CQC report explained · a residential care home
What the CQC found at 330 Guildford Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, staffing levels were sufficient, medicines were safely administered and the environment was well maintained.
- Effective?
- Good
- People's needs were assessed and reviewed. Staff were trained and supported, people's rights under the Mental Capacity Act were followed, and healthcare and nutritional needs were met.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were involved in daily choices and supported to be as independent as possible.
- Responsive?
- Good
- Care plans described people's individual needs, preferences and goals. People were supported with communication, activities, family relationships and access to the community.
- Well-led?
- Good
- Inspectors found an open and positive culture. Managers carried out regular checks, acted on issues and involved people, relatives and staff in reviewing the service.
What inspectors found, October 2018
Living Ambitions Limited - 330 Guildford Road was rated Good; inspectors found safe, kind and personalised care, with previous problems improved.
This was an unannounced comprehensive inspection on 24 August 2018. One inspector reviewed care and medicine records, staff recruitment and training records, health and safety checks, quality audits and how people were supported. The inspector also spoke with staff, relatives and a visiting therapist.
The home supported six people with learning disabilities, all of whom were living there when inspectors visited. Inspectors found enough staff, suitable risk plans, safe medicines management and a clean, well-maintained environment. Staff understood people's needs and communicated with them in ways they could understand.
People were supported to make choices, stay healthy, take part in activities and maintain relationships. Relatives were involved in care planning. The home had an open management style, listened to feedback and used checks and reviews to improve the service.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. At the previous inspection in June 2017, the home was also rated Good but had breached a regulation about dignity and respect and had other areas needing improvement. Inspectors said these problems had been addressed.
Safe staffing and risk management
There were enough staff for people's needs, including one-to-one support where required. Staff followed individual risk plans and the home used checks to keep the building safe.
“There were sufficient and appropriately deployed staff to meet people's needs.” from the report
Kind and respectful care
Staff knew people's preferences and communication methods. Inspectors saw staff offering choices, respecting privacy and supporting people with patience.
“Staff treated people with compassion and kindness; and respected their dignity and privacy.” from the report
Personalised activities and support
People had individual plans and were supported to pursue hobbies, attend activities and use the community. Staff also helped people maintain important relationships.
“People were supported to attend art classes, do pottery, dancing and performing arts, gardening classes and go bowling.” from the report
Open management
Relatives and staff described managers as approachable. The home used meetings, surveys and audits to gather views and improve care.
“There was an open and positive culture at the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure staff continue to follow each person's risk management plan, particularly for community outings, mobility and epilepsy?
- 02How are staffing levels adjusted when people have appointments, activities, staff absences or vacancies?
- 03How will you involve my relative and our family in decisions made under the Mental Capacity Act and in any Deprivation of Liberty Safeguards arrangements?
- 04What activities and community opportunities would be suitable for my relative, and how would you support their communication and choices?
- 05How would you support my relative's end-of-life wishes and work with relatives and healthcare professionals if this became necessary?
This was an unannounced comprehensive inspection covering the overall quality of the home and all five CQC questions. This explanation was written from the published report of 20 October 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, September 2017
Rated Good; inspectors found strengths in medicines, care planning and management, but safety and dignity needed improvement.
This was an unannounced inspection on 12 June 2017. Inspectors spoke with two staff members, the registered manager and two relatives. They also reviewed care plans, staff files, training records, medicines records and quality checks.
The home usually had enough staff, but one person missed about 30 minutes of planned one-to-one support. Some risk assessments were not followed, parts of the flooring were damaged, and staff did not always understand mental capacity and liberty safeguards requirements.
Inspectors found that staff did not always spend enough time talking with people or protect their privacy. This led to a breach about dignity and respect. The home was rated Good overall, with Good ratings for effective, responsive and well-led care, but Requires Improvement for safe and caring care.
Medicines
Medicines were given safely and on time. Records were clear and accurate, and medicines were stored securely.
“Medicines were administered safely and on time. We checked medicines administration records (MAR's) during our inspection, and found that these were clear and accurate.” from the report
Personal care plans
Care plans gave detailed information about people's preferences, communication and support needs. Inspectors saw evidence that care was provided according to those plans.
“Care plans were detailed and contained information on people's lifestyles, preferences and how they communicated.” from the report
Activities and independence
People were supported to take part in activities they chose and to help with shopping, cooking and household tasks.
“People enjoyed a range of activities according to individual choice.” from the report
Management checks
The provider used monthly audits, an annual quality audit and accident reviews to identify improvements.
“The provider had systems in place to monitor the quality of the service.” from the report
Risk controls were not always followed
seriousSome staff did not follow people's risk assessments. One person was not wearing a protective helmet as required and had a lap belt on when it should not have been.
“However, some risk assessments were not always being followed which meant people may not be protected against potential risks” from the report
Staffing and the environment
seriousOn the inspection day, one person missed almost 30 minutes of one-to-one support. Damaged flooring also created possible trip hazards.
“People were not living in an environment that was always appropriately maintained and as a result presented risks for people's safety.” from the report
Dignity and privacy
seriousInspectors saw limited interaction and heard a staff member respond without sympathy to a distressed person. Toilet doors were also left open, and this resulted in a breach.
“People not being treated with dignity and respect was a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Mental capacity knowledge
needs fixingStaff did not always understand the Mental Capacity Act, including that some lap belts were restrictions. The provider was asked to review training.
“Staff were not always aware of the MCA and DoLS and the processes to be followed.” from the report
Feedback from relatives
minorThe provider reviewed a relatives' survey, but had not responded to relatives who said they were not involved in care planning or had not been told about a provider change.
“The survey had been analysed however we noted that relatives had not been responded to.” from the report
- 01How do you now make sure every person receives their planned one-to-one support throughout the day?
- 02What checks show that staff are following each person's risk assessment, including requirements about helmets and lap belts?
- 03What training have staff completed on the Mental Capacity Act, restrictions and Deprivation of Liberty Safeguards?
- 04What has been done to repair or replace the damaged flooring and prevent trip hazards?
- 05How do you check that staff protect people's privacy and spend meaningful time communicating with them?
This was an unannounced comprehensive inspection covering all five rating areas, with records reviewed and feedback taken from staff and relatives. This explanation was written from the published report of 2 September 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 330 Guildford Road
3 rated inspections over 2 years: the service has held its Good rating throughout.
- October 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2015
Registered with the Care Quality Commission on 31 July 2015.
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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