CQC report explained · a nursing home
What the CQC found at OSJCT Athelstan House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
OSJCT Athelstan House was inspected but not rated; inspectors found improvements after earlier safety and governance problems, but the previous Requires Improvement rating remains.
This was an unannounced targeted inspection on 06 December 2022. Inspectors checked whether the home had met a previous Warning Notice about Regulation 17, which covers good governance. They reviewed medicines, accident and safeguarding records, fire safety and electrical safety documents, and spoke with staff and managers.
Inspectors found improvements. Medicines checks had been strengthened, risk assessments were in place, and records showed staff were following safety guidance. Electrical safety work had been completed, fire safety actions were being monitored, and there had been no further incident of a person leaving the home unobserved.
The home had also improved its monitoring of accidents, safeguarding concerns, medicines and legal notifications. The provider was no longer in breach of Regulation 17.
This inspection did not give new ratings. Safe and Well-led were marked Inspected but not rated because only specific parts were checked. The previous overall rating of Requires Improvement remains until a full inspection.
Better risk controls
Risk assessments gave staff clearer instructions, and records showed those instructions were being followed. Measures were also introduced to reduce the risk of people leaving the home unobserved.
“Since our last inspection, no person had left the service unobserved.” from the report
Safety work completed
External electrical safety work had been carried out, and fire safety actions were being monitored. Inspectors found the electrical safety report recorded satisfactory safety.
“The provider had also improved fire safety by working to rectify shortfalls identified in a fire safety risk assessment.” from the report
Stronger management checks
Managers had improved oversight of incidents, safeguarding concerns, medicines and required notifications. The provider was no longer in breach of Regulation 17.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Not a full inspection
needs fixingThe report does not provide a new overall rating. The previous Requires Improvement rating remains, and important areas such as caring, effective and responsive care were not assessed.
“We have not changed the rating as we have not looked at all of the safe key question at this inspection.” from the report
- 01What was the outcome of the most recent full CQC inspection, rather than this targeted follow-up?
- 02How are peer checks used now to make sure medicines are given as prescribed?
- 03How often are risk assessments reviewed, and what happens if staff do not follow the guidance?
- 04What fire safety actions remain under review, if any?
- 05How are the new management roles and audits being used to maintain the improvements?
This was a targeted inspection of specific parts of Safe and Well-led, focused on a previous Regulation 17 Warning Notice; it did not assess the full five key questions and the previous Requires Improvement rating carries over. This explanation was written from the published report of 10 January 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.
What inspectors found, October 2022
OSJCT Athelstan House rated Requires Improvement; inspectors found medicines, risk management and care planning were not consistently safe or person-centred.
This was an unannounced focused inspection on 12, 15 and 20 July 2022. Inspectors spoke with people, relatives, staff and healthcare professionals. They reviewed care records, medicines records, rotas, incident reports, recruitment files and quality checks.
The home was rated Requires Improvement overall. Safe and Well-led were also Requires Improvement. Medicines errors had been high, some safety guidance was missing or not followed, and staffing levels sometimes meant people waited for help.
Effective was rated Good. People had needs assessments, staff received training and support, people could see healthcare professionals, and food and drinks were available. However, some care during mealtimes was not person-centred, and some referrals were not made quickly enough.
The home had a new registered manager, and staff spoke positively about their approach. However, this was the fifth consecutive Requires Improvement rating. The report identified breaches of Regulations 9 and 17, and the CQC issued a Warning Notice for Regulation 17.
Staff training and support
Staff said they received enough training and could discuss their development needs. New staff received an induction, and supervision was available.
“Staff told us they felt they received enough training for their roles.” from the report
Food and drinks
People said they enjoyed the food and had enough to eat. Snacks and drinks were available between meals, including fresh drinks in people's rooms.
“People told us they enjoyed the food and there was enough of it.” from the report
Access to healthcare
People could see a GP when needed, and GPs visited the home weekly. Staff also sought advice from specialist professionals.
“GP's visited the home every week as their surgery was next door to the home.” from the report
Positive view of the new manager
Staff gave positive feedback about the new manager's approach. They described the manager as approachable and involved in the home.
“Feedback about their approach was positive, staff told us they were approachable and "hands on" at the home.” from the report
Teamwork and kindness
People described staff as kind and caring. Staff said they enjoyed their work and felt there was good teamwork.
“People told us whilst they thought staff were busy, staff were caring and tried their best.” from the report
Medicines errors
seriousPeople did not always receive their medicines as prescribed, including more or less than the prescribed dose. Retraining had not reduced the number of incidents by the time of the inspection.
“People had not always received their medicines as prescribed.” from the report
Risks not consistently managed
seriousSome staff did not follow risk guidance, and guidance was missing for some people's needs. Records of welfare checks and headcounts also had gaps.
“Systems had failed to identify, monitor and mitigate risks to the health, safety and welfare of people” from the report
Care was not always person-centred
seriousInspectors saw people being given drinks they had not chosen, activities that were promised but not completed, and clothing protectors being used despite objection. Some care plans were incomplete.
“People were not planned and provided with appropriate, person-centred care that met their needs.” from the report
Staffing delays
needs fixingPeople and staff said there were not always enough staff. Short-notice sickness sometimes left gaps that could not be filled, and some people waited for responses.
“People and staff told us at times there were not enough staff.” from the report
Weak quality checks
seriousThe home's checks did not reliably find problems or make sure improvements were completed. This included medicines reporting, incident records and property actions.
“Systems were not always robust or effective in identifying and driving improvement.” from the report
Safeguarding understanding
needs fixingNot all staff understood safeguarding, whistleblowing or what action to take. Some safeguarding concerns had not been reported to the local authority promptly.
“Not all of the staff we spoke with understood what safeguarding was or how this applied to their roles.” from the report
- 01What action has been taken to stop medicines errors, and how are you checking that people now receive the correct doses?
- 02How do you decide how many staff are needed on each shift, and what happens when there is short-notice sickness?
- 03What new checks make sure risks such as self-harm, catheter care and people leaving the building are managed safely?
- 04How have you improved care plans so they clearly explain each person's needs, preferences and support when they are in pain?
- 05What evidence can you show that the Warning Notice and the breaches of Regulations 9 and 17 have been addressed?
This was a focused inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected and their ratings were not given, while the overall rating used previous ratings for questions not inspected. This explanation was written from the published report of 26 October 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.
Every inspection of OSJCT Athelstan House
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- January 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- October 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Good
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 16 November 2010.
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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