CQC report explained · a residential care home
What the CQC found at Overcliffe House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were enough staff and staff understood safeguarding and infection control. However, checks on agency staff were incomplete, and medicines training, competency checks and auditing were not fully up to date.
- Effective?
- Requires improvement
- People had relevant care assessments, health support and help with eating and drinking. However, mental capacity assessments, best interests decisions and monitoring of Deprivation of Liberty Safeguards were inconsistent.
- Caring?
- Good
- The report does not give a separate rating for Caring. Inspectors described staff as kind and compassionate, and found that staff understood people's individual communication needs.
- Responsive?
- Good
- Care was personalised and reflected people's communication, sensory and support needs. People were supported with activities, family relationships, community access and complaints.
- Well-led?
- Requires improvement
- The management team was approachable and was working on improvements. However, quality checks had not reliably identified or acted on shortfalls, family feedback was not always sought, and there was no registered manager in post.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found kind, personalised care but weaknesses in medicines, consent, recruitment and oversight.
Inspectors visited unannounced on 30 November 2022. They spoke with people, relatives and staff, and checked care records, medicine records, recruitment files, training and management checks. Seven people were living in the two houses at the time.
The home provided kind and personalised support. Staff understood people's communication needs, supported activities and access to healthcare, and there were enough staff to meet people's needs. Relatives were generally positive about the care.
However, inspectors found important gaps. Some medicines staff had not had recent training or competency checks. Mental capacity assessments and checks on legal restrictions were not always completed. Agency staff checks, quality audits and some records were incomplete.
The overall rating changed from Good in 2018 to Requires Improvement. The provider was asked for an action plan, and CQC said it would monitor progress with the provider and local authority.
Kind, individual care
Inspectors found that staff understood people's individual needs and provided compassionate support. Relatives were positive about the quality of care.
“People received kind and compassionate care from staff who understood and responded to people's individual needs.” from the report
Communication support
Staff used different communication methods, including pictures, sounds, body language and Makaton, to understand people.
“People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language) and pictures, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.” from the report
Activities and community life
People were supported to follow their interests, attend day services and use local facilities and transport.
“Staff supported people to take part in activities and pursue their interests in their local area.” from the report
Enough staff
Inspectors found there were enough staff to meet people's needs and keep them safe. Permanent staff also provided continuity for people who had known them for a long time.
“There were enough staff to meet people's needs and keep them safe.” from the report
Medicines checks and training
seriousOnly half of the staff team had completed refresher medicines training, and only two staff had competency checks. The yearly medicines audit had also not been completed.
“Only half of the staff team had completed their two-yearly medication refresher training.” from the report
Mental capacity and legal safeguards
seriousMental capacity assessments and best interests meetings were not always recorded for specific decisions. Deprivation of Liberty Safeguards were not regularly monitored.
“The principles of the MCA had not been applied consistently to ensure where people lacked capacity to make particular decisions, they were made in their best interests.” from the report
Recruitment of agency staff
seriousThe home did not have complete evidence that agency staff had the required checks, training, skills, experience or induction.
“There was no record of any of their training, skills or experience necessary for their role in supporting people safely.” from the report
Quality monitoring
seriousAudits did not consistently identify the problems found by inspectors. Some yearly checks had not been completed, including medicines and infection control audits.
“The provider's quality assurance arrangements had not been consistently applied to identify improvements so they could be acted on in a timely manner.” from the report
Dated areas of the building
minorThe home was clean and safe, but some areas needed redecoration after damp and water leak work. Inspectors found no clear timescale for completing this.
“However, this work had resulted in a number of areas of the home including the dining room and kitchen requiring redecoration.” from the report
- 01What has been done to ensure every staff member who gives medicines has current training and a competency check?
- 02How do you now check agency staff have completed DBS, training, experience and induction checks before supporting people?
- 03Have all people's mental capacity assessments, best interests decisions and Deprivation of Liberty Safeguards conditions been reviewed and recorded?
- 04What quality audits are now completed, how often are they completed, and who checks that problems are put right?
- 05Has a manager now been registered with CQC, and what is the timescale for finishing the redecoration work?
The inspection looked at Safe, Effective, Responsive and Well-led, while the report does not give a separate Caring rating; the report says ratings for any key questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 19 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, January 2018
Rated Good; inspectors found safe, kind and personalised care, with improvements made since earlier concerns.
This was an unannounced inspection on 17 November 2017. One inspector spoke with four people, five staff, a relative and other professionals. They also observed care and checked care files, medicines, staff records, rotas, complaints and incident records.
The home supported 12 people with learning disabilities and/or autism. Inspectors found that people were safe, treated kindly and involved in decisions about their care. Staff knew people well and supported their routines, activities, health needs and contact with family.
The previous inspection had found unsafe hot water and weak checks on quality and safety. At this inspection, water temperatures were being monitored and action was taken when needed. The manager was also reviewing records and audits more closely.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. This means the inspection found a good standard of care at that time, but it does not mean that every part of the service was perfect.
Staff knew people well
Many people had lived at the home for a long time. Staff understood their communication, routines, interests and health needs.
“Many people had been at the home over thirty years, others having lived in other homes within the organisation before coming here.” from the report
Good support with choice
People were involved in planning their care and could choose their routines, meals, activities and community trips.
“People were encouraged to get involved in how their care was planned and delivered.” from the report
Safe medicines and risk management
Staff were trained and competent to give medicines. Risk assessments, incident checks and emergency plans were in place.
“There were safe processes in place for the management and administration of people's medicines.” from the report
Kind and respectful care
Inspectors saw warm relationships between people and staff. Privacy, dignity and individual communication needs were respected.
“The staff took time to listen to people and responded in a friendly and patient way.” from the report
Improvements since the last inspection
The home acted on earlier concerns about hot water and quality checks. The manager was monitoring these areas and taking action when problems were found.
“At this inspection, we found the registered manager had robust audits of water temperatures around the home and immediate action had been taken when necessary to keep people safe.” from the report
Care plans were very long
needs fixingInspectors said some care plans were not easy to search quickly. The manager was preparing shorter summary plans for key information.
“These plans had become very long and it was not always easy to find specific information quickly.” from the report
Some DoLS applications were still awaiting confirmation
minorThere was a backlog of applications being confirmed. Staff were expected to avoid unnecessary restrictions and offer choices wherever possible.
“There was a back log of applications being confirmed and therefore staff were mindful not to restrict peoples liberty and offered choices whenever possible.” from the report
Staff did not know the provider's stated values
minorStaff described similar aims for people's care, but inspectors found they were not familiar with the provider's actual documented vision and values.
“Although the staff were not familiar with the providers actual vision and values as documented they did describe the similar good outcomes for the people living in the home that they strived for.” from the report
- 01Have the shorter care plan summaries been completed, and how do staff find urgent information quickly?
- 02Are all outstanding Deprivation of Liberty Safeguards applications now confirmed?
- 03How are hot water temperatures checked now, and what happens if one is above the safe level?
- 04How are people's finances independently audited, and can families see how this is overseen?
- 05How are staff introduced to the provider's vision and values?
This was an unannounced inspection covering all five key questions and the overall rating, using conversations, observations and checks of care, staff and service records. This explanation was written from the published report of 11 January 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.
Every inspection of Overcliffe House
3 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 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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