CQC report explained · a residential care home
What the CQC found at Housman Care Ltd
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risk assessments had improved, but care records were not always updated promptly and staff observations about possible falls risks were not always followed up. Controlled medicines were stored safely, but the drugs register was not always accurate and up to date.
- Effective?
- Requires improvement
- Inspectors were not assured that oral care was carried out consistently, although this improved by the second inspection day. People had access to healthcare, suitable food and drinks, staff training, and support with decisions.
- Caring?
- Requires improvement
- People were not always treated with dignity and respect. Inspectors saw clothing, personal care and moving practices that did not protect people's dignity, and people were moved without always being asked about their wishes.
- Responsive?
- Requires improvement
- Care plans were detailed, but care did not always reflect people's changing needs. Handover information was not recorded consistently, and staff did not always respond promptly when people needed help or said they felt unwell.
- Well-led?
- Requires improvement
- Management systems had improved but had not reliably identified poor dignity, incomplete care records or risks. The provider remained in breach of Regulation 17, and there was no registered manager in post at the time of the inspection.
What inspectors found, January 2024
Rated Requires Improvement; inspectors found risks in dignity, personalised care and management systems, although some safety improvements had been made.
The inspection was unannounced and took place on 15 and 22 November 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care files, medicines, recruitment records and management systems.
All five areas were rated Requires Improvement. People were not always treated with dignity, and care was not always provided in line with their needs. Records did not always accurately show people's health or care, and staff did not always respond promptly when people felt unwell or needed help.
There were some positive findings. Staff understood safeguarding, people and relatives generally felt safe, staffing levels appeared sufficient, medicines were stored safely, and people had access to activities and health professionals. Some improvements were made during or just after the inspection, but the CQC said these needed to become consistent.
Safeguarding
Staff understood how to recognise and report abuse. There were systems for reporting safeguarding concerns to the relevant authorities.
“Staff had knowledge of how to detect abuse and how to raise concerns.” from the report
Staffing and recruitment
Inspectors found recruitment checks were robust. People, relatives and staff said there were enough staff to provide support when needed.
“People, staff and relatives told us there were enough staff to ensure people received care and support when needed.” from the report
Emergency planning
Each person had an emergency evacuation plan, and these plans were regularly updated and accessible.
“There were detailed fire procedures including Personal Emergency Evacuation Plans (PEEPS) for every person using the service.” from the report
Activities and relationships
People took part in activities during the inspection and relatives said they were encouraged to maintain contact with their loved ones.
“There were a range of activities in the home during both days of inspection.” from the report
Dignity and respect
seriousInspectors saw people left with clothing or undergarments exposed and saw personal care being carried out without enough privacy. People were also moved without always being asked where they wanted to go.
“The provider had failed to ensure people were treated with dignity and respect.” from the report
Care records and handovers
needs fixingRecords did not always reflect people's actual health or care. Important information from shift handovers, including when people were unwell, was not recorded consistently.
“There was no consistent system to identify and record key information from shift handovers, for example when people were unwell.” from the report
Responding to illness or requests
seriousA person told inspectors they felt unwell, but action had not been taken promptly to find out what was wrong. Another person asked quietly for help and did not receive a timely response.
“However, no action had been taken to seek medical advice to identify what was wrong.” from the report
Oral care
needs fixingInspectors found toothbrushes that appeared unused and staff could not explain how oral care was being provided for some people. The provider reinforced expectations, and inspectors found improvement on the second day.
“We were not assured that oral care was being carried out consistently.” from the report
Medicine records
needs fixingMedicines were stored safely, but records for controlled medicines were not always accurate or up to date.
“Improvements were needed to how they were recorded in the drugs register, which providers need to ensure is accurate and up to date.” from the report
- 01What has changed to make sure people's dignity and privacy are protected during personal care and moving?
- 02How do you now record handover information and make sure staff act quickly when someone feels unwell?
