency checks.
“We checked the medicine administration records (MAR) for two people and did not find any recording errors.” from the report
Improved records
The home had acted on the previous recommendation about electronic care records. Records were clearer and accessible to staff.
“The provider had fully integrated the computer based system and people's care and support records were now clear and accessible for staff.” from the report
Open leadership
Inspectors found that people, relatives and staff were involved in discussions about the service and that incidents were discussed openly.
“The provider discussed incidents openly with people, relatives and staff and was honest about lessons they learned.” from the report
Building larger than current guidance
minorThe home was larger than current best practice guidance for this type of service. Inspectors noted that it still fitted into the residential area and had no identifying signs outside.
“The service was a large home, bigger than most domestic style properties. This was larger than current best practice guidance.” from the report
- 01How do you keep each person's electronic care record up to date and make sure all staff read it?
- 02How do you support people who communicate mainly through body language or other non-verbal cues?
- 03How do you make sure there are enough staff for one-to-one activities, community visits and healthcare appointments?
- 04How are medicines reviewed and how are staff competency checks recorded?
- 05How will you make the home feel suitable for the people living there, given that the building is larger than current best practice guidance?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not assessed. This explanation was written from the published report of 5 April 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, November 2017
Esther Care Home was rated Good overall, but inspectors found records and management systems needed improvement.
This was an unannounced comprehensive inspection on 12 October 2017. The inspector spoke with people using the home, staff, the administration manager and the registered manager, and reviewed care, medicines, staff, finance, quality and maintenance records. Feedback was also gathered from a relative and healthcare professionals.
People were safe and received kind, respectful care. Inspectors found enough staff, clear risk plans, safe medicines management, access to food and healthcare, and support with activities and relationships.
The main weaknesses were in record keeping. Care information was split between paper files and an electronic system, making it harder to find the latest information. Records of staff inductions and assessed skills were also not easy to access. The overall rating was Good, but well-led was rated Requires Improvement.
Safety planning
The home had detailed risk plans covering areas such as medicines, mobility and leaving without direct staff support. These plans gave staff guidance on how to keep people safe.
“The service had developed comprehensive risk management plans that identified the risk and gave staff clear guidance on how to keep people safe.” from the report
Respectful care
Staff supported people to make decisions, maintain privacy and dignity, and develop their independence.
“People had their privacy and dignity maintained and respected by staff.” from the report
Activities and choice
People were supported to take part in activities at home and in the community, including walks, shopping, meals out, day centres and religious or cultural visits.
“People were supported to engage in activities of their choice both in the service or in the community.” from the report
Care records were difficult to find
needs fixingInformation was split between electronic records and paper folders because the transfer to the electronic system was incomplete. This could make it harder for new staff to find current information and deliver up-to-date care.
“We found it difficult to navigate what information had been stored electronically and what information was still in folders, thus making the information often hard to locate.” from the report
Training records were not clear
needs fixingThe home could not initially show accessible records of staff inductions and assessed competencies. Some training had expired, although updated information was later provided and expired training had been rescheduled.
“We were unable to confirm this as the provider did not maintain accessible records of the induction programme and competencies assessed.” from the report
- 01Has all care information now been transferred into one clear and up-to-date record system?
- 02How can staff quickly find the latest care plan and risk information for a person?
- 03How are staff induction and competency records stored and checked now?
- 04Have all expired training courses been completed or rescheduled?
- 05How are people and relatives involved in reviewing care plans and giving feedback?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 15 November 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 Esther Care Home
3 rated inspections over 7 years: the service has held its Good rating throughout.
- April 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Goodstayed GoodSafe: GoodWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2011
Registered with the Care Quality Commission on 2 November 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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