CQC report explained · a residential care home
What the CQC found at Horton House Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2018
Rated Good; inspectors found safe, kind and personalised care across all five areas.
The unannounced inspection took place on 7 and 8 August 2018. One inspector spoke with people, visitors, staff and health professionals. They observed care and reviewed care records, medicines records, recruitment, training, safety and quality checks.
The home supported 22 older people, including 17 people living with dementia. Inspectors found enough staff, safe medicines practice, suitable risk assessments and good infection control. People were supported to stay healthy, make choices and remain as independent as possible.
Care was described as individualised and person centred. Staff knew people well and treated them with respect. People had access to activities, outings, family visits and support with their cultural and spiritual needs.
The overall rating was Good, and each of the five areas was rated Good. This was the same overall rating as at the comprehensive inspection in February 2016.
Personalised care
Care plans reflected people's backgrounds, preferences, routines and changing needs. Staff knew people well and supported their independence.
“People's care was individualised and person centred, reflecting their backgrounds, likes and dislikes and needs.” from the report
Safety and staffing
The home had enough staff and did not use agency staff. Risks, accidents, safeguarding concerns and medicines were monitored.
“People were supported by enough staff to meet their needs who had been through a satisfactory recruitment process.” from the report
Kind relationships
Inspectors saw people relaxed and enjoying time with staff. Staff offered reassurance and respected people's privacy and dignity.
“People had positive relationships with staff. They were observed enjoying the company of staff.” from the report
Activities and choice
People were supported to choose how to spend their time and could join activities, walks, meals out, day trips and religious services.
“People had access to a wide range of activities.” from the report
Improvements to the home
Since the previous inspection, the home had added a conservatory, created bedrooms, replaced flooring and furniture, and improved signs for people living with dementia.
“Considerable improvements had taken place since our last inspection in 2016.” from the report
Inspectors raised no specific concerns in this report.
- 01How many staff are usually on duty for each shift, and how do you make sure staffing remains enough when people's needs change?
- 02How do you support people living with dementia when they become anxious or upset?
- 03Which activities and outings are currently available, and how are residents involved in choosing them?
- 04How are relatives involved in reviewing care plans and decisions about changing needs?
- 05How would you support my relative and our family if end of life care became necessary?
This was an unannounced inspection covering all five CQC questions, with the overall and individual ratings remaining Good. This explanation was written from the published report of 30 August 2018 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, January 2017
Rated Good; a focused inspection found that a previous legal issue about liberty authorisations had been addressed.
This was an unannounced, focused inspection on 11 January 2017. The inspector checked whether the home had fixed a legal problem found at the previous inspection in January 2016.
The home had taken action for people who were unable to make decisions about their care and whose liberty was restricted. Authorisations were in place for some people, and applications had been submitted for others.
Inspectors found that the home looked for less restrictive ways to keep people safe. It also used a monitoring tool to track applications and review dates. The overall rating was Good, and the effective question was rated Good.
Action on previous problem
The home had acted on the legal issue identified at the earlier inspection. Authorisations had been agreed for some people and applications had been submitted for others.
“At our focused inspection on 11 January 2017 we found the provider had taken action to address these issues.” from the report
Less restrictive care
The home used alternatives to bed rails and allowed people to walk in a secure garden or with staff support in the community.
“People's records confirmed the least restrictive solution was sought when placing restrictions on them to keep them safe.” from the report
Monitoring system
The registered manager used a spreadsheet to track each person's application and identify when reviews were needed.
“The registered manager monitored the status of each person's DoLS through a spread sheet which also highlighted when reviews were needed.” from the report
Previous missing authorisations
seriousAt the January 2016 inspection, some people whose liberty was restricted did not have the required authorisations. The report says this was a breach, although inspectors found the home had since taken action.
“At our inspection of 5 January 2016 we found people who had been deprived of their liberty did not have the appropriate authorisations in place.” from the report
Applications still awaiting assessment
needs fixingFifteen applications had been submitted but were still waiting for assessment by the local authority at the time of the inspection.
“Another 15 applications had been submitted to the supervisory body which were awaiting assessment.” from the report
- 01How many of the 15 applications that were awaiting assessment have now been decided?
- 02How do you check that each person's authorisation is reviewed on time?
- 03What less restrictive options are used for people who may be at risk of falling or leaving unsafely?
- 04How do staff support people who want to walk in the local community?
- 05Can we see how the person's liberty restrictions and authorisations are recorded in their care plan?
This was a focused inspection of the effective question and the previous Regulation 13 issue; it did not review the other four questions in detail. This explanation was written from the published report of 24 January 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 Horton House Residential Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Horton House Residential Care Home →
- January 2017Goodstayed GoodEffective: Good
Read what inspectors found at Horton House Residential Care Home →
- February 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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38 live-in carers within about an hour of Gloucestershire
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 £1,030 to £1,360 a week. 31 can care for a couple. 12 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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.