- 03What checks now confirm that care records accurately reflect the care people receive?
- 04How are falls risks, including concerns about footwear, reviewed and acted on?
- 05What action has been taken to improve oral care and keep the controlled medicines register accurate?
This was an unannounced inspection prompted by concerns about medicines, management and staffing; inspectors assessed all five key questions, and the inspection activity ran from 15 to 28 November 2023. This explanation was written from the published report of 12 January 2024 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, May 2023
Rated Requires Improvement; inspectors found kind care and safe medicines systems, but risks and management oversight were not always handled safely.
This was an unannounced focused inspection on 29 and 30 March 2023. Inspectors looked only at Safe and Well-led because concerns had been raised about how people's care needs were managed. They spoke with people, relatives and staff, and checked care records, medicines records and management records.
The home was not always safe. Some care plans and risk assessments did not reflect people's current needs. Important changes in health were not always identified quickly, and falls were not always reviewed properly. Medicines, infection control, staffing and safeguarding systems were otherwise found to be effective.
The home was not always well-led. Audits and other checks did not reliably identify risks, improve care records or ensure required notifications were sent to CQC. The provider breached regulations on safe care and treatment and good governance.
This was the first inspection of the newly registered service. The overall rating and both inspected questions were Requires Improvement. The provider was asked for an action plan, and CQC said it would monitor progress with the provider and local authority.
Medicines
Staff were trained before administering medicines. Records, storage, checks and prescribed medicines were found to support safe administration.
“There were comprehensive systems to ensure medicines were administered safely.” from the report
Infection control
Inspectors were assured that the home used suitable infection prevention procedures, including effective use of PPE and up-to-date guidance.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Staff availability
Inspectors saw enough staff to meet people's needs. Call bells were answered promptly and staff spent time talking with people.
“We saw that when people asked for assistance staff were available quickly, and call bells were answered promptly.” from the report
People felt safe
People told inspectors they felt safe and were happy with the care they received.
“People told us they felt safe and were happy with the care they received.” from the report
Open response to feedback
The management accepted the concerns raised during the inspection and began reviewing records, reporting arrangements and risk assessments before the inspection ended.
“The registered manager was receptive to improving the service” from the report
Out-of-date risk information
seriousSome care plans and risk assessments did not match people's current needs. This could have led staff to give unsafe support, including after a fall or when someone had seizures.
“Some people who had risks associated with their care, were not always protected from harm.” from the report
Falls and health changes
seriousThe home did not always identify changes in health or patterns of falls quickly enough. This delayed referrals and increased the risk of further falls or missed healthcare.
“This meant that timely referral to health professionals did not happen and there was an increased risk of further falls.” from the report
Weak management checks
seriousAudits and monitoring did not reliably identify care-record problems, risks or missed statutory notifications to CQC.
“The provider's systems and procedures did not always provide the level of information or oversight about significant changes to people's needs.” from the report
Missed CQC notifications
seriousSome injuries had been reported to families, the local authority and safeguarding services, but not to CQC as required.
“We found where injuries had been sustained by people, although families and the local authority and Safeguarding were informed, CQC were not.” from the report
- 01How do you now make sure care plans and risk assessments reflect changes in a person's mobility, seizures and other health needs?
- 02What system do you use to identify patterns in falls and make timely referrals to doctors or other healthcare professionals?
- 03What action has been completed in response to the Regulation 12 and Regulation 17 breaches?
- 04How do you check that all injuries and other events that must be reported have been notified to CQC?
- 05How will you show families that the action plan has improved safety and management oversight?
This was a focused inspection of Safe and Well-led only; the other three question ratings were not given in this report. This explanation was written from the published report of 11 May 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.
Every inspection of Housman Care Ltd
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2023Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- January 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- March 2022
Registered with the Care Quality Commission on 1 March 2022.
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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Most charge £980 to £1,260 a week. 85 can care for a couple. 9 years' experience on average.
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