CQC report explained · a residential care home
What the CQC found at 5 Courtenay Avenue
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and risks were assessed and managed. Medicines, recruitment, staffing, fire safety, money and infection control arrangements were checked and found to be safe, although some safeguarding refresher training was due.
- Effective?
- Good
- Staff had relevant training, understood people's communication needs and supported access to healthcare. Some refresher training had not been completed within the home's timescales, and an action plan was in place.
- Caring?
- Good
- Staff treated people warmly and respectfully, knew them well and supported privacy, dignity, independence and relationships. People were involved in decisions about their care and daily lives.
- Responsive?
- Good
- Care plans were personalised and people were involved in reviewing them. People could take part in chosen activities, and complaints were taken seriously and addressed appropriately.
- Well-led?
- Good
- The home had a clear management structure and staff said managers were supportive and approachable. Quality checks had improved, although monitoring systems were still being developed.
What inspectors found, September 2018
Idelo Limited - 5 Courtenay Avenue was rated Good; inspectors found kind, safe and personalised care, with some records and staff refresher training still being improved.
This was an unannounced comprehensive inspection on 7 August 2018. Inspectors observed care, spoke with the three people living there, staff, managers, relatives and a local authority representative. They also checked care records, staff files, audits and policies.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they were happy and felt safe. Inspectors found staff knew people well, supported their choices, managed medicines and money safely, and provided activities that matched people's interests.
The home had improved since the previous inspection in August 2017. The earlier breach about protecting people from financial abuse had been addressed, and there were no breaches at this inspection. Some improvements were still being developed, including medicines information, medical care plans and refresher training.
Kind and respectful staff
Staff knew people well and supported them in a warm, calm and respectful way. People appeared comfortable with staff and relatives spoke positively about their approach.
“People were treated with kindness from staff who knew them well.” from the report
Better money safeguards
The home had acted on the previous financial abuse concern. Money was stored safely, people signed for cash, and records, receipts and checks were clearer.
“Arrangements were in place to manage people's monies effectively and safely.” from the report
Personalised support and choice
Care plans described people's needs, preferences, routines and goals. People were involved in decisions and could choose how to spend their time.
“People had the opportunity to choose, plan and take part in a range of activities that met their preferences and needs.” from the report
Medicine information was incomplete
needs fixingCare records listed people's medicines but did not explain why they had been prescribed. Management said this information would be added while the medicines system was being reviewed.
“there was no information about the reason the medicines had been prescribed.” from the report
Two medical care plans were added after the inspection
needs fixingThe home had information about the medical conditions, but specific care plans were not in place for two of them at the time of inspection. Management completed these after the inspection.
“specific care plans were not in place for supporting them with two medical conditions.” from the report
Some refresher training was overdue
needs fixingSome staff had not completed refresher training within the provider's stated timescales. Management had reviewed training needs and created an action plan.
“some staff had not completed refresher training in some areas within the provider's set timescales.” from the report
- 01Have the care records been updated to explain why each person's medicine is prescribed?
- 02What was added to the care plans for the two medical conditions after the inspection?
- 03Has all overdue refresher training been completed, including safeguarding training?
- 04How are medicines checks and medicine cabinet temperature checks carried out now?
- 05How will people and their families be consulted about the planned work to create a fourth bedroom?
This was an unannounced comprehensive inspection covering the overall quality of the home and all five CQC areas. This explanation was written from the published report of 11 September 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, October 2017
Rated Requires Improvement; inspectors found kind, effective and personalised care, but serious weaknesses in handling people's money and oversight.
This was an unannounced inspection on 24 August 2017, continued on 25 August to complete staff record checks. One inspector spoke with all three people living in the home, staff and a relative, observed care and reviewed care plans, staff records and other records.
People told inspectors they felt safe and were happy with the care. Staff were kind, respected privacy, supported people's choices and provided personalised care. Medicines, staffing, training, food and access to healthcare were generally well managed.
The main problem was the way people's money was recorded, checked and handled. Records were unclear, some receipts were missing and there was no proper agreement for one regular vehicle payment. The home also needed stronger checks to identify problems. The home was rated Requires Improvement overall, with Good ratings for Effective, Caring and Responsive, and Requires Improvement ratings for Safe and Well-led.
Kind and respectful staff
Inspectors saw staff respond in a friendly and kind way. People were treated with dignity and their privacy was respected.
“During our visit staff responded to people's individual needs in a friendly and kind manner.” from the report
Personalised care
Care plans contained detailed information about people's health, support needs, preferences and communication. Staff knew people well and adjusted support when needs changed.
“The three care plans we looked at were person centred.” from the report
Safe medicines support
Medicines were stored and administered safely. Staff had medicines training and regular checks of their competence.
“The medicines administration records [MAR] we looked at showed that people received the medicines they were prescribed at the right time.” from the report
Good support and training
Staff received relevant training, supervision and support. Staffing levels were organised so people received the care they needed.
“People were cared for by staff who had completed relevant training to enable them to care for people effectively.” from the report
Choice and activities
People were involved in decisions about their daily lives and took part in activities such as shopping, day trips, eating out and holidays.
“People led busy lives and took part in a range of social activities.” from the report
People's money was not adequately protected
seriousFinancial records were unclear, receipts were missing or disorganised, and regular audits were not recorded. One vehicle payment had no documented agreement, capacity assessment or best-interests decision.
“This lack of clarity in people's expenditure records and receipts of purchases, the lack of regular audits of people's monies by management staff and the provider and the absence of agreement regarding a regular payment from a person for transport were a breach of Regulation 13” from the report
Written guidance was missing for a medical need
needs fixingStaff knew how to respond when one person's medical condition caused significant symptoms, but the written protocol was not in the care plan during the inspection. A detailed protocol was supplied afterwards.
“But this procedure was not included in the person's care plan.” from the report
Quality checks missed problems
needs fixingThe home carried out several checks, but these did not identify the financial recording problems or the missing written medical guidance. The service was asked to develop more effective quality assurance systems.
“These had not identified the issues we found where improvements to the service were needed.” from the report
Some maintenance issues
minorA bathroom window handle was broken and parts of the garden path were uneven and could cause a trip. The provider later said the handle had been repaired and the path was being renovated.
“However, we noted that a bathroom window handle was broken, and a garden path was uneven in some areas, which could be a trip hazard.” from the report
- 01How are each person's cash, purchases and receipts now recorded, checked and independently audited?
- 02What written agreement and capacity or best-interests records are now in place for any vehicle or transport payments?
- 03What action was taken in response to the Regulation 13 breach, and what did CQC confirm when it checked the provider's action?
- 04How are medical protocols kept in each person's care plan and checked when their needs change?
- 05What new quality checks are now used to make sure financial and care-record problems are found promptly?
This was a comprehensive inspection of the overall service, including all five rating areas, and the previous Good rating from 2015 did not carry over because the service was reassessed. This explanation was written from the published report of 3 October 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 5 Courtenay Avenue
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 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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